Heartburn Research Papers - Academia.edu (original) (raw)

Eur J Clin Invest 2011Background Heartburn is commonly associated with the presence of acid in the oesophageal lumen. However, in patients with nonerosive reflux disease (NERD), the mechanism by which acid traverses the mucosa is not... more

Eur J Clin Invest 2011Background Heartburn is commonly associated with the presence of acid in the oesophageal lumen. However, in patients with nonerosive reflux disease (NERD), the mechanism by which acid traverses the mucosa is not clear. We hypothesized that the luminal acid signal traverses the oesophageal epithelium in the form of the highly permeant gas CO2, which then is reconverted to H+ in the submucosa.Materials and methods Ten patients with heartburn, normal upper endoscopy and increased oesophageal acid exposure (NERD patients) and 10 healthy subjects were enrolled. Perceptual responses to intraoesophageal acid (0·1 N HCl solution) and a high PCO2 solution were determined using a randomized cross over design. Stimulus–response functions to perfusions were quantified by three parameters: lag time to symptom perception, intensity rating and perfusion sensitivity score.Results In NERD patients, the difference in lag time to typical symptom perception, intensity rating an...

Background: Gastroesophageal reflux disease (GERD) is one of common esophageal diseases in adolescents. Recent evidence has shown that dietary patterns might be associated with GERD risk. The aim of this study was to assess the... more

Background: Gastroesophageal reflux disease (GERD) is one of common esophageal diseases in adolescents. Recent evidence has shown that dietary patterns might be associated with GERD risk. The aim of this study was to assess the association between a Mediterranean style diet (MedDiet) and GERD in a large sample of adolescents living in central Iran.Methods: This cross-sectional study conducted on 5141 adolescents aged between 13-14 years. Dietary intake assessed by using a food frequency method. The GERD diagnosed using a six-item questionnaire, which askes about its symptoms including heartburn, sense of reflux, poor sleep, medication use, nausea and epigastric pain. A binary logistic regression used to evaluate the relationship between the MedDiet score and GERD and its associated symptoms.Results: The analyses revealed that after adjustment for all possible confounding variables, the adolescents in the highest adherence to the MedDiet score had lower odds of GERD [odds ratio (OR)=...

Background and Aims Involvement of the gastrointestinal tract is common in systemic sclerosis. The aim of this study was to identify the frequency and severity of dyspeptic symptoms in systemic sclerosis patients and to identify the... more

Background and Aims Involvement of the gastrointestinal tract is common in systemic sclerosis. The aim of this study was to identify the frequency and severity of dyspeptic symptoms in systemic sclerosis patients and to identify the common patterns of upper gastrointestinal endoscopic pathology from Kashmir valley, the study being first of its kind in the region. Methods Thirty seven sequential, newly and already diagnosed cases of systemic sclerosis were taken up for the study. This included 28 patients with limited systemic sclerosis and 9 patients with diffuse disease. They were enquired about the frequency and severity of symptoms of dysphagia, acid regurgitation and heartburn. Patients were then subjected to upper gastrointestinal endoscopy to identify abnormal findings. Results Esophageal symptoms were present in 26 (70.3%) patients. 17 (60.7%) patients with limited disease showed esophageal symptoms while all 9 (100%) patients with diffuse disease showed these symptoms (p=0.0...

To assess efficacy ofDA alginate-antacidchewable tablets for reducing esophageal acid exposure in Chinese patients with gastroesophageal reflux disease (GERD) METHODS: Forty-fourpatients reporting moderately severe heartburn... more

To assess efficacy ofDA alginate-antacidchewable tablets for reducing esophageal acid exposure in Chinese patients with gastroesophageal reflux disease (GERD) METHODS: Forty-fourpatients reporting moderately severe heartburn symptomsunderwent two pHmonitoring visits. Treatment sequence was randomized:patients receivedDAalginate-antacid or placebo at one visit and the alternate treatment seven days later. Aftera standardizedreflux-provoking meal,patients took four tablets of DAalginate-antacid or placebo. Esophageal pH was measured for 4 h post-dosing,using an electrode positioned 5 cm above the lower esophageal sphincter. percentage of 4-hpost-dosing period with pH <4. Secondary endpoints:number of acid refluxepisodes (pH <4), longest reflux time,and DeMeester scores. Forty-four patients completed the study and provided data for analysis.With DA alginate-antacid, mean percentage time with pH <4was 5.1%, significantly less (p = 0.0003) than with placebo (14.8%).DAalginate-an...

