scholarly journals Prevalence and risk factors of endoscopically confirmed gastroesophageal reflux disease (GERD) in patients with liver cirrhosis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Taha M. Hassanin ◽  
Yasser Foaud ◽  
Hala Mohamed ◽  
Zienab Saad ◽  
Amr Elsayed ◽  
...  

Abstract Background Gastroesophageal reflux disease (GERD) is one of the most common diseases in modern civilization that originates basically from a disturbance in the structure and function of the lower esophageal sphincter (LES). Liver cirrhosis with or without esophageal varices (EV) may predispose to GERD, and GERD may precipitate rupture of esophageal varices. As variceal bleeding is a serious life-threatening complication of liver cirrhosis, GERD prevalence among cirrhotic patients is continuously subjected to research. We aimed to determine the prevalence of endoscopy-confirmed GERD in patients with liver cirrhosis and its possible risk factors. So, one hundred patients with HCV-related liver cirrhosis were consecutively enrolled in this study. They were subjected to history taking {including Reflux Disease Questionnaire}, thorough clinical examination, abdominal ultrasound, and lab investigations and then referred for upper endoscopy to screen for GERD and/or esophageal varices. Results GERD was endoscopically confirmed in 83 patients (83%) and the highest prevalence was in patients with Child B and C. Among 82 patients with esophageal varices, there were 68 patients who had endoscopic GERD (82.9%), and among 62 patients with ascites, there were 56 patients who had endoscopic GERD (90.3%). Conclusion We found a high prevalence of GERD (83%) among patients with liver cirrhosis. The severity of GERD was significantly related to the Child grade, the grade of varices, and the degree of ascites but ascites was the only significant risk factor for GERD development in cirrhotic patients.

2012 ◽  
Vol 146 (6) ◽  
pp. 984-990 ◽  
Author(s):  
Amy C. Dearking ◽  
Brian D. Lahr ◽  
Admire Kuchena ◽  
Laura J. Orvidas

Objective. To determine whether patient factors (eg, indication for initial surgery, medical comorbidity, or age) are associated with adenoid regrowth and subsequent need for revision adenoidectomy and whether surgical factors (eg, surgical technique or level of surgeon’s training) are associated with adenoid regrowth and subsequent need for revision adenoidectomy. Study Design. Historical cohort study. Setting. Tertiary care academic medical center. Subjects and Methods. Children (≤18 years) who underwent adenoidectomy or adenotonsillectomy between 1980 and May 2009 were identified. Medical and surgical records were reviewed for sex, age at surgery, indication for surgery, training level of surgeon, surgical technique, and history of allergies, asthma, or gastroesophageal reflux disease. Results. Of 8245 surgical cases (53.8% male), 163 were revision adenoidectomies. Age at initial adenoidectomy was a significant factor for revision adenoidectomy, with younger ages associated with higher increased risk. Indication for adenoidectomy was also a significant risk factor; adjusted for age, patients with ear rather than infectious indications were about 10 times more likely to require revision. A diagnosis of gastroesophageal reflux disease was a significant risk factor (hazard ratio, 2.23; P = .002). Conclusion. Several risk factors are associated with revision adenoidectomy: young age at initial procedure, indication for adenoidectomy, and diagnosis of gastroesophageal reflux disease. Surgical technique, level of experience of the initial surgeon, and diagnosis of asthma or allergies were not significant risk factors for revision adenoidectomy.


2019 ◽  
Vol 147 (5-6) ◽  
pp. 295-300
Author(s):  
Vesna Brzacki ◽  
Bojan Mladenovic ◽  
Nenad Govedarovic

Introduction/Objective. The most important complication of gastroesophageal reflux disease (GERD) is Barrett?s esophagus (B?) and the development of esophageal adenocarcinoma. Prevalence of BE is 5?15% in patients with GERD symptoms. The aim of the study was to investigate the prevalence and risk factors for BE in patients with chronic reflux symptoms. A prospective study was conducted in the Clinic of Gastroenterology, Nis Clinical Center. Methods. We included 676 patients with chronic reflux symptoms, who underwent esophagogastroduodenoscopy. The biopsy specimens were obtained in a four-quadrant fashion at intervals of 2 cm from the circumferential endoscopic Barrett?s epithelium in the distal esophagus. BE was diagnosed by pathological examination. Results. Out of the total number patients with GERD, 92 were diagnosed with columnar-lined esophagus (CLE), the prevalence being 13.6%. Histological examination of biopsy from 92 patients with CLE revealed specialized intestinal metaplasia in 15 patients, with the prevalence of 2.22%. Compared to patients without BE, patients with BE were older and more commonly male. Univariable analyses showed that hiatal hernia and Helicobacter pylori infection were two significant risk factors for the onset of esophagitis. The age and the presence of reflux symptoms were associated with the presence of BE. Older age could be considered a significant risk factor for the development of BE and GERD. Conclusion. Prevalence of biopsy-proven BE and CLE in Serbia was 2.22% and 13.6%, respectively, in patients with GERD symptoms.


