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 Anti-Heartburn Effects of Sugar Cane Flour: A Double-Blind, Randomized, Placebo-Controlled Study

Nutrients ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1813
Author(s):  
Jeffrey M. Beckett ◽  
Neeraj K. Singh ◽  
Jehan Phillips ◽  
Krishnakumar Kalpurath ◽  
Kent Taylor ◽  
...  
Keyword(s):  
Pilot Study ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Intervention Group ◽  
Controlled Study ◽  
Control Group ◽  
Life Questionnaire ◽  
Positive Effects ◽  
Symptom Scores

Gastroesophageal reflux disease (GERD) affects approximately 20% of Australians. Patients suffer a burning sensation known as heartburn due to the movement of acidic stomach content into the esophagus. There is anecdotal evidence of the effectiveness of prebiotic sugarcane flour in controlling symptoms of GERD. This pilot study aimed to investigate the effectiveness of a prebiotic sugarcane flour in alleviating symptoms in medically-diagnosed GERD patients. This pilot study was a single center, double-blinded, placebo-controlled randomized trial conducted on 43 eligible participants. The intervention group (n = 22) were randomized to receive 3 g of sugarcane flour per day, and the control group (n = 21) received 3 g of cellulose placebo per day. Symptoms of gastroesophageal reflux disease were assessed before and after three weeks treatment using the validated Gastroesophageal Reflux Disease-Health Related Quality of Life questionnaire (GERD-HRQL). After three weeks there were significant differences in symptoms for heartburn, regurgitation, and total symptoms scores (p < 0.05) between the sugarcane flour and placebo. Mean GERD-HRQL scores increased in the placebo group for regurgitation (mean increase 1.7; 95% CI 0.23 to 3.2; p = 0.015) and total symptom scores (2.9; 95% CI 0.26 to 5.7; p = 0.033). In contrast, there were significant reductions in heartburn (mean decrease −2.2; 95% CI −4.2 to −0.14; p = 0.037) and total symptom scores (−3.7; 95% CI −7.2 to −0.11; p = 0.044) in the intervention group. This pilot study has shown significant positive effects of sugarcane flour in the reduction of GERD symptoms, and a larger randomized controlled trial is warranted.

scholarly journals Treatment of Non-erosive Effect of Clinical Study of Gastroesophageal Reflux Disease

2018 ◽  
Vol 6 (3) ◽  
Author(s):  
Qian Liu
Keyword(s):  
Treatment Group ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Clinical Symptoms ◽  
Effective Rate ◽  
Control Group ◽  
Significant Difference ◽  
Before And After ◽  
And Control

<p class="18">Abstract: Objective: To observe the clinical effect of “Chaihu Shugan Powder Zuojin Pill” in the treatment of non-erosive gastroesophageal reflux disease. Methods: Sixty patients with non-erosive gastroesophageal reflux disease were randomly divided into treatment group and control group (30 cases in each group). The patients were treated with “Zaohu Shugan Powder” and “Zangjin Pills” and omeprazole respectively. For 8 weeks, the clinical efficacy and changes in clinical symptoms were observed. Results: The total effective rate was 93.3% in the treatment group and 80.0% in the control group. There was significant difference between the two groups before and after treatment (P &lt;0.05). Conclusion: “Chaihu Shugan Powder Zuojin Pill” can effectively improve the clinical symptoms of non-erosive gastroesophageal reflux disease.</p>

scholarly journals Klotho protein as a mediator of antioxidant defense in young people with gastroesophageal reflux disease and autoimmune thyroiditis

2020 ◽  
Vol 49 (4) ◽  
pp. 73-77
Author(s):  
T. M. Pasiieshvili
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Young People ◽  
Gastroesophageal Reflux ◽  
Autoimmune Thyroiditis ◽  
Reflux Disease ◽  
Antioxidant Defense ◽  
Control Group ◽  
Morphological Form ◽  
Significant Difference ◽  
Klotho Protein

Aim: to establish the content and role of Klotho protein in the pathogenesis of gastroesophageal reflux disease, which occurs against the background of autoimmune inflammation in young people. Materials and methods. Three groups of patients were involved in the study: with the gastroesophageal reflux disease (GERD ) and autoimmune thyroiditis (AIT ) (120 persons), isolated GERD (45) and AIT (42) aged 18 to 25 years, of the same sex and duration of the disease. The content of Klotho protein was determined in the serum by ELISA, Elabscience reagents (ELISA, USA). Results. Significant increase in Klotho protein was detected in patients with GERD and especially in its combination with AIT relative to the control. Content of Klotho protein did not correlate with the morphological form of the disease and its duration. In patients with isolated AIT , Klotho protein level did not have a significant difference with control group. Conclusion. The GERD and its combination with AIT in young people are accompanied by an increase in Klotho protein content, as a result of the presence of an active inflammatory process in the esophagus mucosa and its stimulating effect on antioxidant defense processes.

