A PROSPECTIVE STUDY INVOLVING COMPARISON OF ACOTIAMIDE WITH RABEPRAZOLE VS. DOUBLE DOSE RABEPRAZOLE IN PATIENTS HAVING OVERLAPPING SYMPTOMS OF PROTON PUMP INHIBITOR REFRACTORY GASTROESOPHAGEAL REFLUX DISEASE AND FUNCTIONAL DYSPEPSIA

2020 ◽  
Vol 8 (1) ◽  
pp. 1-11
Author(s):  
Ayesha Abdul Bari ◽  
Dr. Syed Ibrahim Hassan ◽  
Aaminah Najmus Sahar ◽  
Syeda Batool Safiyya ◽  
Asif Rasheed
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Functional Dyspepsia ◽  
Reflux Disease ◽  
Gastrointestinal Symptoms ◽  
Double Dose ◽  
Refractory Gerd ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Introduction: Gastroesophageal reflux disease (GERD) is a digestive disorder that affects the lower esophageal sphincter (LES). Functional dyspepsia (FD) is characterized by troublesome early satiety, epigastralgia or heart burn. It is often overlooked as the symptoms overlap with GERD. This study aims to compare the effectiveness of Acotiamide+Rabeprazole vs. a double dose of Rabeprazole in Indian population. Method: In this study 60 patients diagnosed with PPI refractory GERD (taking PPI>8weeks) and FD with no gastric or duodenal organic abnormalities were randomly allocated in two groups. Group 1 received a combination of Acotiamide (200mg/day) +Rabeprazole (20mg/day) and group 2 received a double dose of Rabeprazole (40mg/day). Follow ups were done every month for 3 consecutive months. The frequency and severity of symptoms were assessed using standard Izumo scale and FSSG scale. Results: The total score and GERD score from the baseline were significantly reduced in group 1 however the reduction in FD score from baseline did not differ significantly in the two treatment groups according to F-scale. The proportion of patients with ≥ 50% reduction in the total score for three upper gastrointestinal symptoms (heart burn, epigastralgia, and epigastric fullness) in the izumo scale was 96.7% in group 1 and 33.3% in group 2. Significant difference were noticed between the two groups. No serious adverse events were observed. Conclusion: The combination group of Acotiamide+Rabeprazole was found to be more effective than double dose of Rabeprazole in reducing the overlapping symptoms of PPI refractory GERD and FD.

The Effects of Diaphragmatic Breathing and Omeprazole on Respiratory Indices and Diaphragmatic Excursion in Patients with Gastroesophageal Reflux Disease

2020 ◽  
Vol 22 (7) ◽  
Author(s):  
Mehdi Ahmadi ◽  
Mohsen Amiri ◽  
Tahere Rezaeian ◽  
Amir Mansour Rezadoost ◽  
Enayatollah Bakhshi ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Clinical Problem ◽  
Forced Expiratory Volume ◽  
Control Group ◽  
Diaphragmatic Breathing ◽  
Positive Effects ◽  
Refractory Gerd ◽  
Significant Difference

Background: Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal disorders that can disturb patients’ respiratory indices. Proton pump inhibitors (PPIs) such as omeprazole are currently the most common treatment in the patients. PPI-refractory GERD is a clinical problem constituting around 30% of patients with GERD. Objectives: The aim of this study was to investigate the effects of diaphragmatic breathing (DB) and omeprazole on respiratory indices (RI) and diaphragmatic excursion (DEX) in patients with GERD. Methods: This is a clinical trial conducted for eight weeks among 40 patients with severe GERD in Tehran in 2018. The block randomization method was designed to randomize 40 patients into two groups (DB and control) that resulted in equal sample sizes. The control group received omeprazole 20 mg once daily, and the DB group, in addition to omeprazole, performed DB. Respiratory indices, including (Forced Vital Capacity (FVC), Forced Expiratory Volume in 1 second (FEV1), Peak Expiratory Flow (PEF)), and DEX were evaluated before, immediately, and six weeks after the end of intervention by spirometry and ultrasonography; respectively. Results: There was no significant difference in the RI and DEX before the intervention between groups. FVC (P = 0.04) and PEF (P = 0.02) significantly changed in the control group, but FEV1 (P = 0.001), FVC (P = 0.002), PEF (P = 0.001) and DEX (0.001) significantly changed after DB. There was a significant difference in terms of RI between before and followed up in DB. Conclusions: Diaphragmatic breathing with omeprazole had more effects on RI and DEX than omeprazole alone. The positive effects of DB remain at least six weeks after the end of the intervention.