2007 ◽  
Vol 44 (2) ◽  
pp. 145-150 ◽  
Author(s):  
Rosana Bihari Schechter ◽  
Eponina Maria Oliveira Lemme ◽  
Henrique Sérgio Moraes Coelho

BACKGROUND: Portal hypertension in patients with liver cirrhosis causes manifestations such as esophageal varices, ascites and edema. Some studies have been conducted about the role of esophageal varices in the development of esophageal motor disorders and abnormal gastroesophageal reflux in these patients. Ascites could be a factor promoting gastroesophageal reflux and it has been questioned whether reflux would favor the rupture of varices. However there are a few studies using ambulatory esophageal pH recording in the evaluation of these patients. AIMS: Evaluate gastroesophageal reflux by pH recording in cirrhotic patients with esophageal varices and possible predictors. METHODS: Fifty one patients (28 men, 23 women, mean age of 54 years) with liver cirrhosis, diagnosed by clinical, laboratorial, image and histological findings were prospectively evaluated. All patients had esophageal varices confirmed by endoscopy and were submitted to a questionnaire about typical gastroesophageal reflux disease symptoms (heartburn and or acid regurgitation). pH recording was performed with the probe placed 5 cm above the superior lower esophageal sphincter limit, as determined by manometry. Abnormal reflux (% total time with pH < 4 >4.5%) was related to the size of varices, congestive gastropathy, ascites, severity of cirrhosis and typical gastroesophageal reflux disease symptoms. RESULTS: The caliber of the varices was considered to be small in 30 patients (59%), medium in 17 (33%) and large in 4 (8%), 21 (41%) congestive gastropathy. Ascites was observed in 17 (33%), 32 patients (63%) were classified as Child-Pugh A, 17 (33%) Child-Pugh B and 2 (4%) Child-Pugh C. Twenty seven patients (53%) presented with typical gastroesophageal reflux disease symptoms. Abnormal reflux at pH recording was found in 19 patients (37%). One of them presented with erosive esophagitis at endoscopy. There was no relation between ascites, variceal size, congestive gastropathy and Child-Pugh score and abnormal reflux. There was a correlation between typical gastroesophageal reflux disease symptoms and abnormal reflux. CONCLUSION: Abnormal gastroesophageal reflux was found in 37% of the patients with hepatic cirrhosis and esophageal varices. Only typical gastroesophageal reflux disease symptoms predicted these findings.


2019 ◽  
Vol 91 (2) ◽  
pp. 126-133 ◽  
Author(s):  
I V Maev ◽  
G L Yurenev ◽  
E M Mironova ◽  
T V Yureneva-Thorzhevskaya

The relevance of studying such problems as gastroesophageal reflux disease (GERD) and obesity is caused by their high prevalence in the developed countries of the world. Epidemiological data indicate that obesity is a significant risk factor for developing GERD due to increased intra-abdominal pressure and gastroesophageal gradient, slowing of gastric evacuation and formation of hiatal hernia. Abdominal obesity increases the likelihood of complications of GERD: erosive esophagitis, Barrett's esophagus and adenocarcinoma. This fact is connected with humoral influences: increased production of pro-inflammatory cytokines and leptin, and decreased secretion of adiponectin. Treatment of comorbid patients requires higher dosages and longer courses of antisecretory medicines, and an additional prescription of ursodeoxycholic acid.


