scholarly journals A Case Report on Reflux Esophagitis Treated with Korean Medicine in a Patient with Spinal Stenosis

2021 ◽  
Vol 42 (5) ◽  
pp. 800-807
Author(s):  
So-won Kim ◽  
Geon-sik Kong ◽  
Jin-young Song ◽  
Jin-hun Park ◽  
Yen-min Wang ◽  
...  
Keyword(s):  
Chest Pain ◽  
Medical Treatment ◽  
Reflux Esophagitis ◽  
Herbal Medicines ◽  
Acid Reflux ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Korean Medicine ◽  
Five Dimension ◽  
Pain Symptoms

Objectives: This study investigated the efficacy of Korean medical treatment for reflux esophagitis.Methods: We used Korean medical treatment (herbal medicines, acupuncture, herbal acupuncture, and therapy) to treat a hospitalized patient with reflux esophagitis. To evaluate the treatment, we measured the symptoms using the Reflux Symptom Index (RSI) and the Visual Analogue Scale (VAS) for heartburn, acid reflux, chest pain, foreign body sensations in the throat, chronic cough, hoarseness, and bronchial asthma. The generic health status was evaluated using the European Quality of Life Five-Dimension (EQ-5d) Scale.Results: The RSI and EQ-5d scores improved following treatment, but the VAS scores showed that only heartburn, acid reflux, and chest pain symptoms were relieved.Conclusions: This study suggests that Korean medicine may be effective for treating reflux esophagitis.

scholarly journals A Case Study of Eyelid Edema Post Craniotomy

2021 ◽  
Vol 42 (5) ◽  
pp. 939-948
Author(s):  
Seo-young Kim ◽  
Jeong-woo Choi ◽  
Tae-bin Yim ◽  
Hye-jin Lee ◽  
Seung-yeon Cho ◽  
...  
Keyword(s):  
Visual Field ◽  
Medical Treatment ◽  
Visual Field Defect ◽  
Herbal Medicines ◽  
Korean Medicine ◽  
Eyelid Edema ◽  
Effective Option ◽  
Field Defect

Objectives: This study considered the effectiveness of Korean medicine for the treatment of eyelid edema post craniotomy.Methods: The patient was diagnosed with Taeumin-one of the four constitution types in Korean medicine-and treated with herbal medicines: Cheongsimyeunja-tang, Chungpyesagan-tang, and Hwangryunhaedok-tang pharmacoacupuncture treatment. The severity of eyelid edema was assessed using Kara and Gokalan’s scale, daily imaging of the patient’s eyelids, and the ratio of the length of the left eye to that of the right.Results: Following treatment, the Kara and Gokalan score decreased from 3 to 0. The changes in the ratios were 29% and 50%, respectively. The visual field defect due to edema in the left eye was also repaired.Conclusion: This study suggests that Korean medical treatment could be an effective option for treating eyelid edema following craniotomy.

Gastroesophageal reflux disease and salivary pepsin in patients with heterotopic gastric mucosa in the upper esophagus

2021 ◽  
Author(s):  
Xin Xiong ◽  
Suyu He ◽  
Fei Xu ◽  
Zhihong Xu ◽  
Xiumei Zhang ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastric Mucosa ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Acid Reflux ◽  
Heterotopic Gastric Mucosa ◽  
Control Group ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Demeester Score

Summary Background Heterotopic gastric mucosa in the upper esophagus (HGMUE) is reported to be related to gastroesophageal reflux disease (GERD). This study investigated the prevalence of GERD and the use of salivary pepsin to diagnose gastroesophageal reflux, especially proximal reflux, in HGMUE patients. Methods One hundred and fifty-three HGMUE patients and 50 healthy volunteers were studied. All subjects took a reflux symptom index questionnaire (RSI); underwent endoscopy, barium esophagogram, high-resolution manometry (HRM), and 24-hour multichannel intraluminal impedance-pH-metry (MII-pH); and salivary pepsin test. Results Ninety-five (62.1%) HGMUE patients but no control subjects were diagnosed with GERD. The salivary pepsin concentration, RSI score, DeMeester score, acid exposure time (AET), total reflux episodes, proximal acidic reflux episodes, and proximal weakly acidic reflux episodes were significantly higher in the HGMUE group than in the control group (P < 0.05). The salivary pepsin test showed a sensitivity of 85.9% and specificity of 56.9% for diagnosing GERD using the optimal cut-off value of 75 ng/mL. One hundred and seven (69.9%) and 46 (30.1%) HGMUE patients were categorized as pepsin (+) and pepsin (−), respectively when 75 ng/mL was used as a cut-off value. Male sex, RSI, AET, and proximal acid reflux episodes were positive predictive factors for the occurrence of pepsin (+) in HGMUE patients. Conclusions GERD, especially GERD with proximal acid reflux and related symptoms, was common in HGMUE patients. The salivary pepsin test could be an additional useful test for testing reflux in HGMUE patients, but it will not replace the MII-pH.

