scholarly journals Penyakit Refluks Gastroesofageal Berat (PRGE) pada Anak dengan Riwayat Gizi Buruk dan Kelahiran Prematur

2021 ◽  
Vol 36 (2) ◽  
pp. 63-70
Author(s):  
Pramita G.D. Poerwantoro ◽  
Yuni Astria
Keyword(s):  
Quality Of Life ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Premature Birth ◽  
Feeding Tube ◽  
Z Score

Abstrak Penyakit refluks gastroesofageal berat (PRGE)adalah gerakan retrograd isi lambung ke kerongkongan. Pada prematuritas, kelemahan peristaltik esofagus terjadi akibat kurangnya relaksasi reseptif bersihan material refluks ke esofagus. Penyakit ini menyebabkan penurunan kualitas hidup dan komplikasi. Laporan ini bertujuan menggambarkan kasus PRGE parah pada anak marasmik dengan kelahiran prematur. Kasus berasal dari seorang anak perempuan berusia tiga tahun dirawat di Rumah Sakit Umum Cipto Mangunkusumo karena menderita muntah terus-menerus setiap kali setelah menyusu. Pasien lahir prematur pada usia kehamilan 31 minggu dengan berat lahir 900 gram, mengalami malnutrisi berat dan keterlambatan perkembangan. Pasien menjalani prosedur endoskopi, pemeriksaan histopatologi dan didapatkan esofagitis berat, gastritis erosif, striktur pilorik, dan refluks laringofaringeal (LPR).Pasien diberikan proton pump inhibitors (PPIs), menjalani dilatasi pilorik satu kali dan pemasangan nasogastricjejunal feeding tube (NJFT), serta susu formula khusus medium chain tryglyceride (MCT) enam kali sehari. Dalam 18 bulan masa tindak lanjut, pasien menunjukkan peningkatan skor Z berat-berdasarkan-panjang badan, panjang berdasarkan usia dan lingkar kepala berdasarkan usia.Dalam menangani bayi prematur, harus mempertimbangkan PRGE sebagai salah satu etiologi pertumbuhan yang terganggu. Prosedur endoskopi dan pemasangan NJFT untuk terapi nutrisi jangka panjang mengurangi komplikasi dan meningkatkan kualitas hidup.Follow up intensif diperlukan agar mencapai pertumbuhan dan perkembangan optimal.   Kata kunci: anak, komplikasi, GERD, lahir prematur, proton pump inhibitors Severe Gastroesophageal Reflux Disease in Malnourished Children with History of Prematurity Abstract Gastroesophageal reflux disease (GERD) is an involuntary retrograde propulsion of gastric contents to esophagus. In prematurity, esophagus peristaltic weakness due to lack of receptive relaxation contribute to inadequate cleaning of material reflux to esophagus which become GERD predisposition. Furthermore, GERD can cause a decline of quality of life and various complications. This report aimed to describe severe GERD case in a marasmic child with premature birth. A 36-month-old girl was hospitalized at dr. Cipto Mangunkusumo General Hospital because of persistent vomitus after every milk feeding. She was prematurely born at 31 weeks of gestation with birthweight of 900 grams, and become severely malnourished with developmental delayed. She then underwent gastrointestinal endoscopic procedure and histopathology examination that revealed a severe esophagitis, erosive gastritis, pyloric stricture, and laryngopharyngeal reflux (LPR).She was treated with proton pump inhibitors (PPI) and underwent one-time pyloric dilatation with nasogastricjejunal feeding tube (NJFT) insertion and continued with medium chain triglycerides formula six times a day. At 18-month follow-up, weight-for-length Z score, length-for-age and head circumference Z score are increased.In dealing with premature baby, we should consider GERD as one of growth faltering etiologies. Endoscopy procedure followed by NJFT insertion for long-term nutrition therapy in severe GERD are the cornerstones to reduce complications and to improve quality of life. Moreover, close follow up for optimal growth and development should be done in such case. Keywords: children, complications, GERD, premature birth, proton pump inhibitors

Mucosal Protective Compounds in the Treatment of Gastroesophageal Reflux Disease. A Position Paper Based on Evidence of the Romanian Society of Neurogastroenterology

2016 ◽  
Vol 25 (4) ◽  
pp. 537-546 ◽  
Author(s):  
Teodora Surdea-Blaga ◽  
Ion Băncilă ◽  
Daniela Dobru ◽  
Vasile Drug ◽  
Ovidiu Frățilă ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Reflux Disease ◽  
Position Paper ◽  
Esophageal Mucosa ◽  
Reflux Symptoms

