Gastroesophageal reflux leads to esophageal cancer in a surgical model with mice

Background  

Esophago-gastroduodenal anastomosis with rats mimics the development of human Barrett's esophagus and esophageal adenocarcinoma by introducing mixed reflux of gastric and duodenal contents into the esophagus. However, use of this rat model for mechanistic and chemopreventive studies is limited due to lack of genetically modified rat strains. Therefore, a mouse model of esophageal adenocarcinoma is needed.     

Therapeutic management of elderly patients with esophageal cancer

Background  

In an aging population, it is important to evaluate the therapeutic management of diseases. Esophagectomy is a reliable treatment for esophageal cancer, but it remains controversial for elderly patients as it could carry additional postoperative risks.     

Impedance-pH reflux patterns can differentiate non-erosive reflux disease from functional heartburn patients

Introduction  

Symptom association is important to distinguish non-erosive reflux disease [NERD; abnormal oesophageal acid exposure time (AET) and/or positive symptom association] from functional heartburn (FH; normal AET and negative symptom association). Asymptomatic patients during reflux monitoring are challenging as symptom association cannot be assessed.     

Effects of pectin liquid on gastroesophageal reflux disease in children with cerebral palsy

Background  

The use of thickeners is a standard therapy for decreasing episodes of regurgitation or vomiting in infants. However, it remains to be investigated whether thickener is effective for vomiting and/or chronic respiratory symptoms in children with cerebral palsy.     

Endoscopic observations around the gastroesophageal junction in patients with symptomatic gastroesophageal reflux disease in South Asia

Introduction  

We studied the inter-relationships of endoscopic findings around the gastroesophageal junction in patients with symptomatic gastroesophageal reflux.     

Impact of microarousal associated with increased negative esophageal pressure in sleep-disordered breathing

Purpose  

“Microarousals” during sleep have not been analyzed systematically. We investigated the importance of “microarousals” (lasting 1.5–3 s).     

A double-blind, controlled study comparing lafutidine with placebo and famotidine in Japanese patients with mild reflux esophagitis

Purpose  

This randomized, double-blind, controlled study examined whether lafutidine is superior to placebo and non-inferior to famotidine in terms of healing rates as assessed by endoscopy in Japanese patients with mild reflux esophagitis. Safety and improvement in symptoms of heartburn were also assessed.     

Patients with <Emphasis Type="Italic">Helicobacter pylori</Emphasis> infection have less severe gastroesophageal reflux disease: a study using endoscopy, 24-hour gastric and esophageal pH metry

Background and aim  

The relationship between gastroesophageal reflux disease (GERD) and Helicobacter pylori is controversial. We evaluated endoscopic, 24-h gastric and esophageal acid profile among patients with GERD in relation to H. pylori, as the latter might alter gastric acid secretion.     

Bile reflux index after therapeutic biliary procedures

Background  

Therapeutic biliary procedures disrupt the function of the sphincter of Oddi. Patients are potential "bile refluxers". The aim of this study was to assess how these procedures affect the histology-based bile reflux index (BRI), which can be used to reflect duodenogastric reflux (DGR).     

Oral symptoms including dental erosion in gastroesophageal reflux disease are associated with decreased salivary flow volume and swallowing function

Background  

This preliminary clinical study aimed to evaluate the effects of salivary flow volume and swallowing function on oral symptoms including dental erosion in gastroesophageal reflux disease (GERD).     

High prevalence of reflux esophagitis among upper endoscopies in Chinese patients with chronic liver diseases

Background  

Reflux esophagitis (RE) is increasing in prevalence in China. There are very few studies on the prevalence and factors related to RE in patients with chronic liver diseases. The aims of this study were to determine the prevalence of RE by endoscopy in patients with chronic liver diseases and the possible related predictors of RE.     

Body mass index has no effect on the results of laparoscopic fundoplication in Japanese patients with reflux esophagitis

Background  

The influence of obesity on the outcome of laparoscopic fundoplication is yet to be determined. Furthermore, results of fundoplication in Japanese patients have not been reported. Accordingly, we examined whether obesity affects the outcome of laparoscopic fundoplication in Japanese patients.     

Non-erosive reflux disease rather than cervical inlet patch involves globus

Background  

Gastroesophageal reflux is the most favored etiology for globus; however, recent studies suggest that a cervical inlet patch (heterotopic gastric mucosa in the cervical esophagus) involves globus. This study aimed to reveal whether these two conditions were associated with globus.     

Late toxicity after definitive chemoradiotherapy for esophageal squamous cell carcinoma

Background  

This study was designed to conduct a retrospective analysis of late toxicity following chemoradiotherapy (CRT) for esophageal carcinoma.     

Transient elastography for predicting esophageal/gastric varices in children with biliary atresia

Background  

Transient elastography (TE) is an innovative, noninvasive technique to assess liver fibrosis by measuring liver stiffness in patients with chronic liver diseases. The purpose of this study has been to explore the accuracy of TE and clinical parameters in predicting the presence of esophageal/gastric varices in children with biliary atresia (BA) following portoenterostomy.     

Predictors of esophageal varices in patients with HBV-related cirrhosis: a retrospective study

Background  

All patients with liver cirrhosis are recommended to undergo an evaluation of esophageal varices (EV) to assess their risk of bleeding. Predicting the presence of EV through non-invasive means may reduce a large number of unnecessary endoscopies. This study was designed to develop a predictive model for varices in patients with Hepatitis B virus-related cirrhosis.     

