scholarly journals Extra-Esophageal Presentation of Gastroesophageal Reflux Disease: 2020 Update

2020 ◽  
Vol 9 (8) ◽  
pp. 2559
Author(s):  
Marilena Durazzo ◽  
Giulia Lupi ◽  
Francesca Cicerchia ◽  
Arianna Ferro ◽  
Federica Barutta ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Proton Pump ◽  
Reflux Disease ◽  
Clinical Manifestations ◽  
Stomach Contents ◽  
Diagnostic Strategy ◽  
First Line ◽  
Clinical Presentations ◽  
Gerd Symptoms

Gastroesophageal reflux disease (GERD) is defined by the presence of symptoms induced by the reflux of the stomach contents into the esophagus. Although clinical manifestations of GERD typically involve the esophagus, extra-esophageal manifestations are widespread and less known. In this review, we discuss extra-esophageal manifestations of GERD, focusing on clinical presentations, diagnosis, and treatment. Common extra-esophageal manifestations of GERD include chronic cough, asthma, laryngitis, dental erosions, and gingivitis. Extra-esophageal involvement can be present also when classic GERD symptoms are absent, making the diagnosis more challenging. Although available clinical studies are heterogeneous and frequently of low quality, a trial with proton pump inhibitors can be suggested as a first-line diagnostic strategy in case of suspected extra-esophageal manifestations of GERD.

scholarly journals Extraesophageal signs of gastroesophageal reflux disease: otorhinolaryngologist’s view

2021 ◽  
Vol 93 (4) ◽  
pp. 521-525
Author(s):  
Elena Yu. Radtsig ◽  
Daniil I. Konstantinov
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Reflux Disease ◽  
Chondroitin Sulphate ◽  
Clinical Manifestations ◽  
Esophageal Mucosa ◽  
Allergenic Potential ◽  
Repairing Effect

The data on association between various pathologies of the ENT organs and gastroesophageal reflux disease (GERD) is analysed in the article. The variety of extraesophageal signs of GERD in children and adults is given, what is advisable to inform physicians of different specialties about the possibilities of antireflux therapy. These options are expanded with the emergence of a unique new drug, Alfasoxx. Its bioadhesive formula is based on hyaluronic acid and chondroitin sulphate thereby protecting the esophageal mucosa. Alfasoxx acts on the surface of the esophageal mucosa without penetrating into the systemic bloodstream and it also has a low allergenic potential, which has been confirmed by numerous studies. With its healing and repairing effect on erosive lesions of the esophageal epithelium, Alfasoxx in combination with proton pump inhibitors is more effective in achieving regression of clinical manifestations of the disease and improving patients quality of life (according to SF-36 questionnaire) compared to proton pump inhibitors monotherapy.

scholarly journals A Randomized Placebo-Controlled N-of-1 Trial: The Effect of Proton Pump Inhibitor in the Management of Gastroesophageal Reflux Disease

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Fernando Sierra-Arango ◽  
D. M. Castaño ◽  
Jennifer D. Forero ◽  
Erika D. Pérez-Riveros ◽  
Gerardo Ardila Duarte ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Proton Pump ◽  
Reflux Disease ◽  
Wilcoxon Test ◽  
Esophageal Mucosa ◽  
Single Patient ◽  
Adequate Treatment ◽  
Nonnormal Distribution ◽  
Gerd Symptoms

Background. Gastroesophageal reflux disease (GERD) is the most frequent chronic gastrointestinal disorder. It is defined as a condition developed when the reflux of gastric contents causes troublesome symptoms (heartburn and regurgitation). This requires adequate treatment since it can lead to long-term complications including esophagus adenocarcinoma. Proton pump inhibitors (PPI) are generally used to treat GERD due to their high-security profile and efficiency on most patients. However, recurrent reflux despite initial treatment is frequent. N-of-1 trial is a study that allows the identification of the best treatment for each patient. The objective of this study is to compare the efficacy of standard dose with double dosage of esomeprazole, to improve the GERD symptoms in a single patient. Methods. A single-patient trial, placebo-controlled, randomized, double-blind, was carried out from September 25th, 2012, to April 26th, 2013. It included one outpatient at the gastroenterology service in a fourth-level hospital, diagnosed with nonerosive reflux disease (NERD). Yet, his symptoms were heartburn and reflux, and his endoscopic results were normal esophageal mucosa, without hiatal hernia, though pathological pH values. A no-obese male without any tobacco or alcohol usage received esomeprazole 40 mg/day and 40 mg/bid for 24 weeks. A standardized gastroesophageal reflux disease questionnaire (GerdQ) was used weekly to evaluate symptom frequency and severity. The consumption of 90% of the capsules was considered as an adequate treatment adherence. D’agostino–Pearson and Wilcoxon test were used to determine normal or nonnormal distribution and compare both treatments, respectively, both with a significant statistical difference of p<0.05. Results. The patient completed the study with 96% of adherence. The double dosage of esomeprazole did not improve the control of symptoms compared with the standard dosage. Mean symptomatic score was 9.5±0.5 and 10.2±0.6 for each treatment, respectively (p>0.05). Conclusion. There was no significant improvement in the patient GERD symptoms increasing the dose of oral esomeprazole during the 6 months of study. N-of-1 trials in chronic pathologies including GERD are recommended due to their potential value as systematic methods that evaluate therapies without strong scientific evidence.