scholarly journals Laryngopharyngeal Reflux: Symptoms, Signs, and Presence of Pepsin in Saliva - A Reliable Diagnostic Triad

2020 ◽  
Author(s):  
Shilpa Divakaran ◽  
Sivaa Rajendran ◽  
Roshan Marie Thomas ◽  
Jaise Jacob ◽  
Mary Kurien
Keyword(s):  
Positive Response ◽  
Laryngopharyngeal Reflux ◽  
Ph Monitoring ◽  
Tertiary Care ◽  
Acid Reflux ◽  
Response To Treatment ◽  
Care Hospital ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Chi Squared

Abstract Introduction Twenty-four-hour multichannel intraluminal impedance with double probe pH monitoring (MII-pH), though considered the most sensitive tool for the diagnosis of gastroesophageal reflux disease (GERD), is invasive, time consuming, not widely available, and unable to detect non-acid reflux. In contrast, the presence of pepsin in the saliva would act as a marker for reflux, considering that pepsin is only produced in the stomach. Objective To evaluate the predictive value of salivary pepsin in diagnosing laryngopharyngeal reflux (LPR) as suggested by the results of reflux symptom index (RSI > 13), reflux finding score (RFS > 7), and positive response to treatment with a 4-week course of proton-pump inhibitors. Methods This prospective study was done at a tertiary care hospital on 120 adult patients attending ENT OPD with clinical diagnosis of LPR. The presence of pepsin in their pharyngeal secretions and saliva using a lateral flow device, the Peptest, was compared with RSI, RFS, and with the response to medical treatment using the Chi-squared test. Results Salivary pepsin was found to be positive in 68% of the patients, with 87.5% of them showing positive response to treatment. Chi-squared analysis showed a significant association between positive salivary pepsin and RFS > 7, RSI >13, a combination of RFS > 7 and RSI > 13 as well as with response to treatment (p < 0.0001). Conclusion When considered along with the clinical indicators of RFS and RSI of more than 7 and 13, respectively, and/or with a response to treatment, a positive salivary pepsin test indicates statistically significant chance of presence of LPR.

Awareness of General Practitioners towards Treatment of Laryngopharyngeal Reflux: A British Survey

2005 ◽  
Vol 133 (4) ◽  
pp. 505-508 ◽  
Author(s):  
P.D. Karkos ◽  
L. Thomas ◽  
R.H. Temple ◽  
W.J. Issing
Keyword(s):  
Primary Care ◽  
General Practitioners ◽  
Chronic Cough ◽  
Early Recognition ◽  
Laryngopharyngeal Reflux ◽  
Acid Reflux ◽  
Postal Survey ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Throat Clearing

OBJECTIVE: Patients with acid reflux can occasionally present with atypical symptoms such as globus pharyngeus, constant throat clearing, chronic cough, hoarseness, catarrh, choking episodes or asthma-like symptoms. The aim of this survey was to determine whether general practitioners are aware of the atypical manifestations of reflux and the differences in treatment between laryngopharyngeal reflux and gastroesophageal reflux. DESIGN: Questionnaire Survey. SETTING: Primary Care RESULTS: One hundred and sixty general practitioners who routinely refer patients to our Department of Otolaryngology were selected and a postal survey was conducted. One hundred and fifty of these responded (94% response rate). The commonest symptoms for which proton pump inhibitors are prescribed are heartburn (65%), followed by a combination of heartburn and other symptoms (15%), chronic cough (4%), choking episodes (4%), asthmalike symptoms (3%), hoarseness (2%), globus (2%), catarrh (1%), dysphagia (1.5%), frequent throat clearing (1.5%), halitosis and/or bitter taste (1%). CONCLUSIONS: Our results suggest that the majority of the general practitioners surveyed are unaware of the entity laryngopharyngeal reflux or reflux symptom index. More awareness is required in the primary care setting for early recognition of patients with suspected laryngopharyngeal reflux.

