scholarly journals Gastroesophageal reflux disease: actual aspects of diagnostics and treatment in real clinical practice of therapist

2019 ◽  
pp. 22-31
Author(s):  
D. I. Trukhan ◽  
I. A. Viktorova
Keyword(s):  
Clinical Practice ◽  
General Practitioner ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Proton Pump ◽  
Reflux Disease ◽  
Point Of View ◽  
Diagnosis And Treatment ◽  
Multimorbid Patients ◽  
Real Clinical Practice

Gastroesophageal reflux disease (GERD) in terms of prevalence ranks first among gastroenterological diseases. A large number of works on the diagnosis and treatment of GERD, forms the point of view that about GERD «everything is long and well known.» However, in real clinical practice, for various reasons, possible «pitfalls, reefs and shallows» are not taken into account, the underestimation of which can introduce certain difficulties in the diagnosis and treatment. This review discusses the most significant aspects of the diagnosis and treatment of GERD in real clinical practice by a general practitioner and general practitioner. Currently, proton pump inhibitors are the main drugs for the treatment of GERD and other acid-dependent diseases. The results of numerous foreign and Russian studies indicate the effectiveness and safety of pantoprazole in the treatment of GERD, especially in multimorbid patients due to the lower potential of drug interactions. The presence on the Russian pharmaceutical market of two forms of release of the generic drug pantoprazole Panum® increases the availability of effective and safe therapy for GERD and other acid-dependent diseases.

scholarly journals Modern attitude towards management of laryngopharyngeal form of gastroesophageal reflux disease. Lithuanian clinical practice guidelines for adults

Medicina ◽  
2007 ◽  
Vol 43 (10) ◽  
pp. 832
Author(s):  
Nora Šiupšinskienė ◽  
Virgilijus Uloza ◽  
Rūta Pribuišienė ◽  
Evaldas Butkus ◽  
Limas Kupčinskas
Keyword(s):  
Clinical Practice ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Reflux Disease ◽  
Primary Care Physicians ◽  
Combined Therapy

The aim of this article is to introduce Lithuanian clinical practice guidelines for the management of laryngopharyngeal form of gastroesophageal reflux disease for standardization of the diagnosis and treatment of the disease and prevention of its complications. Composed guidelines provide recommendations for primary care physicians as well as otorhinolaryngologists and gastroenterologists for the management of adults with uncomplicated laryngopharyngeal form of gastroesophageal reflux disease. Committee composed of experts from Lithuanian Otorhinolaryngological and Gastroenterological Societies developed guidelines based on a comprehensive review of the evidence-based literature related to laryngopharyngeal form of gastroesophageal reflux disease and guidelines of other countries. The guidelines provide description of each medicine groups with emphasis on proton pump inhibitors as the most effective drugs for the treatment of laryngopharyngeal form of gastroesophageal reflux disease. Indications for empirical treatment with proton pump inhibitors are described, as well as duration of treatment, doses, optimal regimen of use, and assessment of treatment efficacy. The therapy should begin with the application of proton pump inhibitors twice daily, before meal for three months. Combined therapy for nonresponders is described. Algorithm for stopping the medication is recommended. These recommendations may provide an efficient and economical approach to the management of this problem.

Gastric NET Subtypes: Do We Need An Additional One?

2021 ◽  
Author(s):  
Guntram Lock ◽  
Michael Oelckers ◽  
Till Sebastian Clauditz ◽  
Jörg Schrader
Keyword(s):  
Risk Factors ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Neuroendocrine Tumors ◽  
Proton Pump ◽  
Reflux Disease ◽  
Gastric Surgery ◽  
Malignant Potential ◽  
Point Of View ◽  
Type I

AbstractDepending on etiology, prognosis and malignant potential, recent S2k guideline differentiates gastric neuroendocrine tumors (gNET) in 4 types with different treatment implications.We report on a 55-year-old patient with the accidental finding of a 15 mm gNET. Apart from a prolonged use of proton pump inhibitors (PPI) for 20 years as a treatment for gastroesophageal reflux disease, there were no other associations or risk factors for gNETs. Formally, this patient would have been classified as a type III gNET, implicating gastric surgery. From a pathophysiological point of view, however, the assumed prolonged gastrin hypersecretion would have justified an assignment as a type I gNET. The gNET was resected by ESD, but histology showed an R1 situation. After cessation of PPIs, there is no recurrence so far. Besides, the initially documented numerous and large gland polyps showed an impressive regression only a few weeks after cessation of PPI.This case points to a probably underestimated gap in the present gNET classification. On the basis of present literature, the therapeutic dilemma of PPI-associated gNETs is discussed. A new assignment of PPI associated gNETs as type Ib could help to overcome this dilemma.

scholarly journals Phenotypes of Gastroesophageal Reflux Disease in real clinical practice

2019 ◽  
Vol 21 (8) ◽  
pp. 15-22
Author(s):  
Igor G. Bakulin ◽  
◽  
Oxana M. Drapkina ◽  
Dmitriy S. Bordin ◽  
◽  
...  
Keyword(s):  
Clinical Practice ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Real Clinical Practice

Potential reasons for proton pump inhibitor failure in the treatment of gastroesophageal reflux disease

2008 ◽  
Vol 149 (40) ◽  
pp. 1881-1888 ◽  
Author(s):  
Márk Juhász ◽  
Zsolt Tulassay
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Proton Pump Inhibitor ◽  
Gastroesophageal Reflux ◽  
Proton Pump ◽  
Reflux Disease

