Effects of Endoscopic Full-Thickness Plication On GERD Measured By Multichannel Intraluminal Impedance Monitoring
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Bolus (digestion)
Esophageal pH monitoring
瞄准：为了检验长期的质子的效果，抽禁止者(PPI ) 身体重量(BW ) 和在有胃的食道的倒流疾病(GERD ) 的病人的身体质量索引(BMI ) 上的治疗。方法：题目是有 GERD 和 58 匹配性、匹配年龄的健康控制的 52 个病人。GERD 病人为 2.2 年的一个平均数与 PPI 被对待(范围， 0.8-5.7 年) ，并且也在生活方式上劝告了修正(例如选择饮食，重量管理) 。BW， BMI 和另外的参数在学习的基线和结束被测量。结果：24 个 GERD 病人每天与 10 mg omeprazole 被对待， 12 与 20 mg omeprazole， 8 与 10 mg rabeprazole， 5 与有 30 mg lansoprazole 的 15 mg lansoprazole，和 3 个病人。在基线，在在倒流病人和控制之间的 BW 和 BMI 没有差别。有 GERD 的病人在 BW 显示出增加(基线：56.4 +/- 10.4 kg，结束：58.6 +/- 10.8 kg，吝啬的 +/- SD， P < 0.0001 ) 并且 BMI (基线：23.1 +/- 3.1 kg/m2，结束：24.0 +/- 3.1 kg/m2， P < 0.001 ) ，但是没有如此的变化在控制组被注意。3.5 kg (6.2% 基线) 在 37 增加的吝啬的 BW (71%) 倒流病人但是减少了在仅仅 6 (12%) 病人在治疗期间。结论：长期的 PPI 治疗与 GERD 在病人与 BW 获得被联系。收到 PPI 的倒流病人应该被鼓励通过生活方式修正管理 BW。
Lansoprazole
Rabeprazole
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Objectives To study lower esophageal pH changes and its clinical value in neonates with gastroesophageal reflux (GER).Methods Thc distal esophageal monitoring was per formed using a Synectics Digitrapper Systenl for ambulatory pH rccording. Each period longer than 15 seconds during which the pH4. 0 is defined as a reflux episode. Thirty-six cases suspected GER were done and 15 asymptomatic newborn served as controls.Results The results showed that 22 cases of 36 were physiologicaI reflux and 14 cases pathological reflux according to Boix -Ochoa score more than 11. 99 and acid reflux index more than 10% while 2 of 15 controls to be physiological reflux and the other 13 remained normal.Conclusions The results indicated that 24-hour esophageal pH monitoring should be considered as the most reliable way for early diagnosis of neonatal GER.
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One approach to diagnosis and management of gastroesophageal reflux disease (GERD) is empirical treatment with a proton-pump inhibitor (PPI) to see if symptoms resolve. But PPI response might not predict accurately the diagnosis of GERD. Researchers performed …
Esophageal pH monitoring
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Fasting gastric pH can predict the likelihood of pathologic esophageal reflux in gerd patients treated with a proton pump inhibitor
Esophageal disease
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Objective
To evaluate the prevalence and characteristics of Jackhammer esophagus (JE).
Methods
From December 2015 to December 2018, the clinical data of 20 patients with JE in the People's Hospital of Yuhuan were retrospectively analyzed.The clinical data of JE patients with typical symptoms of proton pump inhibitor reactive gastroesophageal reflux disease (GERD) were evaluated.The differences between JE patients with or without GERD or allergic esophagus were analyzed, which including esophagogastroscopy (EGD), dynamic pH impedance monitoring of proton pump inhibitors and proton pump inhibitor tests.
Results
Of 20 patients with JE, the average age was (55.86±3.23) years old, and BMI was (26.10±3.21)kg/m2.Among JE patients, 10 cases (50.0%) were GERD positive, 2 cases (10.0%) were acid sensitive esophagus, and 8 cases (40.0%) were GERD negative.There were no statistically significant differences in heartburn (P=0.167), nausea (P=0.250), dysphagia (P=0.714) or non-cardiac chest pain (P=0.906) and their duration (P=0.319) among the three types of patients.It also affected the intake of proton pump inhibitor (P=0.377) and heartburn (P=0.494). The total number of reflux in patients with positive GERD caused by JE proton pump inhibitor was significantly increased (P=0.027).
Conclusion
JE has a low prevalence rate in patients with typical symptoms of GERD and proton pump inhibitor treatment response.In this study, only nearly half of the people were diagnosed as GERD positive, which indicates that additional objective tests are needed to stratify JE phenotypes.