Association of Heartburn and Laryngopharyngeal Symptoms with Endoscopic Reflux Esophagitis, Smoking, and Drinking

2009 ◽  
Vol 141 (2) ◽  
pp. 264-271 ◽  
Author(s):  
Chang-Chun Lin ◽  
Ya-Yu Wang ◽  
Kai-Li Wang ◽  
Han-Chung Lien ◽  
Ming-Tai Liang ◽  
...  
Keyword(s):  
Reflux Esophagitis ◽  
Case Series ◽  
Clinical Importance ◽  
Whole Body ◽  
Reflux Symptom Index ◽  
Voice Change ◽  
Symptom Index ◽  
Taiwanese People ◽  
Patients At Risk ◽  
Endoscopic Esophagitis

OBJECTIVES: This study was conducted to investigate the association of laryngopharyngeal symptoms and heartburn with endoscopic esophagitis, smoking, and drinking. The clinical importance of the Reflux Symptom Index (RSI) in predicting endoscopic esophagitis was also evaluated. STUDY DESIGN: Case series with planned data collection. SUBJECTS AND METHODS: From November 2006 to February 2007, 156 adults received a whole-body physical check-up. They filled out the RSI questionnaire and were dichotomized into either a “no problem group” or a “possible patients group” according to their scores on the RSI. All subjects received an esophagoscopy. The relationship between RSI score and endoscopic esophagitis, smoking, and drinking was analyzed. RESULTS: Voice change, but not heartburn, was significantly associated with endoscopic reflux esophagitis. Based on the RSI scores, some items in addition to voice change were significantly associated with smoking or drinking but not with endoscopic esophagitis. CONCLUSIONS: While screening patients for reflux esophagitis by using the RSI questionnaire, there is little value in using heartburn to predict endoscopic esophagitis in Taiwanese people. On the other hand, a husky voice might be a good clinical indicator of patients at risk of having reflux esophagitis.

scholarly journals Sex-Based Differences in pH Parameters and Esophageal Impedance of Patients With Gastroesophageal Reflux Disease

2021 ◽  
Vol 8 ◽  
Author(s):  
Bixing Ye ◽  
Yanjuan Wang ◽  
Lin Lin ◽  
Liuqin Jiang ◽  
Meifeng Wang
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Ph Monitoring ◽  
Acid Reflux ◽  
Mucosal Barrier ◽  
Esophageal Mucosa ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Esophageal Impedance

Background/Aims: The incidence of reflux esophagitis (RE) has a striking predominance in males. Conversely, non-erosive reflux disease (NERD) is more common in females. This imbalance of gastroesophageal reflux disease (GERD) implies sex-related differences in its pathogenesis. However, limited studies have analyzed the sex-based differences in pH parameters and esophageal impedance of GERD patients.Methods: This study evaluated sex-based pathogenesis differences by comparing reflux episodes, mean nocturnal baseline impedance (MNBI) values, and post-reflux swallow-induced peristaltic wave (PSPW) index values of males with GERD and females with GERD using 24-h multichannel intraluminal impedance and pH monitoring.Results: We analyzed 181 patients (102 males and 79 females) with GERD. Reflux symptom index (RSI) scores were higher in females than that in males (P &lt; 0.05). Males had significantly longer acid exposure times, higher DeMeester scores, and more acid reflux episodes than females (P &lt; 0.05). Females had more instances of weakly acidic reflux than males (P &lt; 0.01). The PSPW index values of males and females were similar (P &gt; 0.05). Compared with females, males had lower MNBI values for the mid and distal esophagus (P &lt; 0.05). However, with increasing age, the MNBI values of females decreased more rapidly than those of males. MNBI values of elderly patients of both sexes older than 60 years were similar.Conclusions: Acid reflux is more likely to occur in males; however, females tend to have more instances of weakly acid reflux. The integrity of the esophageal mucosa is more fragile in males than in females; however, the esophageal mucosal barrier attenuates more rapidly with increasing age in females than in males.