Background & Aims: Gastroesophageal reflux disease (GERD) therapy is challenging and suppression of acid secretion or prokinetics do not cure all cases. Some drugs with protective action on the esophageal mucosa have been used alternatively or in association with proton pump inhibitors (PPIs) and/or prokinetics. The Romanian Society of Neurogastroenterology undertook an Evidence-Based analysis, from which this position paper evolved. Methods: We performed a systematic literature search in PubMed until October 2015, using the terms: sucralfate, guaiazulene, gaiazulene, dimethicone, alginate, antacids and gastroesophageal reflux. Forty-seven papers were included and analyzed. Several statements were elaborated regarding the use of these drugs in GERD. The evidence and recommendations were discussed between the authors. Results: There is evidence in the medical literature suggesting the benefit of these drugs in GERD. In patients with persistent or mild reflux symptoms antacids rapidly relieve heartburn. Alginate-antacid combination is superior both over placebo and antacids to treat mild reflux symptoms, and can be used to treat persistent reflux symptoms despite acid suppressant therapy. Sucralfate is superior over placebo in alleviating GERD symptoms and can be used as maintenance therapy. Guaiazulene-dimethicone improves the quality of life in patients with GERD. Conclusions: Drugs used to protect the esophageal mucosa against acid are useful in alleviating chronic heartburn, especially in patients with mild reflux symptoms. Abbreviations: CS: Chondroitin sulfate; DA: Double Action; EE : Erosive esophagitis ; GERD: Gastroesophageal reflux disease; HA: Hyaluronic acid; H2RA: Histamine 2 receptor antagonist; ITT: Intention to treat; IM: Irsogladine maleate; NERD: Non-erosive reflux disease; PPIs: Proton pump inhibitors; RCT: Randomized controlled trial; RDQ: Reflux disease questionnaire; QoL: Quality of life.

Primary laparoscopic fundoplication in selected patients with gastroesophageal reflux disease

2021 ◽  
Author(s):  
K H Fuchs ◽  
W Breithaupt ◽  
G Varga ◽  
B Babic ◽  
T Schulz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Patient Selection ◽  
Laparoscopic Fundoplication ◽  
Quality Of Life Index ◽  
Selection For ◽  
Gastrointestinal Quality Of Life

Summary Background Despite proton pump inhibitors being a powerful therapeutic tool, laparoscopic fundoplication (LF) has proven successful in the treatment of gastroesophageal reflux disease (GERD), through mechanical augmentation of a weak antireflux barrier and the advantages of minimally invasive access. A critical patient selection for LF, based on thorough preoperative assessment, is important for the management of GERD-patients. The purpose of this study is to provide an overview on the management of GERD-patients treated by primary LF in a specialized center and to illustrate the possible outcome after several years. Methods Patients were selected after going through diagnostic workup consisting of patient’s history and physical examination, upper gastrointestinal endoscopy, assessment of gastrointestinal Quality of Life Index, screening for somatoform disorders, functional assessment by esophageal manometry, (impedance)-24-hour-pH-monitoring, and selective radiographic studies. The indication for LF was based on EAES-guidelines. Either a floppy and short Nissen fundoplication was performed or a posterior Toupet-hemifundoplication was chosen. A long-term follow-up assessment was attempted after surgery. Results In total, n = 1131 patients were evaluated (603 males; 528 females; mean age; 48.3 years; and mean body mass index: 27). The mean duration between onset of symptoms and surgery was 8 years. Nissen: n = 873, Toupet: n = 258; conversion rateerativ: 0.5%; morbidity 4%, mortality: 1 (1131). Mean follow-up (n = 898; 79%): 5.6 years; pre/post-op results: esophagitis: 66%/12.1%; Gastrointestinal Quality of Life Index: median: 92/119; daily proton pump inhibitors-intake after surgery: 8%; and operative revisions 4.3%. Conclusions In conclusion, our data show that careful patient selection for laparoscopic fundoplication and well-established technical concepts of mechanical sphincter augmentation can provide satisfying results in the majority of patients with severe GERD.

A Durable Laparoscopic Technique for the Repair of Large Paraesophageal Hernias

2016 ◽  
Vol 82 (10) ◽  
pp. 911-915
Author(s):  
Jessica L. Reynolds ◽  
Joerg Zehetner ◽  
Nikolai Bildzukewicz ◽  
Namir Katkhouda ◽  
John C. Lipham
Keyword(s):  
Quality Of Life ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Laparoscopic Repair ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Over Time

Laparoscopic repair of large paraesophageal hernias has been challenging due to high recurrence rates with primary repair and complications associated with the use of nonabsorbable mesh to reinforce the hiatus. The aim of our study was to evaluate the recurrence rate over time and mesh-related complications using an absorbable polyglactin mesh secured with Bioglue to reinforce the hiatus after laparoscopic repair of large paraesophageal hernias. There were 190 patients who met inclusion criteria from June 2006 to June 2014. Follow-up was routinely performed at 1-year intervals, including endoscopy and/or video esophagram, and the gastroesophageal reflux disease health-related quality of life questionnaire. Mean follow-up was 21 months (3–88). There were no incidences of mesh erosion. Recurrence was detected in 17 patients (15.3%), with a median time to recurrence of 23 months (8–67). Recurrence rate was estimated with the Kaplan-Meier method to be 2.9 ± 1.6 per cent, 11.6 ± 3.7 per cent, 22.4 ± 5.6 per cent, 25.1 ± 6.0 per cent, and 29.5 ± 7.9 per cent at 12, 24, 36, 48, and 60 months, respectively. The mean gastroesophageal reflux disease health-related quality of life was 2 in patients both with and without recurrence. Laparoscopic intrathoracic stomach repair using absorbable polyglactin mesh and Bioglue for crural reinforcement is effective, safe, and durable. The rate of recurrence plateaus over time with the majority of recurrences being small to moderate asymptomatic hernias.

Sign in / Sign up

Export Citation Format

Share Document