scholarly journals Gastroesophageal reflux disease and vocal disturbances

2011 ◽  
Vol 48 (2) ◽  
pp. 98-103 ◽  
Author(s):  
Maria Aparecida Coelho de Arruda Henry ◽  
Regina Helena Garcia Martins ◽  
Mauro Masson Lerco ◽  
Lídia Raquel Carvalho ◽  
Vânia Cristina Lamônica-Garcia
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Ph Value ◽  
Upper Esophageal Sphincter ◽  
Esophageal Ph ◽  
Esophageal Sphincter ◽  
Group 2 ◽  
Vocal Disturbances ◽  
Group 1

CONTEXT: Gastroesophageal reflux disease is a chronic disease in which gastroduodenal contents reflux into the esophagus. The clinical picture of gastroesophageal reflux disease is usually composed by heartburn and regurgitation (typical manifestations). Atypical manifestations (vocal disturbances and asthma) may also be complaint. OBJECTIVE: To analyse the clinical, endoscopic, manometric and pHmetric aspects of patients suffering from gastroesophageal reflux disease associated with vocal disturbances. METHODS: Fifty patients with gastroesophageal reflux disease were studied, including 25 with vocal disturbances (group 1 - G1) and 25 without these symptoms (group 2 - G2). All patients were submitted to endoscopy, manometry and esophageal pHmetry (2 probes). The group 1 patients were submitted to videolaryngoscopy. RESULTS: Endoscopic findings: non-erosive reflux disease was observed in 95% of G1 patients and 88% of G2. Videolaryngoscopy: vocal fold congestion, asymmetry, nodules and polyps were observed in G1 patients. Manometric findings: pressure in the lower esophageal sphincter (mm Hg): 11.6 ± 5.2 in G1 and 14.0 ± 6.2 in G2 (P = 0.14); pressure in the upper esophageal sphincter (mm Hg): 58.4 ± 15.9 in G1 and 69.5 ± 30.7 in the controls. pHmetric findings: De Meester index: 34.0 ± 20.9 in G1 and 15.4 ± 9.4 in G2 (P<0.001); number of reflux episodes in distal probe: 43.0 ± 20.4 in G1 and 26.4 ± 17.2 in G2 (P = 0.003); percentage of time with esophageal pH value lower than 4 units (distal sensor): 9.0% ± 6.4% in G1 and 3.4% ± 2.1% in G2 (P<0.001); number of reflux episodes in proximal probe: 7.5 ± 10.9 in G1 and 5.3 ± 5.7 in G2 (P = 0.38); percentage of time with esophageal pH values lower than 4 units (Proximal probe): 1.2 ± 2.7 in G1 and 0.5 ± 0.7 in G2 (P = 0.21). CONCLUSIONS: 1) The clinical, endoscopic, and manometric findings observed in patients with vocal disturbance do not differ from those without these symptoms; 2) gastroesophageal reflux intensity is higher in patients with vocal disturbance; 3) patients without vocal disturbance can also present reflux episodes in the proximal probe.

scholarly journals Omeprazole-Domperidone Fixed Dose Combination vs Omeprazole Monotherapy: A Phase 4, Open-Label, Comparative, Parallel Randomized Controlled Study in Mild to Moderate Gastroesophageal Reflux Disease

2017 ◽  
Vol 10 ◽  
pp. 117955221770945 ◽  
Author(s):  
KY Marakhouski ◽  
GA Karaseva ◽  
DN Ulasivich ◽  
Y Kh Marakhouski
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Combined Therapy ◽  
Fixed Dose ◽  
Controlled Study ◽  
Randomized Controlled ◽  
Reflux Symptoms ◽  
Group 2 ◽  
Group 1