BACKGROUND: Esomeprazole, an S-isomer of omeprazole, is the first proton pump inhibitor developed as an optical isomer, and it has shown high healing rates in erosive esophagitis. AIM: To evaluate the efficacy and tolerability of... more

BACKGROUND: Esomeprazole, an S-isomer of omeprazole, is the first proton pump inhibitor developed as an optical isomer, and it has shown high healing rates in erosive esophagitis. AIM: To evaluate the efficacy and tolerability of esomeprazole in subjects with erosive esophagitis, according to the Los Angeles classification study design: an open, multi-center clinical study. MATERIAL AND METHODS: Two hundred and eighteen subjects with reflux esophagitis confirmed by endoscopy were included in an open, multi-center study in Brazil. All of them received esomeprazole 40 mg, once daily, for a 4-week period. Subjects who had unhealed esophagitis by week 4 continued the treatment for another 4 weeks. The primary efficacy endpoint was the healing rates by weeks 4 and 8. The secondary endpoints were the number of patients with symptom resolution by week 4, the number of days to sustained symptom resolution, number of symptom-free days and nights and safety and tolerability of the drug. RESUL...

Paraesophageal hernias are rare and, when associated with symptoms, the risk of complications increases, becoming a surgical emergency. We report a case of a 53 year-old female with 3 weeks of clinical evolution including abdominal pain,... more

Paraesophageal hernias are rare and, when associated with symptoms, the risk of complications increases, becoming a surgical emergency. We report a case of a 53 year-old female with 3 weeks of clinical evolution including abdominal pain, nausea and occasional vomiting; 24 h prior to admission she presented intestinal occlusion. Radiographic and tomographic findings showed a paraesophageal hernia, requiring exploratory laparotomy, which demonstrated a 9 cm paraesophageal diaphragmatic defect with a hernia sac containing transverse colon, omentum, fundus and body of the stomach (this last one presented ~60% of necrosis), performing nonanatomic gastrectomy and simple diaphragmatic reconstruction. The patient had a complicated postoperative period requiring two additional surgeries attempting to correct gastrectomy dehiscence and ending with a third procedure for cervical esophagostomy and Witzel jejunostomy. Elective repair is recommended in all patients with asymptomatic paraesophagea...

ObjectiveAntireflux surgery can be proposed in patients with GORD, especially when proton pump inhibitor (PPI) use leads to incomplete symptom improvement. However, to date, international consensus guidelines on the clinical criteria and... more

ObjectiveAntireflux surgery can be proposed in patients with GORD, especially when proton pump inhibitor (PPI) use leads to incomplete symptom improvement. However, to date, international consensus guidelines on the clinical criteria and additional technical examinations used in patient selection for antireflux surgery are lacking. We aimed at generating key recommendations in the selection of patients for antireflux surgery.DesignWe included 35 international experts (gastroenterologists, surgeons and physiologists) in a Delphi process and developed 37 statements that were revised by the Consensus Group, to start the Delphi process. Three voting rounds followed where each statement was presented with the evidence summary. The panel indicated the degree of agreement for the statement. When 80% of the Consensus Group agreed (A+/A) with a statement, this was defined as consensus. All votes were mutually anonymous.ResultsPatients with heartburn with a satisfactory response to PPIs, pati...

Objective To determine if fermented soy supplementation relieves heartburn and improves gastrointestinal symptoms and quality of life, a randomized, double-blind parallel study was conducted with adults experiencing mild or moderate... more

Objective To determine if fermented soy supplementation relieves heartburn and improves gastrointestinal symptoms and quality of life, a randomized, double-blind parallel study was conducted with adults experiencing mild or moderate heartburn. Participants consumed up to 3, 1 g sachets of flavored, Lactobacillus delbrueckii fermented with soy flour (n = 23) or placebo (maltodextrin) (n = 27) sachets per heartburn incident as needed for 3 weeks. Symptom intensity at 5, 15, and 30 min post-administration was assessed using a Likert-like scale. The Gastrointestinal Symptoms Rating Scale (GSRS) and Gastro-esophageal Reflux Disease Quality of Life Questionnaire (GERD-QOL) were administered at baseline, post-intervention and following a 1-week washout. Results No significant differences between groups were seen for heartburn severity or frequency, GSRS syndromes, or GERD-QOL domains. However, individual QOL items related to inconvenience of taking medications, fear of eating, inability to...