A protonpumpagátlók (protonpumpa-inhibitorok, PPI) bevezetése új fejezetet nyitott a gastrooesophagealis refluxbetegség (gastroesophageal reflux disease, GERD) kezelésében. A betegek kisebb, de nem jelentéktelen hányadában azonban a PPI sem hatékony. Ilyen esetekben az első kérdés mindig az, hogy a tünetek valóban GERD-nek tulajdoníthatók-e, vagy egyéb betegség után kell kutatnunk. Ha a GERD a legvalószínűbb lehetőség, akkor a további vizsgálatok és a több támadáspontú kezelés előtt fel kell térképeznünk a beteg együttműködését (compliance). Ha az eredménytelen PPI-kezelés hátterében nem helytelenül kezelt GERD áll, akkor számos egyéb kórkép lehetőségét is fel kell vetnünk. Összefoglaló közleményünkben az elkülönítő diagnosztikai kérdésekről adunk áttekintést.

scholarly journals Profile of the Change in Depression during Proton-Pump Inhibitor Therapy in Patients with Gastroesophageal Reflux Disease: Influence of the Mucosal Break

2021 ◽  
Vol 18 (11) ◽  
pp. 5964
Author(s):  
Chia-Liang Wu ◽  
Chien-Lin Chen ◽  
Shu-Hui Wen
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Proton Pump ◽  
Reflux Disease ◽  
Proton Pump Inhibitor Therapy ◽  
Linear Regression Models ◽  
Independent Variable ◽  
The Difference ◽  
Mucosal Break ◽  
The Impact

Given the frequent concomitance between depression and gastroesophageal reflux disease (GERD), it is important to evaluate the change of depression in patients with GERD, especially considering the presence of esophageal mucosal breaks (MB). This study aimed to examine the change in the levels of depression in patients with GERD during proton-pump inhibitors (PPI) therapy. We designed a prospective cohort study to explore the profile of the alteration in depression with respect to the impact of esophageal MB. This study recruited 172 eligible patients with GERD between February 2016 and May 2018. The change in depression was defined as the difference between the respective Taiwanese Depression Questionnaire (TDQ) scores obtained at baseline and after PPI therapy. Multivariate linear regression models were used to estimate the factors associated with the change in depression. The results revealed statistically significant improvements in the TDQ score (mean score: baseline = 13.2, after PPI therapy = 10.9, p < 0.01, Cohen’s d = 0.30) during PPI therapy for GERD. Moreover, the MB was an independent variable associated with changes in the TDQ score [B = 3.31, 95% confidence interval (CI): (1.12, 5.51), p < 0.01] and the improvement in depression [odds ratio = 0.38, 95% CI: (0.17, 0.86), p = 0.02]. Our findings revealed that depressive symptoms improved slightly following PPI therapy. Moreover, MB was an unfavorable prognostic factor for the improvement in depression.

675 FUNDOPLICATION VERSUS ORAL PROTON PUMP INHIBITORS FOR GASTROESOPHAGEAL REFLUX DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CLINICAL TRIALS

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Luca Schiliró Tristão ◽  
Francisco Tustumi ◽  
Guilherme Tavares ◽  
Letícia Nogueira Datrino ◽  
Maria Carolina Andrade Serafim ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Adverse Events ◽  
Proton Pump ◽  
Reflux Disease ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Oral Intake

Abstract   Gastroesophageal reflux disease (GERD) is a widely studied and highly prevalent condition. However, few is reported about the exact efficacy and safety of fundoplication (FPT) compared to oral intake proton-pump inhibitors (PPI). This systematic review and meta-analysis of randomized clinical trials (RCT) aims to compare PPI and FPT in relation to the efficacy, as well as the adverse events associated with these therapies. Methods This systematic review was guided by PRISMA statement. Search carried out in June 2020 was conducted on Medline, Cochrane, EMBASE and LILACS. The inclusion criteria were (I) patients with GERD; (II) Randomized clinical trials, comparing oral intake PPI with FPT; (III) relevant outcomes for this review. The exclusion criteria were (I) reviews, case reports, editorials and letters (II) transoral or endoscopic FPT (III) studies with no full text. No restrictions were set for language or period. Certainty of evidence and risk of bias were assessed with GRADE Pro and with Review Manager Version 5.4 bias assessment tool. Results Ten RCT were included. Meta-analysis showed that heartburn (RD = −0.19; 95% CI = −0.29, −0.09) was less frequently reported by patients that underwent FPT. Furthermore, patients undergoing surgery had greater pressure on the lower esophageal sphincter than those who used PPI (MD = 7.81; 95% CI 4.79, 10.83). There was no significant difference between groups in the percentage of time with pH less than 4 in 24 hours, sustained remission and Gastrointestinal Symptom Rating Scale. Finally, FPT did not increase significantly the risk for adverse events such as postoperative dysphagia and impaired belching. Conclusion FPT is a more effective therapy than PPI treatment for GERD, without significantly increasing the risk for adverse events. However, before indicating a possible surgical approach, it is extremely important to correctly assess and select the patients who would benefit from FPT, such as those with severe erosive esophagitis, severe respiratory symptoms, low adherence to continuous drug treatment and patients with non-acid reflux, to ensure better results.

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