scholarly journals Clinical features of gastroesophageal reflux disease in children with different genotypes of C825T polymorphic loci of GNB3 gene

2017 ◽  
Vol 86 (3) ◽  
pp. 207
Author(s):  
Marta Dats-Opoka ◽  
Halyna Makukh
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Nutritional Status ◽  
Clinical Features ◽  
Reflux Disease ◽  
Control Group ◽  
Healthy Children ◽  
Polymorphic Loci ◽  
Increased Risk ◽  
Significant Difference

Introduction. Considering the steady growth of the gastroesophageal reflux disease (GERD) in children in recent decades, the difficulty of GERD diagnosing in children, the variety of GERD clinical and morphological features as well as the factors that cause it, including genetic predisposition, a detailed analysis of each of them remains relevant.Aim. To analyze the peculiarities of nutritional status in children with GERD and its correlation with the different genotypes of C825T polymorphic loci of GNB3 gene as well as its association with different GERD clinical manifestations.Material and Methods. The analysis of GERD clinical features was carried out and the nutritional status in 100 children of school age was estimated. Molecular and genetic research of C825T loci of GNB3 gene using PCR method (rs5443) was carried out in the studied group (100 children) and in 40 healthy children that formed the control group.Results. The distribution of the genotypes of C825T polymorphic loci of the GNB3 gene in children with GERD and healthy children in the control group did not have any statistically significant difference (χ2 = 0.27, р = 0.87). Among more than a half of the children in both groups, the GNB3 825ST heterozygous genotype were detected (54.0% of the experimental group and 57.5% of the control group), according to de Vries et al. data is a factor of GERD increased risk. The association between the genotype of C825T locus of GNB3 gene and the data of intragastric endoscopy with pH monitoring was found: in patients with hyperacidic GERD the genotype 825CT was predominantly revealed, and in children with normal and hypoacidic GERD a higher frequency of the 825TT genotype was found. In children with GERD having a lack of the nutritional status (61%), the genotype 825CT (61.82%, p = 0.013) and 825TT (100%, p = 0.005) of the GNB3 gene were detected significantly more often.Conclusions. The distribution of the genotypes of C825T polymorphic loci of the GNB3 gene in children with GERD was determined. Differences in GERD development depending on the different GNB3 genotypes were not detected. The distribution of the genotypes of C825T loci of the GNB3 gene remained unchanged at different GERD clinical manifestations. The presence of 825CT and 825TT genotypes of GNB3 gene in patients with GERD is associated with a decrease in physical development signs. The association between genotype of C825T loci of GNB3 gene and pH intragastric endoscopy data was identified: in patients with hyperacidity GERD 825CC genotype was usually found, and in children with normal- and hypoacidity GERD 825TT genotype was usually found.

Clinical observation of different anti-reflux methods in the treatment of gastroesophageal reflux disease with hiatus hernia

2021 ◽  
Author(s):  
Zhi-tong Li ◽  
Rui Zhang ◽  
Xin-wei Han ◽  
Chun-xia Li ◽  
Li Wang ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Postoperative Period ◽  
Hiatus Hernia ◽  
Reflux Disease ◽  
Operation Time ◽  
Control Group ◽  
Demeester Score ◽  
Significant Difference ◽  
Experimental Group

Abstract Hiatus hernia (HH) is a common benign disease of the digestive tract, which weaks the function of the anti-reflux barrier and causes gastroesophageal reflux disease (GERD). Laparoscopic HH repair and fundoplication is a classic surgical treatment for GERD patients with HH; however, some patients may complain of dysphagia and gas-bloating after the operation. For reducing complications of fundoplication, we adopted a new type of anti-reflux surgery for GERD treatment. We analysed our database of 40 patients with GERD plus HH who had LDF or a new anti-reflux surgery. At 12 months　after surgery, the total score(Sc), DeMeester score, numbers of reflux detected by impedance monitoring all decreased in two groups postoperatively, and there was no significant difference between the two groups after surgery. The minimum respiratory value increased after the operation in the control group, but there was no significant difference between the two groups. The mean respiratory value both increased in two groups postoperatively, and there was no significant difference between the two groups. The dysphagia in the experimental group was less common than that in the control group from early to 12 months after surgery. There was no significant difference in gas-bloating between the two groups in the early postoperative period but it was significantly lower in the experimental group than that in the control group in the late postoperative period. The short-term efficacy of the new anti-reflux surgery is the same as that of the LDP in the treatment of GERD with HH; however, the operation time, intraoperative blood loss, and the surgical complication rate are lower than that of the LDF, therefore, it is more commonly recommended.

