Mucosal integrity and sensitivity to acid in the proximal esophagus in patients with gastroesophageal reflux disease

Acid reflux episodes that extend to the proximal esophagus are more likely to be perceived. This suggests that the proximal esophagus is more sensitive to acid than the distal esophagus, which could be caused by impaired mucosal integrity in the proximal esophagus. Our aim was to explore sensitivity to acid and mucosal integrity in different segments of the esophagus. We used a prospective observational study, including 12 patients with gastroesophageal reflux disease (GERD). After stopping acid secretion-inhibiting medication, two procedures were performed: an acid perfusion test and an upper endoscopy with electrical tissue impedance spectroscopy and esophageal biopsies. Proximal and distal sensitivity to acid and tissue impedance were measured in vivo, and mucosal permeability and epithelial intercellular spaces at different esophageal levels were measured in vitro. Mean lag time to heartburn perception was much shorter after proximal acid perfusion (0.8 min) than after distal acid perfusion (3.9 min) (P = 0.02). Median in vivo tissue impedance was significantly lower in the distal esophagus (4,563 ·m) compared with the proximal esophagus (8,170 ·m) (P = 0.002). Transepithelial permeability, as measured by the median fluorescein flux was significantly higher in the distal (2,051 nmol·cm–2·h–1) than in the proximal segment (368 nmol·cm–2·h–1) (P = 0.033). Intercellular space ratio and maximum heartburn intens...
Source: AJP: Gastrointestinal and Liver Physiology - Category: Gastroenterology Authors: Tags: NEUROGASTROENTEROLOGY AND MOTILITY Source Type: research

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CONCLUSION: In patients with heartburn and regurgitation symptoms, the prevalence of dysphagia was at least 48%, and has a positive correlation with the overall symptoms of gastroesophageal reflux.
Source: Clinics - Category: General Medicine Source Type: research
This report discusses the potential mechanisms that might underlie refractory GERD and functional heartburn, and how to distinguish among those mechanisms using a systematic evaluation that includes careful medical history, endoscopy with esophageal biopsy, esophageal manometry, and esophageal multichannel intraluminal impedance-pH monitoring. The report provides an approach to patient management that depends on the underlying mechanism identified by this systematic evaluation.
Source: Gastrointestinal Endoscopy Clinics of North America - Category: Gastroenterology Authors: Source Type: research
Most people know about the damaging effects that binge drinking can bring to someone’s life. Loss of enjoyment of life, losing family relationships, financial and career struggles, homelessness, and legal consequences are just the tip of the iceberg. However, it can be more difficult to realize the long-term effect of binge drinking on the body, because you cannot always see it. Frequent binge drinking poses many dangerous health risks, and many of them can lead to death. Facts on Long-Term Effect of Binge Drinking on the Body For men, binge drinking is defined as consuming five or more drinks within about two hour...
Source: Cliffside Malibu - Category: Addiction Authors: Tags: Alcohol Alcohol Rehab Information Alcoholism alcohol abuse alcohol dependence alcohol treatment alcohol treatment center binge binge drinking Source Type: blogs
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. PMID: 31929980 [PubMed - in process]
Source: Canadian Journal of Gastroenterology - Category: Gastroenterology Tags: Can J Gastroenterol Hepatol Source Type: research
ConclusionLaparoscopic 270 ° fundoplication achieves a better outcome than 360° total fundoplication, especially in terms of postoperative dysphagia, although other types of partial fundoplication might be equally effective.Registration no.CRD42017074783.
Source: Surgical Endoscopy - Category: Surgery Source Type: research
AbstractBackgroundBarrett ’s esophagus (BE), a complication of long-term gastroesophageal reflux disease (GERD), has been reported to affect 6–8% of those with heartburn. Most patients are males, Caucasians and middle aged. However, there are no recent demographic studies that evaluated the proportion trends of BE. We ai med to assess proportion trends of BE over an 11-year period, using a very large national dataset.MethodsThis was a population-based analysis of the national Explorys dataset. Explorys is an aggregate of electronic medical record database representing over 54 million patients. Proportions of BE...
Source: Esophagus - Category: Gastroenterology Source Type: research
Authors: Rouphael C, Shakya S, Arora Z, Gabbard S, Rice T, Lopez R, Raja S, Murthy S, Thota PN Abstract Background and aims: Acid suppressive therapy (AST) is frequently used after fundoplication. Prior studies show that most patients requiring AST after fundoplication have normal esophageal acid exposure and therefore do not need AST. Our aim was to determine the indications for AST use following fundoplication and the associated factors.Methods: Retrospective analysis of patients who underwent fundoplication at our institution between 2006 and 2013 with pre and postoperative esophageal physiologic studies was per...
Source: Scandinavian Journal of Gastroenterology - Category: Gastroenterology Tags: Scand J Gastroenterol Source Type: research
HEARTBURN and acid reflux are very common and often occur during the festive period after overindulging in food and drink. But how do you know if you have it so you can treat it and prevent it happening in the future? There are six signs to look out for.
Source: Daily Express - Health - Category: Consumer Health News Source Type: news
This study was undertaken to explore the usefulness of Robinia pseudoacacia in the treatment of GERD. Traditionally, since many centuries, Robinia pseudoacacia has been in use for various gastric disturbances in physiological doses. This study is an effort to understand its utility in GERD when prescribed on homoeopathic indications. Methods A prospective, observational study was conducted at Bakson Homeopathic College and Hospital, Greater Noida, Uttar Pradesh from 2016 to 2018. Patients who were 20 to 60 years of age suffering from heartburn and regurgitation were screened. Purposive sampling technique was used t...
Source: Homoeopathic Links - Category: Complementary Medicine Authors: Tags: Original Article Source Type: research
(Natural News) According to the website Healthline.com, upwards of 30 percent of all Americans suffer from Gastroesophageal Reflux Disease (GERD), a chronic condition which causes heartburn or indigestion several times a week. In addition, millions more people struggle with heartburn on a regular basis, even if they haven’t been officially diagnosed with GERD. Doctors are...
Source: NaturalNews.com - Category: Consumer Health News Source Type: news
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