Transoral incisionless fundoplication with EsophyX for gastroesophageal reflux disease: clinical efficacy is maintained up to 10 years

Conclusions Transoral incisionless fundoplication with EsophyX is an effective therapeutic option for symptomatic gastroesophageal reflux disease patients, with Hill grades I – II or hiatal hernia 
Source: Endoscopy International Open - Category: Gastroenterology Authors: Tags: Original article Source Type: research

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Heartburn and regurgitation are the primary “typical” symptoms of GERD.1 Proton pump inhibitor (PPI) therapy controls heartburn in the vast majority of patients and improves regurgitation in many, but certainly not all, patients. Dysfunction of the lower esophageal sphincter (either hypotension or transient relaxation) often combined with weakness in esophageal acid clearance is the underlying pathophysiology of reflux disease, so refractory regurgitation is not surprising because acid blockers neutralize the gastric contents but do not actually change the underlying motility deficits.
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Tags: Original article Source Type: research
Conclusions: Vegetable proteins are associated with a lower number of refluxes, particularly acid refluxes, and with a reduced number of symptoms during the first postprandial hour. This is a pilot study and future investigations are warranted to confirm these results. PMID: 29849599 [PubMed]
Source: Gastroenterology Research and Practice - Category: Gastroenterology Tags: Gastroenterol Res Pract Source Type: research
MedTech Strategist working together with The Medical Alley Association for the very first time brought their premier innovation summit to Minnesota, a place now considered by many to be the global epicenter of health innovation and care. Over the two...
Source: Medgadget - Category: Medical Devices Authors: Tags: Exclusive Source Type: blogs
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 tis...
Source: AJP: Gastrointestinal and Liver Physiology - Category: Gastroenterology Authors: Tags: NEUROGASTROENTEROLOGY AND MOTILITY Source Type: research
Abstract Background Hypersensitive esophagus (HE) is defined by endoscopy-negative heartburn with a normal acid exposure time but positive symptom association probability (SAP) and/or symptom index (SI) on impedance–pH monitoring, and proton pump inhibitor (PPI) responsiveness. Functional heartburn (FH) is distinguished by negative SAP/SI and PPI refractoriness. The clinical value of SAP and SI has been questioned. We aimed to investigate whether impairment of chemical clearance and of mucosal integrity, expressed by the postreflux swallow-induced peristaltic wave (PSPW) index and the me...
Source: Journal of Gastroenterology - Category: Gastroenterology Source Type: research
Conclusion In GERD patients off acid secretion-inhibiting medication, acid exposure in the proximal segment of the esophagus provokes symptoms earlier than acid exposure in the distal esophagus, whereas mucosal integrity is impaired more in the distal esophagus. These findings indicate that the enhanced sensitivity to proximal reflux episodes is not explained by increased mucosal permeability. PMID: 27198192 [PubMed - as supplied by publisher]
Source: Am J Physiol Gastroi... - Category: Gastroenterology Authors: Tags: Am J Physiol Gastrointest Liver Physiol Source Type: research
Abstract BackgroundMultiple rapid swallowing (MRS) during high‐resolution manometry (HRM) is increasingly utilized as provocative test to assess esophageal peristaltic reserve. The aim of this study was to evaluate the correlation between MRS response and impedance and pH (MII‐pH) parameters in endoscopy negative heartburn (ENH) patients. MethodsWe enrolled consecutive ENH patients, who underwent HRM and MII‐pH study, with a selected MII‐pH profile: abnormal MII‐pH (pH+/MII+); normal MII‐pH (pH−/MII−). HRM was performed with 10 wet swallows (WS) and one MRS. Mean distal contractile integral (DCI) du...
Source: Neurogastroenterology and Motility - Category: Gastroenterology Authors: Tags: Original Article Source Type: research
Background and AimPeroral endoscopic myotomy (POEM) does not include any antireflux procedure, resulting in a certain risk of iatrogenic gastroesophageal reflux disease (GERD). The aim of the present study was to evaluate the incidence of iatrogenic GERD after POEM and identify preoperative, perioperative and postoperative factors associated with GERD. MethodsAll patients treated at a single center who had a complete GERD evaluation after POEM were included in the study. Demographics, preoperative and follow‐up data, results of functional studies and procedural data were collected and analyzed. ResultsA total of 103 pati...
Source: Digestive Endoscopy - Category: Gastroenterology Authors: Tags: Original Article Source Type: research
Abstract BackgroundThe role of esophagogastric junction contractile integral (EGJ‐CI) as assessed by high‐resolution manometry (HRM) is unclear. We aimed to correlate the EGJ‐CI with impedance‐pH findings in gastro‐esophageal reflux disease (GERD) patients. MethodsConsecutive patients with GERD symptoms were enrolled. All patients underwent upper endoscopy, HRM, and impedance‐pH testing. The EGJ‐CI was calculated using the distal contractile integral tool box during three consecutive respiratory cycles. The value was then divided by the duration of these cycles. A value below 13 was considered as a defective ...
Source: Neurogastroenterology and Motility - Category: Gastroenterology Authors: Tags: Original Article Source Type: research
ObjectivePer‐Oral Endoscopic Myotomy (POEM) does not include any anti‐reflux procedure, resulting in a certain risk of iatrogenic gastro‐esophageal reflux disease (GERD). Aim of this study is to evaluate the incidence of iatrogenic GERD after POEM, and to try to identify the preoperative, perioperative and post‐operative factors associated with GERD. MethodsAll patients, treated in a single center, which had a complete GERD evaluation after POEM, were included in the study. Demographics, preoperative and follow up data, results of functional studies and procedural data were collected and analyzed ResultsA total of ...
Source: Digestive Endoscopy - Category: Gastroenterology Authors: Tags: Original Article Source Type: research
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