Phenotypes of Gastroesophageal Reflux Disease: Where Rome, Lyon, and Montreal Meet

Gastroesophageal reflux disease (GERD) is now one of the most common diagnoses made in a gastroenterology practice. From a conventional pathophysiological perspective GERD is conceptualized as incompetence of the antireflux barrier at the esophagogastric junction; the more severe that incompetence, the worse the disease. However, it is increasingly clear that many presentations of GERD represent distinct phenotypes with unique predisposing cofactors and pathophysiology outside of this paradigm. Three major consensus initiatives have grappled with this dilemma (the Montreal Consensus, The Rome Foundation, and the Lyon Consensus), each from a different perspective.
Source: Clinical Gastroenterology and Hepatology - Category: Gastroenterology Authors: Source Type: research

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Dysphagia is one of the most common postoperative symptoms reported by patients following antireflux surgery. A recent paper in Clinical Gastroenterology and Hepatology provided a comprehensive overview of recent advances in the management of esophageal motility disorders in general.1 In this issue, Hasak and colleagues2 report outcomes of adults who developed dysphagia following antireflux surgery for treatment of gastroesophageal reflux disease. Of 157 patients, 64.3% reported postoperative dysphagia; about half reported clinically significant dysphagia, defined as a score ≥ 2 on a 5-point Likert scale.
Source: Clinical Gastroenterology and Hepatology - Category: Gastroenterology Authors: Tags: Issue highlights Source Type: research
Laryngopharyngeal reflux (LPR), a growing issue in ear, nose, and throat (ENT) and pediatric medicine, is the backflow of stomach contents into the laryngopharynx. Patients present with frequent upper and/or lower respiratory tract infections and coughs, associated with acid- and pepsin-mediated injury to the mucosae of the larynx and pharynx. LPR is associated with rhinosinusitis, laryngitis, pneumonia, and asthma. Children with LPR often fail to exhibit classic gastroesophageal reflux disease symptoms, or such symptoms may be intermittent.
Source: Journal of Voice - Category: ENT & OMF Authors: Source Type: research
Sleeve gastrectomy has become the most common procedure performed for weight loss. But emerging data indicate that this procedure can result in lifestyle-limiting gastroesophageal reflux disease. The influence of these gastroesophageal reflux disease symptoms on patient satisfaction with the procedure has not been explored.
Source: Surgery - Category: Surgery Authors: Source Type: research
An 82-year-old male, with a history of bowel cancer with partial colectomy, gastroesophageal reflux disease, remote partial gastrectomy for peptic ulcer disease, and no documented prior kidney disease, presents with several months of fatigue and subacute decline in kidney function. He had no history of diabetes, hypertension, kidney stones, or prior urinary tract infections. He denied use of nonsteroidal anti-inflammatory agents, herbal medications, and recent antibiotics. There was no family history of renal disease.
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: Make Your Diagnosis Source Type: research
New international consensus guidelines offer recommendations for selecting adults with gastroesophageal reflux disorder (GERD) for antireflux surgery.Reuters Health Information
Source: Medscape General Surgery Headlines - Category: Surgery Tags: General Surgery News Source Type: news
DiscussionWe suggest an open gastrectomy with roux-en-Y anastomosis as an alternative to the Nissen fundoplication for patients with connective tissue disease that develop terminal pulmonary consequences and require a lung transplant.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
Conclusions: Fundoplication with GT is effective in reducing hospital admissions and emergency department visits from GER and seizures in NI children. Because of high mortality within a year of fundoplication and GT in DNR children, anti-reflux medications with GT might be an alternative. PMID: 31423518 [PubMed - in process]
Source: Saudi Medical Journal - Category: Middle East Health Tags: Saudi Med J Source Type: research
We examined the relationships among symptom burden, EMD, acid exposure time (AET), symptom association probability, and body mass index (BMI).
Source: Clinical Gastroenterology and Hepatology - Category: Gastroenterology Authors: Source Type: research
This study examined the safety and efficacy when repairing defects in 2 anatomical structures (hiatus and lower esophageal sphincter) in a concomitant set of procedures in patients with hiatal hernias between 2 and 5 cm. Methods. Prospective data were collected from 99 patients who underwent hiatal hernia repair followed immediately by the TIF procedure (HH + -TIF). GERD-HRQL (Health-Related Quality of Life), RSI (Reflux Symptom Index), and GERSS (Gastroesophageal Reflux Symptom Score) questionnaires were administered before the procedure and mailed at 6 and 12 months. Results. Ninety-nine patients were enrolled, and all w...
Source: Surgical Innovation - Category: Surgery Authors: Tags: Surg Innov Source Type: research
ConclusionsPatient and physician ’s characteristics were related to high utilization of gastroenterology services among GERD patients. The associations with age and country of birth might reflect more severe disease. The regional differences warrant further research and interventions at the district level. Training in gastroenter ology of primary care physicians without a board certification is warranted.
Source: Israel Journal of Health Policy Research - Category: International Medicine & Public Health Source Type: research
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