Systematic review of the epidemiology of gastroesophageal reflux disease in Japan

Background  

Epidemiological studies of gastroesophageal reflux disease (GERD) in Japan vary in design. This systematic review examines the prevalence of GERD in Japan, distinguishing between study methodologies, and reports on changes over time and factors potentially associated with GERD.     

Gastro esophageal reflux disease (GERD) prevalence and related risk factors in north of Iran

Background

Gastroesophageal reflux disease (GERD) is one of the most frequent disorders in daily clinical practice with numerous associated consequences. A large number of studies were conducted to determine the prevalence of GERD and its associated risk factors which led to inconsistent results. The present study was performed to evaluate the prevalence of GERD and its related risk factors in north of Iran.

Methods

Nine hundred and thirty-three educated participants aged 18–77 years who had at least a High School Diploma were enrolled in the present study. Validated Persian version of Gastroesopahageal reflux questionnaire was used to collect the data. To determine the GERD associated risk factors, logistic regression was performed.

Results

The prevalence of GERD was 53.5 % (frequent GERD: 12.1 %). Among seven potential risk factors, the positive history of reflux in first relatives (OR = 2.37, CI = 1.76–3.20, p value < 0.001) and asthma (OR = 2.605, CI = 1.553–4.368, p < 0.001) were significantly associated with GERD. Spouse history of GERD in interaction with first relatives history of GERD and smoking was significantly associated with GERD too.

Conclusion

The prevalence of GERD is increasing in our country compared to previus studies, which may lead to serious increment of malignant conditions such as esophagus adenocarcinoma.

     

Gastric tube reconstruction reduces postoperative gastroesophageal reflux in adenocarcinoma of esophagogastric junction

Background  

The anastomosis of gastric remnant to esophagus after proximal gastrectomy is the traditional surgical treatment procedure for patients with types II and III adenocarcinoma of esophagogastric junction. However, the postoperative complications such as gastroesophageal reflux are frequent.     

Impact of reflux esophagitis on the esophageal function before and after laparoscopic fundoplication

Background

High-resolution manometry (HRM), which is breakthrough testing equipment to evaluate esophageal motor function, was developed in Europe and United State and has garnered attention. Moreover, multichannel intraluminal impedance pH (MII-pH) testing has allowed us to grasp all liquid/gas reflux including not only acid but also non-acid reflux. We examined the impact of the presence of reflux esophagitis (RE) on esophageal motor function before and after laparoscopic fundoplication.

Materials and methods

The subjects included 100 patients (male: 63 patients, mean age: 54.1?±?15.8) among 145 patients who underwent laparoscopic fundoplication for GERD associated diseases during a 4-year period from October 2012 to September 2016, excluding 6 patients who underwent further surgery, 32 patients on whom HRM was not performed, 3 patients who had technical errors during testing, and 4 patients for whom the status of RE was unknown. Regarding HRM, Mano Scan from Given Imaging Ltd. was used, and for the analysis, Mano View version 3.0 from the same company was used, after which data was calculated based on the Chicago Classification advocated by Pandolfino et al. Moreover, for the MII-pH testing, Sleuth manufactured by Sandhill Scientific. Inc. was used and automatic analysis was conducted by a computer. Postoperative assessments were conducted 3 months following surgery for all. Data was described in the median value and inter-quartile range, with a statistically significant difference defined as p?<?0.05 by Chi square, Mann–Whitney, and Wilcoxon tests.

Results

RE+?group (Los Angeles classification A:B:C:D?=?7:9:16:12 patients) included 44 patients (44%), of older age compared to the RE? group (62 vs. 50 years, p?=?0.012) and a higher Body Mass Index value (24.0 vs. 22.5, p?=?0.045); however, no differences were observed in terms of gender and duration of symptoms. In the preoperative findings on MII-pH, the RE+?group demonstrated significantly longer acid reflux time (4.7 vs. 1.3%, p?=?0.005), while in the HRM findings, the RE? group demonstrated a significantly longer abdominal esophagus (0 vs. 0.4 cm, p?=?0.049) and maintained esophageal body motor function (DCI: 1054 vs. 1407 mmHg s cm, p?=?0.021, Intact peristalsis ratio: 90 vs. 100%, p?=?0.037). As to the comparison of the treatment effect before and after laparoscopic fundoplication (Toupet fundoplication for all), significant improvements were observed in both groups in various parameters regarding reflux including acid reflux time, total number of liquid reflux episodes and total number of reflux episodes. Moreover, for both groups, the total length of the lower esophageal sphincter (LES) (RE+?group: 2.7 vs. 3.2 cm, p?=?0.001, RE? group: 3.0 vs. 3.4 cm, p?=?0.003) and the total length of the abdominal esophagus (RE+?group: 0 vs. 1.6 cm, p?<?0.001, RE? group: 0 vs. 1.8 cm, p?=?0.001) were significantly extended following surgery; however, no change was observed in DCI before and after surgery.

Conclusions

Regardless of the presence of RE, cardiac function and LES function were improved following laparoscopic Toupet fundoplication, but no changes were observed in esophageal body motor function.