How to choose among fundoplication, magnetic sphincter augmentation or transoral incisionless fundoplication

Purpose of review To examine current trends and research in nonmedical approaches to the treatment of gastroesophageal reflux disease (GERD). Recent findings Long-term studies of GERD patients treated with transoral incisionless fundoplication (TIF) have found that a large portion of patients resume proton pump inhibitor therapy. In patients with uncomplicated GERD, magnetic sphincter augmentation (MSA) shows excellent short-term results in both patient satisfaction and physiologic measures of GERD, with fewer postoperative side-effects than fundoplication, although dysphagia can be problematic. Summary Fundoplication remains the standard of care for patients with GERD complicated by hiatal hernias more than 2 cm, Barrett's esophagus and/or grade C and D erosive esophagitis. For the patient with uncomplicated GERD, MSA appears to be a viable alternative that has greater technical standardization and fewer postoperative side-effects than fundoplication. TIF remains an option for patients with refractory GERD who refuse surgical intervention.
Source: Current Opinion in Gastroenterology - Category: Gastroenterology Tags: ESOPHAGUS: Edited by Stuart J. Spechler Source Type: research

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Conclusion: We attempted to confirm the evidence of intestinal inflammation due to PPI use in children and adolescents through clinical symptoms and FC measurement; however, no significant changes were observed. PMID: 31319647 [PubMed - as supplied by publisher]
Source: Korean Journal of Pediatrics - Category: Pediatrics Tags: Korean J Pediatr Source Type: research
Publication date: Available online 19 July 2019Source: International Journal of Surgery Case ReportsAuthor(s): Dario Iadicola, Massimo Branca, Massimo Lupo, Eugenia Maria Grutta, Stefano Mandalà, Gianfranco Cocorullo, Antonino MirabellaAbstractIntroductionTraumatic diaphragmatic injuries are rare complications resulting from a thoracic-abdominal blunt or penetrating trauma. Left-sided diaphragmatic injuries are more commonly reported in literature. Bilateral injuries are extremely rare, occurring in about 3% of the patients and just few cases reported in literature. Traumatic diaphragmatic hernias are definitely a m...
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
This article reviews the current literature regarding established and proposed EE-GERD, reporting on all available options for its correct diagnosis and therapeutic management. Expert opinion: MII-pH could help to identify a hidden GERD that causes EE. Unfortunately, standard MII-pH analysis results are often unable to define this association. New parameters such as the mean nocturnal baseline impedance and post-reflux swallow-induced peristaltic wave index may have an improved diagnostic yield, but prospective studies using impedance-pH are needed. PMID: 31322443 [PubMed - as supplied by publisher]
Source: Expert Review of Gastroenterology and Hepatology - Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research
In conclusion, chronic restraint stress may induce esophageal fibrosis by accumulating ROS and increasing fibrotic gene expression in a murine model. PMID: 31316626 [PubMed]
Source: Experimental and Therapeutic Medicine - Category: General Medicine Tags: Exp Ther Med Source Type: research
Authors: Roy P, S R, MittalMittal R, Mehta S Abstract Vesicoureteral reflux (VUR) in children is often treated with antimicrobials for prolonged durations, which often leads to antimicrobial resistance. In this context, this review article discusses the use of endoscopic injection in VUR as a safe and efficacious option for these children. The literature pertaining to VUR- its clinical manifestation and management, antibiotic resistance- with special reference to management of VUR, and endoscopic dextranomer/hyaluronic acid gel injection for management of VUR was reviewed by identifying key words in a PubMed search...
Source: Journal of the Association of Physicians of India - Category: General Medicine Tags: J Assoc Physicians India Source Type: research
Authors: Kim J, Lee K, Lee W Abstract Eosinophilic esophagitis is a rare disease in Asian countries, but its incidence is growing rapidly in Western countries. The main pathophysiology of eosinophilic esophagitis is esophageal epithelial barrier dysfunction; disruption of the esophageal epithelial barrier easily induces antigen sensitization to foods and aeroallergens, which leads to subsequent esophageal inflammation as a result of eosinophil recruitment. Here we report a case of an 11-year-old Korean boy who suffered from fever, odynophagia, dysphagia, and chest pain. His upper endoscopic findings showed longitud...
Source: Clinical Endoscopy - Category: Gastroenterology Tags: Clin Endosc Source Type: research
ConclusionsOverall H2RA and PPI use did not change among adults taking clopidogrel from 2007 through 2014. Prescribers must consider acid reducing agents that will not interact with clopidogrel. Future studies should evaluate the use of PPIs and H2RAs with dual antiplatelet therapy and in patients with a high risk of gastrointestinal bleeding.
Source: Journal of Pharmaceutical Health Services Research - Category: Drugs & Pharmacology Authors: Tags: Research Paper Source Type: research
Cirrhosis is a life-threatening condition and a major cause of morbidity and mortality worldwide. Improvement in the management of its related complications, of its aetiologies (i.e. viral eradication), and the option of liver transplantation have increased life expectancy of patients with cirrhosis. In this setting, it is not unusual that patients with cirrhosis are proposed for major surgical procedures for orthopaedic, malignancy or cirrhosis related complications. In fact, patients with cirrhosis have a high incidence of gallstones and abdominal wall hernias that require surgical repair[1 –4].
Source: Journal of Hepatology - Category: Gastroenterology Authors: Source Type: research
Asthma control changes over time and many factors contribute to this variability. Environmental exposures such as seasonal allergen fluctuations, second-hand tobacco exposure, and viral upper respiratory tract infections (RTI) are just a few of the known triggers of lability 1. In addition, host factors such as inhaler technique and co-morbid conditions including atopic diseases, obesity, and acid reflux can also contribute to this changeability. During times of lability, overzealous intervention can lead to overuse of oral corticosteroids (OCS) and healthcare visits, while delayed treatment can lead to severe exacerbation...
Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Tags: Review Source Type: research
In this study, we aimed to assess the association between PPIs and cerebro-cardiovascular outcomes independent of clopidogrel.Systematic searches were conducted in the Cochrane Library, PubMed, and Embase databases for all relevant studies up to August 2018. Odds ratios (ORs) with its 95% confidence intervals (CIs) were abstracted and pooled using the random-effects model.A total of 14 observational studies (13 cohort studies and 1 case-control study) were identified. Compared with non-PPI users, PPI users experienced higher risks of stroke (OR: 1.22, 95% CI: 1.08-1.36), myocardial infarction (MI; OR: 1.23, 95% CI: 1.14-1....
Source: International Heart Journal - Category: Cardiology Tags: Int Heart J Source Type: research
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