The Effect of Alginate in Gastroesophageal Reflux in Infants
AbstractBackgroundGuidelines are contradictory regarding the use of alginate in infants with persisting gastroesophageal reflux (GER). While The British National Institute for Health and Care (NICE) guidelines consider alginate as a treatment option, the guidelines of the European and North-American Societies for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN, NASPGHAN) do not recommend alginates.AimsWe assessed the efficacy of alginate to reduce GER episodes in infants.MethodsIn a prospective, observational study, we consecutively enrolled all infants referred for pH-multiple intraluminal impedance (pH-MII) recording because of persisting GER symptoms not responsive to behavior and dietetic modifications. A 48-h pH-MII was performed in all infants; a baseline recording was performed during the first 24 h while magnesium or sodium alginate was administered during the second 24 h. The primary endpoint was the difference in the total number of GER episodes per 24 h between the baseline day and the second day during which the alginate was administered. The secondary outcome was the difference in s ymptoms between each period. We also compared other pH-MII data from before and during alginate administration.ResultsWe recruited 43 infants (median age 68 days, range 25–306); three pH-MII tracings were excluded because of artifacts. The median number of all MII reflux episodes was significantly reduced during alginate administration (76.0 v...
AbstractBackgroundThe purpose of this study was to determine whether magnetic sphincter augmentation (MSA) could effectively treat patients with gastroesophageal reflux disease (GERD) who suffer primarily fromatypical symptoms due to laryngopharyngeal reflux (LPR). MSA has been shown to treattypical symptoms of GERD with good success, but its effect onatypical symptoms is unknown.MethodsA retrospective review of a prospectively maintained institutional review board-approved database was conducted for all patients who underwent MSA between January 2015 and December 2018. All patients had objective confirmation of GERD from ...
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 38-year-old man is evaluated for a 6-month history of dyspnea on exertion. He has gastroesophageal reflux disease and Raynaud phenomenon. He does not smoke and has no cough or wheezing. Current medications are lansoprazole and amlodipine. On physical examination, vital […]Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Conclusions: CC causes other than asthma, UACS and GER are not rare in non-smoking adults and should be considered in the differential diagnosis of CC.
Conclusions: During IMP/pH monitoring patients with CVA did not record more cough episodes at night than other patients. Perception of cough episodes at night was more common in patients with GER-related cough than in patients without GER.
Conclusions: Large proportions of chronic cough patients in this trial were diagnosed with GERD, asthma, or allergic rhinitis. Despite receiving treatment for these conditions, chronic cough for these subjects had persisted for over a decade.
Conclusion: In cases of ISS where GERD is a potential causative factor, resection by endoscopy may be the treatment of choice. Once GERD is effectively treated and if symptoms are still present, one should consider tracheal resection.
Conclusions: with the exception of a later onset and higher BMI in patients with CVA, the clinical features of asthma in patients with CVA and CPA are comparable.
Conclusions: Studies have demonstrated that an increase in airway temperature can activate and sensitize some transient receptor potential vanilloid (TRPV) expressed by sensory neurons; activation of these C-fiber afferents can elicit cough. Our data demonstrate that EBT is elevated in children with chronic cough. The role of EBT in chronic cough needs further investigation.
This study demonstrates the difficulties which arise when assigning a diagnosis of asthma to a symptomatic patient. We believe that careful assessment of airway physiology should be a cornerstone of the diagnostic process in the case of this disease.
Background: Activation of afferent nerves in the esophagus is assumedly a major mechanisms of cough associated with GER, which may lead to sensitization of cough reflex. Transient receptor potential vanilloid (TRPV) 1 is one of the nociceptors activated by acid, whose expression is increased in the airways of chronic cough patients (Groneberg 2004) and in the esophagus of GER patients (Guarino 2010). The expression of nociceptors in the esophagus of patients with GER-associated cough is unknown.Method: We prospectively recruited untreated GER patients with (n=32, C+) and without (n=5, C-) cough. Esophageal endoscopy was pe...