scholarly journals Paciente con regurgitación: cómo estudiarla y cuáles son sus principales diagnósticos diferenciales

2021 ◽  
Vol 51 (1) ◽  
Author(s):  
Mariela Dulbecco ◽  
Yolanda Vargas Rodríguez ◽  
Mauricio Guzmán
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Proton Pump Inhibitor ◽  
Gastroesophageal Reflux ◽  
Behavioral Disorders ◽  
Proton Pump ◽  
Reflux Disease ◽  
Therapeutic Approach ◽  
Stomach Contents ◽  
Functional Disorders ◽  
Typical Symptom

In gastroenterological practice, gastroesophageal reflux disease is one of the most frequent diagnoses. In this article the potential confounding of gastroesophageal reflux will be raised. According to the Montreal definition, “is a condition that develops when the reflux of stomach contents into the esophagus causes troublesome symptoms and/or complications.” However, it is becoming increasingly clear that sometimes symptoms suspected to be caused by gastroesophageal reflux disease are the expression of other functional and behavioral disorders or even structural lesions. From this complexity arise reflux confounding, where rumination and supragastric belching may present symptoms similar to gastroesophageal reflux disease, be initially treated with the proton pump inhibitor-based guidelines, and thus be mistakenly targeted. Likewise, regurgitation may be the symptomatic expression of different functional disorders and not exclusively a “typical” symptom of gastroesophageal reflux disease. Hence the need and the challenge for the treating physician to correctly identify the pathophysiological mechanisms responsible for the patient’s symptoms for a correct therapeutic approach.

Gastroesophageal Reflux Disease

2020 ◽  
Author(s):  
R. Thomas Finn III ◽  
Walter W Chan
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Erosive Esophagitis ◽  
Stomach Contents ◽  
Noncardiac Chest Pain ◽  
International Consensus ◽  
Intraluminal Impedance ◽  
Gerd Symptoms ◽  
Made In

Gastroesophageal reflux disease (GERD) is the most common gastrointestinal diagnosis made in outpatient clinics, responsible for over 5 million annual outpatient visits and likely hundreds of thousands of inpatient stays for noncardiac chest pain. GERD’s current definition, based on international consensus, is a “condition which develops when the reflux of stomach contents causes troublesome symptoms (i.e., at least two heartburn episodes per week) and/or complications.” Also defining GERD is the presence of erosive esophagitis on upper endoscopy (esophagogastroduodenoscopy [EGD]) with or without the presence of troublesome symptoms or the presence of troublesome symptoms without endoscopic evidence of erosive esophagitis (also known as nonerosive reflux disease). This review looks at GERD in detail, including its epidemiology and risk factors, genetics, pathogenesis and etiologic factors, clinical presentation and symptoms, differentials, diagnosis, and complications. Figures presented are an EGD image showing signs of erosive esophagitis, Barrett esophagus, and hiatal hernia and sample recordings from a 24-hour combined multichannel intraluminal impedance and pH testing. Tables list differential diagnoses for GERD, indications for performing EGD in patients with GERD symptoms, and a summary of GERD therapies. This review contains ­2 figures, 4 tables, and 74 references. 

scholarly journals Efficacy of proton pump inhibitor on nighttime reflux symptoms and associated sleep disturbances in patients with gastroesophageal reflux disease: A real-world study in northern China

2020 ◽  
Author(s):  
Kaidi Sun ◽  
Shuang Ma ◽  
Yang-Yang Hui ◽  
Bin Wang ◽  
Bo Yang ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Sleep Quality ◽  
Proton Pump ◽  
Reflux Disease ◽  
Sleep Disturbances ◽  
Final Analysis ◽  
Northern China ◽  
Trial Registration ◽  
Gerd Symptoms

Abstract Background Gastroesophageal reflux disease (GERD) is strongly associated with sleep disturbances. Proton pump inhibitors (PPIs) are the main treatment to improve the symptom of GERD. This study was to investigate the efficacy of PPIs on nighttime GERD symptoms and associated sleep disturbances in general Chinese GERD population. Methods Adult patients with mild or more serious nighttime GERD symptoms were included. The efficacy was evaluated by the relief rate of nighttime GERD symptoms and GERD-related sleep disturbances after 4 weeks PPIs treatment. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index Score (PSQI). Results A total of 750 patients were included in the final analysis. Overall, 51.3% of the patients had achieved a relief of nighttime GERD symptoms after 4 weeks of PPIs treatment. By week 4, the percentages of patients with completely resolved nighttime GERD symptoms and GERD-related sleep disturbances were 32.5% and 51.5%, respectively. PSQI score was significantly improved from 6.82 ± 0.12 at baseline to 4.56 ± 0.09 at 4 weeks (P༜0.001). Conclusion PPIs treatment can provide an effective relief of nighttime GERD symptoms and associated sleep disturbances, improving sleep quality of general GERD patients in northern China. Trial registration: Trial registration: CHiCTR, ChiCTR1800017652. Registered 08 August 2018, http://chictr.org.cn/index.aspx

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.

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