Objectives The aim of this pilot study was to determine the effects of a fermented soy supplement on heartburn relief, gastrointestinal symptoms, and quality of life. Methods A 5-week, randomized, double-blind pilot study was conducted... more

Objectives The aim of this pilot study was to determine the effects of a fermented soy supplement on heartburn relief, gastrointestinal symptoms, and quality of life. Methods A 5-week, randomized, double-blind pilot study was conducted with adults (n = 51; 37F/14 M, 31 ± 12y) experiencing mild or moderate heartburn. Following a 1-week baseline, participants self-treated heartburn symptoms with up to 3, 1 g sachets of a non-GMO soy flour fermented by Lactobacillus delbrueckii ssp. delbrueckii Rosell-187 or placebo (maltodextrin) sachets per incident for 3 weeks followed by a 1-week washout. Differences from baseline between treatments were compared using the Wilcoxon Signed Rank test (alpha 0.05). Symptom intensity at 5, 15 and 30-min post administration was assessed using a Likert-like scale (1, no symptoms to 5, severe discomfort). The Gastrointestinal Symptoms Rating Scale (GSRS) (1-no discomfort to 7-very severe discomfort) and Gastro-oesophageal Reflux Disease Quality of Life Qu...

Cel pracyCelem pracy była ocena częstości występowania choroby refluksowej przełyku (ChR) u dziewcząt z jadłowstrętem psychicznym (JP)MetodaUdział w badaniu zaproponowano dziewczętom z JP w wieku 12-18 lat hospitalizowanym w Klinice... more

Cel pracyCelem pracy była ocena częstości występowania choroby refluksowej przełyku (ChR) u dziewcząt z jadłowstrętem psychicznym (JP)MetodaUdział w badaniu zaproponowano dziewczętom z JP w wieku 12-18 lat hospitalizowanym w Klinice Psychiatrii Wieku Rozwojowego Warszawskiego Uniwersytetu Medycznego. Kryteriami wyłączenia były: obecność innych niż JP zaburzeń psychicznych oraz leczenie lekami prokinetycznymi i(lub) lekami zobojętniającymi np. inhibitorami pompy protonowej lub antagonistami receptora histaminowego w trakcie ostatnich 2 tygodni. Od pacjentek zebrano wywiad dotyczący objawów ze strony przewodu pokarmowego mogącym odpowiadać ChR. Wykonano pomiary antropometryczne w celu oceny stanu odżywienia. U wszystkich pacjentek wykonano 24-godzinną pH-impedancję. Zapis pH-impedancyjny uznawano za nieprawidłowy, gdy ogólna liczba epizodów przekraczała 70 i/lub wyrażony w procentach ogólny czas ekspozycji błony śluzowej przełyku na kwaśną treść przekraczał 6%.WynikiDo badania włączon...

9 Arquivos Catarinenses de Medicina - Vol. 31, Nº 1-2, 2002 ... Doença do Refluxo Gastroesofágico: Sintomas Otorrinolaringológicos e Achados Videoendoscópicos ... Newton Macuco Capella1, Almir Adir Gentil2, Luciano Nascimento Saporiti3,... more

9 Arquivos Catarinenses de Medicina - Vol. 31, Nº 1-2, 2002 ... Doença do Refluxo Gastroesofágico: Sintomas Otorrinolaringológicos e Achados Videoendoscópicos ... Newton Macuco Capella1, Almir Adir Gentil2, Luciano Nascimento Saporiti3, Airton César ...

The world of health is starting to realize that there are hidden dangers behind the excessive use of synthetic drugs, so people's attention is now turning to hereditary medicine. One of them is the use of traditional herbal lolo... more

The world of health is starting to realize that there are hidden dangers behind the excessive use of synthetic drugs, so people's attention is now turning to hereditary medicine. One of them is the use of traditional herbal lolo cemcem. Preliminary studies found that 9 out of 10 residents of Penglipuran Village prefer loloh cemcem as herbal medicine because it has many benefits for treatment. The purpose of this study was to determine the behavior of using loloh cemcem as an herbal medicine in the Penglipuran village community. The research method used is a qualitative approach with an ethnographic study design and data collection techniques by means of interviews. The results showed that loloh cemcem had been used for generations, the community knew the benefits of loloh cemcem, and the personal experience felt by the community regarding the use of loloh cemcem, had the same processing method, and there were differences in how to use it in the dosage section and how many times ...

The clinical diagnosis of gastro-esophageal reflux disease (GERD) is based on the presence of typical esophageal troublesome symptoms. In clinical practice, heartburn relief following a proton pump inhibitor (PPI) trial or endoscopy can... more

The clinical diagnosis of gastro-esophageal reflux disease (GERD) is based on the presence of typical esophageal troublesome symptoms. In clinical practice, heartburn relief following a proton pump inhibitor (PPI) trial or endoscopy can confirm a diagnosis of GERD. In cases of diagnostic uncertainty or before anti-reflux interventions, combined impedance-pH monitoring (MII-pH) provides a comprehensive assessment of both physical and chemical properties of the refluxate, allowing to achieve a conclusive diagnosis of GERD. Recently, the Lyon Consensus proposed the use of mean nocturnal baseline impedance (MNBI) and post-reflux swallow-induced peristaltic wave index (PSPW-I) as novel MII-pH metrics to support the diagnosis of GERD. The calculation of MNBI and PSPW-I currently needs to be performed manually, but artificial intelligence systems for the automated analysis of MII-pH tracings are being developed. Several studies demonstrated the increased diagnostic yield MNBI and PSPW-I fo...