Aim: To compare the efficacy and safety of omeprazole-domperidone combination vs omeprazole monotherapy in gastroesophageal reflux disease (GERD). Methods: In a comparative, randomized controlled, phase 4 study, outpatients with GERD were randomly allocated to either group 1 (omeprazole 20 mg + domperidone 30 mg) or group 2 (omeprazole 20 mg) in an equal ratio; 2 capsules daily in the morning were administered for 8 weeks. Results: Sixty patients were enrolled. Esophagitis reversal was observed in 92% patients in group 1 vs 65.2% in group 2. Approximately, 83.3% patients in group 1 vs 43.3% patients in group 2 demonstrated full cupping of reflux symptoms at 8 weeks. Combined therapy resulted in significantly longer period of heartburn-free days (23 vs 12 days on omeprazole). There were no safety concerns. Conclusions: Omeprazole-domperidone combination was more effective than omeprazole alone in providing complete cupping of reflux symptoms and healing of esophagitis in patients with GERD. Both the treatments were well tolerated with few reports of adverse events. Trial registration: This trial is registered with http://clinicaltrials.gov , number NCT02140073.

scholarly journals Efficacy of Alginate-Antacid Medication in the Treatment of Patients with Gastroesophageal Reflux Disease

2018 ◽  
Vol 28 (5) ◽  
pp. 46-58
Author(s):  
O. A. Storonova ◽  
A. S. Trukhmanov ◽  
V. T. Ivashkin
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Combination Therapy ◽  
Gastric Juice ◽  
Reflux Disease ◽  
Fasting State ◽  
Weakly Acid ◽  
Significant Difference ◽  
Impedance Monitoring ◽  
Group 1

Aim.In this work, we aim to analyze the efficacy of treatment for heartburn and pathological gastroesophageal refluxes (GERs) using alginate-antacid medication. We assess the dynamics of inflammatory process in patients with gastroesophageal reflux disease (GERD) treated with alginate-antacid medication used at conventional dosage, both as a monotherapy and as part of a GERD combination therapy. To this end, we set out to confirm the formation of the layer of unbuffered acidic gastric juice over the gastric chyme after eating, as well as to determine the acidneutralizing effect of alginate-antacid medication upon its interaction with the acidic contents of the stomach.Materials and methods.36 case records of GERD patients were analyzed (20 women and 16 men, mean age 47.03 years old). All patients were asked to report the heartburn intensity (according to a Likert scale) prior and during the treatment. They were subjected to esophagogastroduodenoscopy (EGD) and 24-hour pH impedance monitoring prior and on the 14th day of treatment. Before treatment, high-resolution esophageal manometry was performed to exclude the esophageal hiatal hernia (EHH) and to determine the upper and lower boundaries of the lower esophageal sphincter (LES). Group 1 included patients with non-erosive reflux disease (NERD), who were receiving monotherapy with alginate-antacid. Patients with the I-II degree of erosive esophagitis (EE) comprised groups 2 and 3, respectively, and were receiving proton pump inhibitor (PPI) monotherapy and PPI and alginate-antacid medication combination therapy, respectively. In group 1, 10 patients were examined using a probe pull-through technique with the purpose of determining pH levels in the cardiac stomach, in the area of the gastro-esophageal junction and in the esophagus at a level of 5 cm above the LES, both in the fasting state and after eating, as well as prior and after using alginate-antacid preparations. Results.On the third day of treatment, a complete heartburn relief was observed in 5 (41.6 %) patients of the NERD patient group (group 1), who were receiving a monotherapy with alginate-antacid medication. Heartburn relief was achieved in 3 EE (25 %) and 6 EE patients (50 %) following a PPI treatment course and a PPI and alginate-antacid medication treatment course, respectively. On the 5th day of treatment, heartburn was neutralized in 8 (66.7 %), 7 (58.3 %) and 9 (75 %) patients, with these numbers having risen to 10 (83.3 %), 9 (75 %) and 10 (83.3 %) patients (in the respective groups) on the 14th day. Before treatment, no significant differences in the heartburn intensity were identified between the groups. On the 3rd day of treatment, a significant difference was observed in the dynamics of heartburn intensity between groups 1 – 2 and 2 – 3 (p < 0.05), with this difference having disappeared by the 5th day. According to EGD in the NERD group, inflammation were eliminated in 10 (83.3 %) patients. In EE patients of the 2nd and 3rd groups, the healing of erosions was confirmed in 8 (66.7 %) and 10 (83.3 %) patients, respectively. In general, during the 24-hour pH impedance monitoring, pathological acid, weakly acid and non acid GERs were diagnosed in 28 (77.8 %), 15 (41.7 %) and 9 (25 %) patients, respectively. Under a course of alginate-antacid medication monotherapy, acid reflux was eliminated in 100 % of NERD patients. Among ERD patients undergoing PPI monotherapy, acidic GERs were eliminated in 9 (75 %) patients; however, the addition of alginate-antacid medication to a PPI treatment regimen allowed this result to be increased to 91.7 %. Weakly acid GERs were eliminated in 70 % and 33.3 % of patients in groups 1 and 2, respectively. In group 3, where patients were receiving a PPI and alginate-antacid medication combination treatment, weakly acid GERs were eliminated in 75 % of cases. Non acid refluxes were eliminated in groups 1 and 3 in 50 %, and in 2 – in 33.3 % of cases. When pulling the probe in the fasting state, a sharp change in pH values from acid (0.9–2 units) to weakly acid, and then non acid (5.5–7.6 units), was observed in 100 % of cases. After a meal and before the administration of alginate-antacid medication, the layer of unbuffered acidic gastric juice (pH < 2) was detected in the proximal stomach of 9 patients (90 %). After administration of alginate-antacid medication, the pH ranged from 6.1 to 7.7 units in 7 (70 %) patients, and increased to 4.2 units in 3 people (30 %).Conclusions.The inclusion of alginate-antacid medication into treatment schemes for managing ERD patients significantly increases its effectiveness, reliably increasing the rate of the onset of the clinical effect. alginate-antacid medication is shown to be an effective monotherapy for NERD. An important advantage of alginate-antacid medication in the treatment of GERD postprandial symptoms consists in its ability to neutralize and displace distally the layer of unbuffered acidic gastric juice, which forms above the chyme surface. 