Voice Therapy With Seniors: Attendance, Outcomes, and Associated Patient Characteristics

2019 ◽  
Vol 4 (5) ◽  
pp. 814-824 ◽  
Author(s):  
Bonnie E. Smith ◽  
Ruth Huntley Bahr ◽  
Hector N. Hernandez
Keyword(s):  
Outcome Data ◽  
Voice Therapy ◽  
Similar Data ◽  
Success Rates ◽  
Reflux Symptom Index ◽  
Voice Change ◽  
Related Factors ◽  
Symptom Index ◽  
Younger Patients ◽  
Unsuccessful Treatment

Purpose The purpose of this study was to determine the attendance and success rates for seniors in voice therapy, identify any contributing patient-related factors, and compare results to existing findings for younger patients. Method This retrospective study included information from the voice records of 50 seniors seen by the same speech-language pathologist in a private practice. Analysis of attendance and outcome data divided participants into 6 groups. Outcomes for Groups 1–3 (64% of patients) were considered successful (positive voice change), while outcomes for Groups 4–6 (36% of patients) were considered unsuccessful. These data were compared to similar data collected for younger adults in a previous study. Results The attendance and success rates for seniors in this study were higher than those previously reported for younger patients. Further consideration of patient factors revealed that reports of increased stress, Reflux Symptom Index scores > 13, and higher Voice Handicap Index functional subscale scores were significant in distinguishing between patients in the successful and unsuccessful treatment outcome groups. Conclusions The relatively high attendance and success rates among this sample of seniors suggest the desire to achieve voice improvement does not diminish with age, and chances for success in voice therapy among nonfrail seniors may be greater than for younger patients.

Assessment and Diagnostic Accuracy Evaluation of the Reflux Symptom Index (RSI) Scale: Psychometric Properties using Optimal Scaling Techniques

2020 ◽  
Vol 129 (10) ◽  
pp. 1020-1029
Author(s):  
Andrea Nacci ◽  
Luca Bastiani ◽  
Maria Rosaria Barillari ◽  
Jerome R. Lechien ◽  
Massimo Martinelli ◽  
...  
Keyword(s):  
Psychometric Properties ◽  
Sensitivity And Specificity ◽  
Reflux Symptom ◽  
Original Version ◽  
Control Group ◽  
Clinical Group ◽  
Accuracy Evaluation ◽  
Reflux Symptom Index ◽  
Characteristic Analysis ◽  
Symptom Index

Objectives: To investigate the psychometric properties of the reflux symptom index (RSI) as short screening approach for the diagnostic of laryngopharyngeal reflux (LPR) in patients with confirmed diagnosed regarding the 24-hour multichannel intraluminal impedance-pH monitoring (MII-pH). Methods: From January 2017 to December 2018, 56 patients with LPR symptoms and 71 healthy individuals (control group) were prospectively enrolled. The LPR diagnosis was confirmed through MII-pH results. All subjects (n = 127) fulfilled RSI and the Reflux Finding Score (RFS) was performed through flexible fiberoptic endoscopy. The sensitivity and the specificity of RSI was assessed by ROC (Receiver Operating Characteristic) analysis. Results: A total of 15 LPR patients (26.8%) of the clinical group met MII-pH diagnostic criteria. Among subjects classified as positive for MII- pH diagnoses, RSI and RFS mean scores were respectively 20 (SD ± 10.5) and 7.1 (SD ± 2.5), values not significantly different compared to the negative MII-pH group. The metric analysis of the items led to the realization of a binary recoding of the score. Both versions had similar psychometric properties, α was 0.840 for RSI original version and 0.836 for RSI binary version. High and comparable area under curve (AUC) values indicate a good ability of both scales to discriminate between individuals with and without LPR pathology diagnosis. Based on balanced sensitivity and specificity, the optimal cut-off scores for LPR pathology were ≥ 5 for RSI binary version and ≥ 15 for RSI original version. Both version overestimated LPR prevalence. The original version had more sensitivity and the RSI Binary version had more specificity. Conclusions: It would be necessary to think about modifying the original RSI in order to improve its sensitivity and specificity (RSI binary version, adding or changing some items), or to introduce new scores in order to better frame the probably affected of LPR patient.

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