Patients with esophageal symptoms potentially associated to esophageal motor disorders such as dysphagia, chest pain, heartburn and regurgitation, represent one of the most frequent reasons for referral to gastroenterological evaluation.... more

Patients with esophageal symptoms potentially associated to esophageal motor disorders such as dysphagia, chest pain, heartburn and regurgitation, represent one of the most frequent reasons for referral to gastroenterological evaluation. The utility of esophageal manometry in clinical practice is: (1) to accurately define esophageal motor function, (2) to identify abnormal motor function, and (3) to establish a treatment plan based on motor abnormalities. With this in mind, in the last decade, investigations and technical advances, with the introduction of high-resolution esophageal manometry, have enhanced our understanding and management of esophageal motility disorders. The following recommendations were developed to assist physicians in the appropriate use of esophageal manometry in modern patient care. They were discussed and approved after a comprehensive review of the medical literature pertaining to manometric techniques and their recent application. This position statement ...

Multichannel impedance pH monitoring has shown that weakly acidic refluxes are able to generate heartburn. However, data on the role of different pH values, ranging between 4 and 7, in the generation of them are lacking. The aim of this... more

Multichannel impedance pH monitoring has shown that weakly acidic refluxes are able to generate heartburn. However, data on the role of different pH values, ranging between 4 and 7, in the generation of them are lacking. The aim of this study was to evaluate whether different pH values of weakly acidic refluxes play a differential role in provoking reflux symptoms in endoscopy-negative patients with physiological esophageal acid exposure time and positive symptom index and symptom association probability for weakly acidic refluxes. One hundred and forty-three consecutive patients with gastroesophageal reflux disease, nonresponders to proton pump inhibitors (PPIs), were allowed a washout from PPIs before undergoing: upper endoscopy, esophageal manometry, and multichannel impedance pH monitoring. In patients with both symptom index and symptom association probability positive for weakly acidic reflux, each weakly acidic reflux was evaluated considering exact pH value, extension, physi...

BackgroundRecently, it has been suggested that low esophageal basal impedance may reflect impaired mucosal integrity and increased acid sensitivity. We aimed to compare baseline impedance levels in patients with heartburn and... more

BackgroundRecently, it has been suggested that low esophageal basal impedance may reflect impaired mucosal integrity and increased acid sensitivity. We aimed to compare baseline impedance levels in patients with heartburn and pathophysiological characteristics related to functional heartburn (FH) divided into two groups on the basis of symptom relief after proton pump inhibitors (PPIs).MethodsPatients with heartburn and negative endoscopy were treated with esomeprazole or pantoprazole 40 mg daily for 8 weeks. According to MII‐pH (off therapy) analysis, patients with normal acid exposure time (AET), normal reflux number, and lack of association between symptoms and refluxes were selected; of whom 30 patients with a symptom relief higher than 50% after PPIs composed Group A, and 30 patients, matched for sex and age, without symptom relief composed Group B. A group of 20 healthy volunteers (HVs) was enrolled. For each patient and HV, we evaluated the baseline impedance levels at channe...

Introduction: Dyspepsia is a common problem in regular outpatient clinical practice. In Kashmir province of North India little research has been done on studying clinically important endoscopic findings in non resolving dyspeptic patients... more

Introduction: Dyspepsia is a common problem in regular outpatient clinical practice. In Kashmir province of North India little research has been done on studying clinically important endoscopic findings in non resolving dyspeptic patients of different ages and ethnicities. The purpose of this study was to assess the diagnostic value of Upper Gastrointestinal Endoscopy (UGIE) in patients with non resolving dyspepsia who had not undergone endoscopic evaluation previously. Aim: To determine the diagnostic value of endoscopy in patients with non resolving dyspepsia and to correlate the endoscopic findings with clinical perspective of patients with or without alarming symptoms and signs. Materials and Methods: This retrospective cross-sectional, single-centre study was done in the Department of General Medicine, SKIMS Medical College and Hospital (tertiary care hospital), Srinagar, Jammu and Kashmir, India, from July 2017 to June 2022. Study involved 1600 patients who presented with non ...