The role of adipose tissue hormones in the formation and course of gastroesophageal reflux disease in combination with obesity.

2021 ◽  
Vol 2021 (2) ◽  
pp. 96-98
Author(s):  
O.A. Oparin ◽  
◽  
O.M. Malіar ◽  
T.N. Oparina ◽  
E.J. Abakumova ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Adipose Tissue ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Enzyme Linked Immunosorbent Assay ◽  
Endoscopic Study ◽  
Group 2 ◽  
Group 1

Objective: To investigate the level of leptin in patients with gastroesophageal reflux disease with concomitant obesity and evaluate its effect on the course of the disease. Materials and results. The study involved 50 patients. The first group included patients with GERD with concomitant obesity, the second group — patients with GERD without concomitant pathology. A survey was conducted using the GERDQ questionnaire, which showed that patients with concomitant obesity were more likely to have symptoms of the disease. Leptin levels were determined by enzyme-linked immunosorbent assay. Іn subjects of group 1, the concentration of leptin will be significantly higher than in patients of group 2. An endoscopic study was performed, the results of which were compared with the concentration of leptin. There is a direct correlation between body mass index, the degree of esophageal damage and leptin levels.

scholarly journals Salivary parameters and teeth erosions in patients with gastroesophageal reflux disease

2012 ◽  
Vol 49 (3) ◽  
pp. 214-218 ◽  
Author(s):  
Maria Carolina Canteras Scarillo Falotico Corrêa ◽  
Mauro Masson Lerco ◽  
Maria de Lourdes Ribeiro de Sousa da Cunha ◽  
Maria Aparecida Coelho de Arruda Henry
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Bacterial Count ◽  
Salivary Flow ◽  
Disease Diagnosis ◽  
Dental Erosion ◽  
Buffering Capacity ◽  
Group 2 ◽  
Group 1