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.

scholarly journals THE EFFICACY OF THE DIFFERENT ENDOSCOPIC TREATMENTS VERSUS SHAM, PHARMACOLOGIC OR SURGICAL METHODS FOR CHRONIC GASTROESOPHAGEAL REFLUX DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS

2018 ◽  
Vol 55 (3) ◽  
pp. 296-305 ◽  
Author(s):  
Martin Andrés CORONEL ◽  
Wanderley Marques BERNARDO ◽  
Diogo Turiani Hourneaux de MOURA ◽  
Eduardo Turiani Hourneaux de MOURA ◽  
Igor Braga RIBEIRO ◽  
...  
Keyword(s):  
Systematic Review ◽  
Surgical Treatment ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Meta Analysis ◽  
Short Term ◽  
Significant Difference ◽  
Objective Outcomes

ABSTRACT BACKGROUND: Endoscopic antireflux treatments for gastroesophageal reflux disease (GERD) are still evolving, and most of the published studies address symptom relief in the short-term. Objective - We aimed to perform a systematic review and meta-analysis focused on evaluating the efficacy of the different endoscopic procedures. METHODS: Search was restricted to randomized controlled trials (RCTs) on MedLine, Cochrane, SciELO, and EMBASE for patients with chronic GERD (>6 months), over 18 years old and available follow up of at least 3 months. The main outcome was to evaluate the efficacy of the different endoscopic treatments compared to sham, pharmacological or surgical treatment. Efficacy was measured by different subjective and objective outcomes. RESULTS: We analyzed data from 16 RCT, totaling 1085 patients. The efficacy of endoscopic treatments compared to sham and proton pump inhibitors (PPIs) treatment showed a significant difference up to 6 months in favor of endoscopy with no heterogeneity (P<0.00001) (I2: 0%). The subgroup analysis showed a statistically significant difference up to 6 months in favor of endoscopy: endoscopy vs PPI (P<0.00001) (I2: 39%). Endoscopy vs sham (P<0.00001) (I2: 0%). Most subjective and objective outcomes were statistically significant in favor of endoscopy up to 6 and 12 months follow up. CONCLUSION: This systematic review and meta-analysis shows a good short-term efficacy in favor of endoscopic procedures when comparing them to a sham and pharmacological or surgical treatment. Data on long-term follow up is lacking and this should be explored in future studies.

scholarly journals Food patterns in Russian patients with gastroesophageal reflux disease: the results of pilot comparative study

2020 ◽  
Vol 92 (8) ◽  
pp. 66-72
Author(s):  
V. S. Kropochev ◽  
S. V. Morozov ◽  
M. A. Lantseva ◽  
A. N. Sasunova ◽  
V. I. Pilipenko ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Healthy Eating ◽  
Reflux Disease ◽  
Final Analysis ◽  
Control Group ◽  
Esophageal Ph ◽  
Symptom Evaluation ◽  
Source Data ◽  
Acid Exposure Time

Aim. To evaluate nutritional patterns in patients with gastroesophageal reflux disease (GERD) compared to the control group without GERD. Materials and methods. The data of complex examination of patients referred to perform esophageal pH-impedance recording and who gave written informed consent to participate in the study served as a source data. All the participants underwent complex examination, including clinical data (presence of heartburn and acid regurgitation), symptom evaluation (GERD-Q questionnaire), esophagogastroscopy, esophageal pH-impedance recordings and food frequency questionnaire. Diagnosis of GERD was based on GERD-Q score 8, acid exposure time 6%, number of gastroesophageal refluxes 80/day by 24-hrs esophageal pH-impedance recordings. Nutritional patterns were assessed with the use of healthy eating pyramid principles. Results. Overall 165 patients were enrolled and the data of 150 of them (34 with confirmed GERD and 116 of the control group) were available for the final analysis. The patients of the both groups consumed lower compared to the recommended amounts of dairy and higher amounts of meat. Those with GERD consumed larger amounts of fruits (0.910.68 compared to the values of healthy eating pyramid vs 0.520.57 in the control group, p=0.001), and fats (0.690.55 vs 0.490.55, p=0.001). Compared to the controls, patients with GERD consumed lower amounts of vegetables (0.860.46 of the healthy eating pyramid vs 0.940.63 in the control group, р=0.004) and sugars confectionaries (0.380.39 vs 1.930.98, p=0.0001). Conclusion. Nutritional patterns of patients with gastroesophageal reflux disease significantly differ compared to the control group. The obtained data may be used for diet modification in patients with arterial hypertension.

scholarly journals Disorders of social functioning and quality of life in patients with gastroesophageal reflux disease while combined with undifferentiated connective tissue dysplasia

