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Effects of Esophageal Acidification on Troublesome Symptoms: An Approach to Characterize True Acid GERD in Dysphagic Neonates

AbstractTo quantify and compare maximal extent (height) of acid reflux events (AREs) on symptom generation in dysphagic neonates. Dysphagic neonates (N = 53), born at 30 ± 5.3 weeks gestation, underwent 24-hour pH-impedance study for the evaluation of troublesome symptoms purported to be due to gastroesophageal reflux disease (GERD). AREs (pH 4  s) detected by impedance (Z) were categorized by maximal extent as refluxate reaching distal (Z6, Z5), middle (Z4, Z3), or proximal (Z2, Z1) impedance channels. AREs reaching the pH sensor only were categorized as distal. Symptom correlation (%, symptom index, symptom sensitivity index, and sympto m associated probability) and temporal characteristics (clearance times) of AREs were analyzed using linear mixed and GEE models comparing height categories presented as mean ± SEM, median (IQR), and OR (95% CI). Of the 2003 AREs, 1) distal extent AREs (n = 1642) had increased frequency (p 
Source: Dysphagia - Category: Speech Therapy Source Type: research

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AbstractBackgroundGastroesophageal reflux disease (GERD) is the most common chronic gastrointestinal disorder, affecting one third of the population worldwide. Recently, there has been a renewed interest in Stretta therapy in view of potential long-term side effects of PPIs and the durability of relief with fundoplication.MethodProspective randomized study comparing the Stretta treatment with controls receiving PPIs. Patient (>  18 years,n = 20) with symptoms of heartburn, regurgitation, abnormal esophageal acid exposure (≥ 4%), and endoscopically confirmed esophagitis were included into ...
Source: Indian Journal of Gastroenterology - Category: Gastroenterology Source Type: research
ConclusionsExtraesophageal manifestations of GERD are common, costly, and difficult to treat. ARS might be effective in highly selected patients, especially in those whose extraesophageal manifestations are caused by non-acid reflux. The available data to date are generally of poor quality or outdated. Well-designed randomized controlled trials or large-scale observational cohort studies are urgently needed.
Source: World Journal of Surgery - Category: Surgery Source Type: research
Gastroesophageal reflux disease encompasses a wide spectrum of disorders related to the reflux of gastric contents into the esophagus. Extraesophageal reflux (EER) may be suspected in patients with unexplained chronic cough, pharyngolaryngeal symptoms, and asthma. For physicians, suspected EER is challenging as there is currently no tool that can reliably make a definitive diagnosis. Endoscopic signs are not specific, pharyngeal and proximal reflux monitoring are not reliable, and if distal pH or pH-impedance monitoring can identify patients with abnormal reflux, they cannot predict the response to therapy. Controlled rand...
Source: Journal of Clinical Gastroenterology - Category: Gastroenterology Tags: Clinical Reviews Source Type: research
Abstract ObjectivesSymptomatic cervical heterotopic gastric mucosa also addressed as cervical inlet patch (CIP) may present in varying shapes and causes symptoms of laryngopharyngeal reflux (LPR) like globus sensations, hoarseness and chronic cough. Unfortunately, argon plasma coagulation, standard treatment of small symptomatic CIP, is limited in large CIP mainly due to concerns of stricture formation. Therefore, we aimed to investigate radiofrequency ablation (RFA), a novel minimalā€invasive ablation method, in the treatment of CIP focusing on large symptomatic patches. MethodsConsecutive patients with macroscopic and h...
Source: Digestive Endoscopy - Category: Gastroenterology Authors: Tags: Original Article Source Type: research
ConclusionsOur study confirms that respiratory symptoms often complicate EA and TEF; their persistence despite medical and surgical treatment of GER means that other etiological hypothesis must be examined and that a complete respiratory diagnostic work up must be considered.
Source: Italian Journal of Pediatrics - Category: Pediatrics Source Type: research
Authors: Sadeghi MH, Morice AH Abstract Although the aetiology of chronic cough in guidelines is clearly stated as asthma and related syndromes, gastro-oesophageal reflux disease (GORD), and upper airways disease, the inflammatory mechanisms underlying these conditions differ. Recent studies on asthma have increasingly focused on its molecular phenotypes instead of clinical characteristics. Here, we proposed the hypothesis that divides cough into two groups; the eosinophilic and neutrophilic. This division will enhance our ability to recognise the type of airway inflammation which, as a consequence will lead us to ...
Source: Open Respiratory Medicine Journal - Category: Respiratory Medicine Tags: Open Respir Med J Source Type: research
ConclusionsEndoscopically proven GERD was associated with more severe OSA. GERD symptoms were also associated with deteriorated sleep quality.
Source: Sleep and Breathing - Category: Respiratory Medicine Source Type: research
CONCLUSIONS: Endoscopically proven GERD was associated with more severe OSA. GERD symptoms were also associated with deteriorated sleep quality. PMID: 28687968 [PubMed - as supplied by publisher]
Source: Sleep and Breathing - Category: Sleep Medicine Authors: Tags: Sleep Breath Source Type: research
HEARTBURN, also known as acid reflux or indigestion can cause an unpleasant taste in the mouth, a sore throat, chronic cough and pain in the chest.
Source: Daily Express - Health - Category: Consumer Health News Source Type: news
DiscussionRefractory GERD can be surgically managed with various techniques. In obese individuals, laparoscopic Roux-en-Y gastric bypass should be considered due to significant symptom improvement and lower incidence of recurrent symptoms with weight loss. Otherwise, laparoscopic Nissen fundoplication is the preferred surgical technique for treatment of this disease with concomitant hiatal hernia repair when present for either procedure. The short-term risks associated with these procedures include esophageal or gastric injury, pneumothorax, wound infection, and dysphagia. Emerging techniques for treatment of this disease ...
Source: Journal of Gastrointestinal Surgery - Category: Surgery Source Type: research
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