scholarly journals G366(P) Impedance monitoring in paediatric gastro-oesophageal reflux disease: an evaluation of its use and clinical value

2015 ◽  
Vol 100 (Suppl 3) ◽  
pp. A150.1-A150
Author(s):  
P Crook ◽  
A Ross ◽  
R Heuschkel ◽  
M Zilbauer
Keyword(s):  
Reflux Disease ◽  
Oesophageal Reflux ◽  
Clinical Value ◽  
Oesophageal Reflux Disease ◽  
Impedance Monitoring

Number of reflux episodes on pH-impedance monitoring associates with improved symptom outcome and treatment satisfaction in gastro-oesophageal reflux disease (GERD) patients with regurgitation

Gut ◽  
2020 ◽  
pp. gutjnl-2020-321395 ◽  
Author(s):  
Benjamin D Rogers ◽  
Luis R Valdovinos ◽  
Michael D Crowell ◽  
Reginald Bell ◽  
Marcelo F Vela ◽  
...  
Keyword(s):  
Reflux Disease ◽  
Oesophageal Reflux ◽  
Symptom Improvement ◽  
Characteristic Analysis ◽  
Hrql Score ◽  
Oesophageal Reflux Disease ◽  
Related Quality ◽  
Symptom Response ◽  
Impedance Monitoring ◽  
Acid Exposure Time

ObjectiveNumber of reflux episodes, an adjunctive metric on pH-impedance monitoring, is incompletely studied. We aimed to determine if number of reflux episodes associates with therapeutic outcome in regurgitation predominant gastro-oesophageal reflux disease (GERD).DesignWe performed post hoc analysis of postintervention pH-impedance data from adult patients with moderate/severe regurgitation despite QD proton pump inhibitor (PPI), randomised to either two times a day PPI or magnetic sphincter augmentation (MSA) in 2:1 allocation. After 6 and 12 months, symptom response was defined by improvement in Foregut Symptom Questionnaire (FSQ) regurgitation score to none or minimal, ≥50% reduction in GERD health-related quality of life (HRQL) score and satisfaction with therapy. Univariate and multivariate analyses were performed to determine predictors of symptom improvement.ResultsOf 152 randomised patients, 123 (age 46.9±1.2 year, 43% female) had complete data. Symptom and satisfaction scores significantly improved after MSA compared with two times a day PPI. Both acid exposure time (13.4%±0.7% to 1.3±0.2%, p<0.001) and reflux episodes (86±4 to 48±4, p<0.001) declined with therapy. Reduction to <40 reflux episodes was significantly more frequent in those with symptom response by FSQ regurgitation score, GERD HRQL score and satisfaction with therapy (p≤0.03 for each); <35 episodes performed better on receiver operating characteristic analysis. On multivariate analysis, improvement in regurgitation score remained independently predictive of satisfaction with therapy (p<0.001 for each). In patients crossing over to MSA, >80 episodes pretreatment predicted improvement.ConclusionsReduction of reflux episodes on pH-impedance to physiological levels associates with improved outcomes, while pathological levels predict improvement with MSA in regurgitation predominant GERD.Trail registration numberClinicalTrials.gov: NCT02505945.

Gastro-oesophageal reflux disease

The Lancet ◽  
2006 ◽  
Vol 367 (9528) ◽  
pp. 2086-2100 ◽  
Author(s):  
Paul Moayyedi ◽  
Nicholas J Talley
Keyword(s):  
Reflux Disease ◽  
Oesophageal Reflux ◽  
Oesophageal Reflux Disease

scholarly journals The association between gastro-oesophageal reflux disease and subsequent rheumatoid arthritis occurrence: a nested case–control study from Taiwan

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e016667 ◽  
Author(s):  
Herng-Ching Lin ◽  
Sudha Xirasagar ◽  
Cha-Ze Lee ◽  
Chung-Chien Huang ◽  
Chao-Hung Chen
Keyword(s):  
Rheumatoid Arthritis ◽  
Early Diagnosis ◽  
Reflux Disease ◽  
Treatment Guidelines ◽  
Population Based ◽  
Oesophageal Reflux ◽  
Study Patient ◽  
Oesophageal Reflux Disease ◽  
Increased Risk

ObjectiveGastro-oesophageal reflux disease (GORD) is a common comorbidity among patients with rheumatoid arthritis (RA). While GORD has been attributed to the antirheumatic medications, no studies of human cohorts have investigated a link between GORD and RA. This study investigates whether GORD is associated with a subsequent RA diagnosis over a 5-year follow-up using a population-based dataset.SettingTaiwanParticipantsWe used data from the Taiwan Longitudinal Health Insurance Database. The study group consisted of 13 645 patients with an ambulatory claim showing a GORD diagnosis. We used propensity score matching to select 13 645 comparison patients (one per study patient with GORD).InterventionWe tracked each patient’s claims over a 5-year period to identify those who subsequently received a diagnosis of RA. Cox proportional hazard (PH) regression modelling was used for analysis.ResultsOver 5-year follow-up, RA incidence rate per 1000 person-years was 2.81 among patients with GORD and 0.84 among the comparison group. Cox PH modelling showed that GORD was independently associated with a 2.84-fold increased risk of RA (95% CI 2.09 to 3.85) over 5-year follow-up, after adjusting for the number of ambulatory care visits within the year following the index date (to mitigate surveillance bias).ConclusionsWe observed that GORD might associate with subsequent RA occurrence. Because current treatment guidelines for RA emphasise early diagnosis and prompt treatment, the observed association between GORD and RA may help acquaint clinicians to patients with GORD with higher RA risk and facilitate early diagnosis and treatment.

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