2017 ◽  
Vol 4 (2) ◽  
pp. 65-71
Author(s):  
Oleksandra Slobodianiuk

Slobodianiuk O.L.In recent years much attention has been paid to the upper digestive tract diseases in children, particularly GERD, as a reason t,hat has an impact on quality of life even in children of school age and thereafter in young adults. Scientists came to a consensus that all examinations which are used in pediatric practice must be maximally available, simple and non-invasive to the extent practical for child’s condition.The question about practicability of performing esophagogastroduodenoscopy for all patients with complaints of heartburn and with other symptoms of GERD, the question relative to performing ultrasonography of the esophagus for children as an additional method of examination, usage of questionnaire in pediatric practice, formation of disease course prediction algorithm, and identification of preventive measures specific to every patient remain open.Therefore the goal of this research is to provide an overview of modern literature with reference to problematic issues of clinical evidence, risk factors, diagnostics, prediction of gastroesophageal reflux disease course in children of different age (regarding main causative and pathogenic factors, clinical evidence (esophageal and extra-esophageal), diagnostic methods and modern approaches to gastroesophageal reflux disease treatment).Key words: gastroesophageal reflux disease, non-invasive diagnostics, risk factors, prediction of disease course. СУЧАСНІ ПОГЛЯДИ НА ГЕРХ У ДІТЕЙ: ПРОБЛЕМИ ТА ПЕРСПЕКТИВИСлободянюк О.Л.Останнім часом багато уваги приділяється захворюванням верхніх відділів травного тракту у дітей, зокрема й ГЕРХ,  як причині, що призводить до порушення якості життя вже у дітей шкільного віку, а в подальшому і у людей молодого віку. Вчені дійшли консенсусу, що всі обстеження, які використовуються в педіатричній практиці повинні бути максимально доступними, простими та неінвазивними, наскільки це дозволяє стан дитини.Залишається відкритим питання про доцільність проведення ФЕГДС всім пацієнтам зі скаргами на печію та іншими симптомами ГЕРХ , питання щодо застосування УЗД стравоходу у дітей як додаткового методу обстеження, використання опитувальників в педіатричній практиці, формування алгоритмів прогнозування перебігу захворювання та визначення профілактичних заходів  індивідуально для кожного пацієнта.Отже, метою цієї роботи було виконати огляд сучасної літератури з проблемних питань клінічних проявів, факторів ризику, діагностики, прогнозування перебігу гастроезофагеальної рефлексної хвороби у дітей різного віку (з питань основних етіологічних та патогенетичних факторів, клінічних проявів (стравохідних та позастравохідних), методів діагностики та сучасних підходів до лікування гастроезофагеальної рефлексної хвороби).Ключові слова: гастроезофагеальна рефелюксна хвороба, неінвазивна діагностика, фактори ризику, прогнозування перебігу.  СОВРЕМЕННЫЕ ВЗГЛЯДЫ НА ГЕРБ У ДЕТЕЙ: ПРОБЛЕМЫ И ПЕРСПЕКТИВЫСлободянюк А.Л.В последнее время больше внимания уделяется заболеванием верхних отделов пищеварительного тракта у детей, в том числе и ГЭРБ, как причине, которая приводит к нарушению качества жизни уже у детей школьного возраста, а в дальнейшем и у людей молодого возраста. Ученые пришли к консенсусу, что все обследования, которые используются в педиатрической практике должны быть максимально доступными, простыми и неинвазивными, насколько это позволяет состояние ребенка. Остается открытым вопрос о целесообразности проведения ФЭГДС всем пациентам с жалобами на изжогу и другими симптомами ГЭРБ, вопросы применения УЗИ пищевода у детей в качестве дополнительного метода обследования, использование опросников в педиатрической практике, формирование алгоритмов прогнозирования течения заболевания и определения профилактических мероприятий индивидуально для каждого пациента.Итак, целью этой работы было выполнить обзор современной литературы по проблемным вопросам клинических проявлений, факторов риска, диагностики, прогнозирования течения гастроэзофагеальной рефлексной болезни у детей разного возраста (по вопросам основных этиологических и патогенетических факторов, клинических проявлений (пищеводных и внепищеводных), методов диагностики и современных подходов к лечению гастроэзофагеальной рефлексной болезни).Ключевые слова: гастроэзофагеальная рефелюксная болезнь, неинвазивная диагностика, факторы риска, прогнозирование течения.


2012 ◽  
Vol 142 (5) ◽  
pp. S-590-S-591
Author(s):  
Magda Sofia Pacio-Quiterio ◽  
Jose Emilio G Rodriguez-Aguilar ◽  
Alvaro Montiel-Jarquin ◽  
Juan C. Lopez-Alvarenga ◽  
Sergio R. Sobrino-Cossio ◽  
...  

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