Key words:
Gastroesophageal reflux; Jackhammer esophagus; Proton pump inhibitor; JE-gastroesophageal reflux disease; Esophagus; Dynamic pH value; Acid allergy esophagus; oesophagitis
Heartburn
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The proton pump inhibitor (PPI) test is a short course of high-dose PPI, used to diagnose gastroesophageal reflux disease (GERD). This diagnostic strategy is commonly used globally, primarily because of its availability, simplicity, and high sensitivity. The PPI test has been proven to be a sensitive tool for diagnosing GERD in noncardiac chest pain patients and in preliminary trials in extraesophageal manifestations of GERD. Several recent meta-analyses reevaluated the value of the PPI test in patients with classic GERD-related symptoms and noncardiac chest pain. Although the results were conflicting, the PPI test remains a popular tool for determining the presence of GERD. Attempts to challenge the PPI test without offering attractive alternatives are unlikely to alter clinical practice.
Esophageal pH monitoring
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瞄准：调查成功的预言者在质子泵禁止者并且到电压降低估计生活(QOL ) 的质量。方法：一个星期或更多有心痛两次的病人每天为 8 wk 与 20 mg omeprazole (OPZ ) 被当作一次起始的治疗(学习 1 ) 。其心痛在起始的治疗的结束每周一次或少些减少了到的病人在学习 2 被注册并且与 10 mg OPZ 当作了维护治疗为一另外 6 瞬间(学习 2 ) 。QOL 在起始的治疗前用胃肠的症状等级规模(GSRS ) 被调查，在起始的治疗的 4 和 8 wk 以后，并且在在开始以后的 1， 2， 3，和 6 瞬间维护治疗。结果：在学习 1， 108 个病人被分析。他们的特征如下；中部的年龄：63 (变化：20-88 ) 年，性别：46 个女人和 62 个男人。起始的治疗的成功率是 76% 。在有成功的起始的治疗，腹的疼痛，消化不良和倒流的病人， GSRS 分数被改进。在学习 2， 83 个病人被分析。83 个病人中的七十个完成了学习 2 协议。在每协议分析， 70 个病人中的 80% 个是成功的为电压降低。在基线的 multivariate 分析上人口统计的数据和临床的信息，为 gastroesophageal 倒流疾病(GERD ) 的没有以前的治疗[机会比率(或) 0.255， 95% CI：0.06-0.98 ] 并且在在电压降低的治疗的开始的 GSRS 的一个更低的消化不良分数(或 0.214， 95% CI：0.06-0.73 ) 被发现是成功的电压降低的治疗的预言者。由起始的治疗的改进 GSRS 分数通过电压降低的治疗被维持。结论：OPZ 为大多数 GERD 病人是有效的。然而，为 GERD 和经验消化不良有以前的治疗的那些以前电压降低要求为恶化的特别监视。
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Abstract Background and Aim: Proton‐pump inhibitor (PPI) therapy is the first‐line treatment for gastroesophageal reflux disease; however, there are some reports of PPI failure in cases of non‐erosive reflux disease (NERD). Among the pathogenic factors associated with PPI‐refractory NERD, reflux other than acid reflux can not be detected by conventional pH monitoring. The purpose of this study was to clarify the usefulness of multichannel intraluminal impedance‐pH (MII‐pH) monitoring for PPI‐refractory NERD patients and examine the pathogenesis. Methods: We used MII‐pH monitoring to examine 29 PPI‐refractory NERD patients on PPI treatment. Reflux parameters, symptom index (SI: positive if ≥ 50%), and proximal migration were analyzed. The acidity of the reflux was divided into acid (nadir pH ≤ 4) and non‐acid (nadir pH > 4). Subjects were classified into reflux‐related disease (abnormal reflux parameters or positive SI) and non‐reflux‐related disease (normal reflux parameters and negative SI). Results: Of the 29 subjects, 21 were diagnosed with reflux‐related disease, including 6 with acid reflux type and 15 with non‐acid reflux type, and 8 were diagnosed with non‐reflux‐related disease. Of the total 1816 liquid reflux episodes, 834 showed proximal migration, which was more common in symptomatic reflux than in asymptomatic reflux. Conclusions: MII‐pH monitoring could distinguish reflux‐related disease (especially non‐acid type) from PPI‐refractory NERD. Proximal migration was associated with symptomatic reflux in PPI‐refractory NERD patients.
Nerd
Refractory (planetary science)
Esophageal pH monitoring
Reflux esophagitis
Pathogenesis
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Gastroesophageal reflux disease (GERD) merupakan salah satu penyakit gastrointestinal (GI) paling umum pada lanjut usia (lansia). Gejala GERD pada lansia umumnya atipikal dan tidak terlalu parah, namun lebih berisiko terjadi kelainan mukosa dan komplikasi. Proton pump inhibitor (PPI) masih menjadi sarana farmakoterapi terapi lini pertama pasien GERD lansia. Namun, penggunaan PPI pada lansia dikaitkan dengan beberapa efek samping. Hingga saat ini, belum ada konsensus mengenai durasi optimal penggunaan PPI pada lansia. Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal (GI) diseases in the elderly. GERD symptoms in the elderly are generally atypical and less severe, but with a higher risk of mucosal abnormalities and complications. Proton pump inhibitor (PPI) therapy is still the first line pharmacotherapy for elderly GERD patients. However, PPI use in elderly are associated with several side effects. To date, there is no consensus yet on the optimal duration of PPI use in the elderly.
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