2020 ◽  
Vol 3 (1) ◽  
pp. 11-16
Author(s):  
Iryna Romash
Keyword(s):  
Quality Of Life ◽  
Gastroesophageal Reflux Disease ◽  
Connective Tissue ◽  
Gastroesophageal Reflux ◽  
Social Functioning ◽  
Reflux Disease ◽  
Control Group ◽  
Group I ◽  
Group Ii

Introduction. It has been scientifically confirmed that the risk of developing gastroesophageal reflux disease (GERD) increases especially with generalized or regional disruption of connective tissue structure, which is widespread among the population. Patients with such comorbid pathology may have a wide range of symptoms that may go beyond the general symptoms of heartburn and regurgitation. The symptoms and complications of GERD affect general health, daily and social functioning, physical and emotional activity. It also affects the quality of life (QoL) associated with health through frequent breaks during sleep, work and social activities. Purpose. study the dynamics of the level of quality of life and social functioning in patients with gastroesophageal reflux disease in combination with the syndrome of undifferentiated connective tissue dysplasia. Methodology. A total of 120 patients were included in the study: 65 men and 55 women: in 75 of them (Group II) GERD occurred on the background of UCTD, in 45 (Group I) as an independent disease. The control group consisted of 12 healthy individuals. The study was comprehensive. The Medical Outcomes Study 36-Item Short-Form Health Status (SF-36),the Gastrointestinal Symptom Rating Scale (GSRS) and the scale of "Personal and social performance" (PSP) -  were used to study patients in detail. Results and Discussion. Analyzing the results obtained on the basis of the GSRS questionnaire (Table 1), in patients with GERD on the background of UCTD, compared with patients of group I and the control group, there is a significant increase in three and four from the five scales. QoL in patients of Group II on the scale "Abdominal pain" were 14.3 ± 0.4 points, in Group I - 5.6 ± 1.3 points, in the Control Group - 2.4 ± 0.8 points, on the scale "Reflux syndrome": 13.7 ± 0.9, 10.5 ± 1.3 and 3.1 ± 0.9, respectively. "Dyspeptic syndrome" - 15.3 ± 0.4 points in Group II, 12.2 ± 0.6- in Group I and 6.1 ± 0.3- in the control group. "Constipation syndrome" 9.5 ± 0.8, 5.6 ± 1.03 and 5.7 ± 0.4, respectively (p <0,05). Conclusions: In this research we investigated the effect of comorbid pathology on QoL in patients with GERD, which developed against the background of UCTD. The results confirm that patients with such combined pathology have a lower level of quality of life and social functioning, and the tactics of treatment of such patients should take into account these changes

scholarly journals Efficacy and Safety of Robotic Dor Fundoplication on Severe Gastroesophageal Reflux Disease in Patients With Scleroderma

2021 ◽  
Vol 9 ◽  
pp. 232470962110512
Author(s):  
Priyadarshini Loganathan ◽  
Mahesh Gajendran ◽  
Brian Davis ◽  
Richard McCallum
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Surgical Complication ◽  
Smooth Muscles ◽  
Dor Fundoplication ◽  
High Resolution Manometry ◽  
Refractory Gerd ◽  
Significant Impairment ◽  
Gerd Symptoms

Systemic sclerosis (SSc) is a disease that affects the gastrointestinal tract resulting in its atrophy and fibrosis of smooth muscles. Approximately 80% of SSc patients develop both gastroesophageal reflux disease (GERD) and dysphagia. The nocturnal GERD can cause regurgitation and aspiration, which can further aggravate the pulmonary fibrosis from SSc. Also, their dysphagia is further worsened by performing standard Nissen fundoplication. Therefore, we aimed to investigate whether Dor fundoplication (a 180° anterior wrap) can reduce nocturnal heartburn and regurgitation without worsening dysphagia in patients with SSc and severe GERD. Five SSc patients with drug-refractory severe GERD underwent a Dor fundoplication procedure with a median follow-up of 2 years (range: 1-5 years). In all 5 patients, the preoperative high-resolution manometry showed significant impairment of esophageal motility. Patients were interviewed postoperatively to assess for nocturnal and diurnal GERD symptoms, treatment response, the status of dysphagia, and adverse effects of surgery. The average age of 5 patients was 50 years and all were females. Four of the 5 patients (80%) reported 90% improvement in both diurnal and nocturnal GERD symptoms since surgery, with no nocturnal reflux, heartburn, or regurgitation, and reports to sleep at night without requiring any more pillows or wedges. About 50% of patients reported a decrease in their proton pump inhibitor dosage after surgery compared to before surgery. No surgical complication was reported and specifically, no worsening of dysphagia. The Dor fundoplication performed for refractory GERD in SSc patients substantially decreases heartburn and regurgitation, primarily nocturnal, without affecting dysphagia, thus improving the quality of life.

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