CONTEXT: In the gastroesophageal reflux disease (GERD), a highly prevalent digestive disorder, gastric content may return to the esophagus and reach the mouth, thus leading to a small number of carious lesions and high incidence of dental erosion. Since saliva plays a major role in oral homeostasis, evaluating salivary parameters is necessary in attempting to explain such outcome. OBJECTIVES: This study aimed at analyzing salivary parameters (salivary flow, pH and buffering capacity), bacterial count, caries index and dental erosion in patients with GERD. MATERIALS: Sixty patients were studied, and of these, 30 had GERD (group 1), and 30 were controls (group 2). Gastroesophageal reflux disease diagnosis confirmation was achieved by means of endoscopy, manometry and pH metric esophageal monitoring. The above mentioned salivary parameters were evaluated in patients from groups 1 and 2. RESULTS: The number of erosions in patients with GERD (group 1) was larger than in controls (P<0.001). The number of carious teeth was smaller in group 1 than in group 2 (P<0.001). Salivary flow (non-stimulated and stimulated) and pH did not show differences between the 2 groups (P = 0.49; P = 0.80 and P = 0.85, respectively). Salivary buffering capacity in patients with GERD showed lower values in controls (P = 0.018). The number of bacteria (Lactobacilli and Streptococci) was smaller in patients with gastroesophageal reflux disease than in controls (P = 0.0067 and P = 0.0017, respectively). CONCLUSION: It was concluded that the large number of erosions must be a result of GERD patients reduced salivary buffering capacity. The reduced number of caries of patients in group 1 can be explained by the low prevalence of bacteria (Lactobacilli and Streptococci), observed in the saliva of patients with chronic reflux.

scholarly journals Features of the clinical course of asthma combined with gastroesophageal reflux disease in children

2020 ◽  
pp. 54-58
Author(s):  
T.R. Umanets ◽  
◽  
A.A. Buratynska ◽  
Keyword(s):  
Atopic Dermatitis ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Clinical Course ◽  
Bronchodilator Therapy ◽  
Children With Asthma ◽  
Asthma In Children ◽  
Group 2 ◽  
Group 1

Among the comorbid conditions in children with asthma a significant place is occupied by lesions of the upper digestive tract+in particular, gastroesophageal reflux disease (GERD). It is known that asthma can provoke the development of reflux, and reflux in turn leads to a worsening of the course of asthma. Scientific studies indicate a better ability to control asthma in children after appropriate treatment for GERD. Purpose — to study the features of the clinical course of asthma combined with gastroesophageal reflux disease in children. Materials and methods. Ninety+nine children aged 6–17 years with asthma of varying severity and level of control were examined. These children which were randomly divided into two groups: group 1–79 children with asthma combined with GERD, and group 2–20 children with asthma without GERD. A questionnaire was administered, an assessment of day and night symptoms of asthma according to the scoring system was conducted, and an ACT test according to age was performed on all examined children. With the consent of the parents, twenty-two children who had complaints characteristic of gastrointestinal lesions, underwent fibroesophagogastroduodenoscopy with biopsy from the proximal and distal esophageal mucosa. Results. In children with asthma combined with GERD, atopic dermatitis is probably more common (in 46.8% of patients), and symptoms of hypersensitive reactions to food are registered (in 74.6% of patients). Children in group 1, in contrast to children in group 2, had a longer and more severe course of asthma and probably more frequent nocturnal symptoms of the disease, which was associated with poorer control of asthma and the need for bronchodilator therapy (8.5±0.5 inhalations per month against 4.5±0.5 inhalations per month, respectively, p<0,05). Peculiarities of GERD in children with asthma were: nonspecific complaints, catarrhal changes of the lower third of the esophagus (reflux esophagitis in 98.7%), focal hyperplasia of the basal layer of the epithelium and intraepithelial eosinophilia up to 5% (9%). Girls and boys of different ages experience significant differences in complaints from the gastrointestinal tract. Conclusions. The presence of GERD has been shown to affect the control of asthma in children, associated with nocturnal symptoms, the need for bronchodilator therapy, more severe and prolonged course of the disease, concomitant atopic dermatitis and food hypersensitivity reactions. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Keywords. asthma, gastroesophageal reflux disease, children.

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