In defense of four decades of esophageal function tests. reply to reaction to articles on high resolution manometry, the length of the lower esophageal sphincter and the diagnosis of gastroesophageal reflux disease

CONCLUSION: Recognizing the historical evolution of GERD management can help care providers to better understand therapeutic options for their patients, as well as focus on unmet needs that deserve further attention. PPIs are still the first choice therapy, with good evidence in favor of their efficacy, despite some safety concerns. However, as with any medical intervention, it is recommended to prescribe PPIs for patients with clear indication, using adequate dosing and monitoring for adverse events.RESUMO CONTEXTO: A doen ça do refluxo gastroesofágico (DRGE) é uma das doenças gastrointestinais mais prevalentes, resultando em limitações significativas na qualidade de vida dos pacientes e, também, relevante utilização de recursos médicos. Um melhor entendimento da fisiopatologia da doença nas últimas cinco décadas tem favorecido a evolução das estratégias de tratamento, desde intervenções não farmacológicas e antiácidos, a alternativas mais eficazes e seguras. OBJETIVO: Resumir os dados sobre a evolução histórica do manejo da DRGE no Brasil, focando na terapia medicamentosa e abordando e vidências sobre a eficácia e segurança de classes medicamentosas atualmente recomendadas. MÉTODOS: Uma revisão narrativa foi conduzida para sistematizar informações sobre descober...
Source: Arquivos de Gastroenterologia - Category: Gastroenterology Source Type: research

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CONCLUSION: Recognizing the historical evolution of GERD management can help care providers to better understand therapeutic options for their patients, as well as focus on unmet needs that deserve further attention. PPIs are still the first choice therapy, with good evidence in favor of their efficacy, despite some safety concerns. However, as with any medical intervention, it is recommended to prescribe PPIs for patients with clear indication, using adequate dosing and monitoring for adverse events.RESUMO CONTEXTO: A doen ça do refluxo gastroesofágico (DRGE) é uma das doenças gastrointestinais...
Source: Arquivos de Gastroenterologia - Category: Gastroenterology Source Type: research
AbstractBackgroundGastroesophageal reflux disease (GERD) is present in half of the obese candidates for bariatric surgery. Variability of symptoms and new onset of GERD are often debated. Prior studies have demonstrated that sleeve gastrectomy (SG) is associated with significant weight loss.ObjectivesWe prospectively evaluated the effect of a standardized SG technique on GERD symptoms in 104 patients.MethodsAll patients were surveyed on the presence of heartburn and/or regurgitation with a specific questionnaire (GERD-HRQL). Esophagogastroduodenoscopy (EGDS) was performed in the preoperative phase and after 12  months...
Source: Obesity Surgery - Category: Surgery Source Type: research
Authors: Hajer J, Novák M, Rosina J Abstract Gastroesophageal reflux disease (GERD) is a rather common disease with a prevalence reaching up to 10 or 20% in the western world. The most specific symptoms which point to the diagnosis of GERD are feelings of heartburn and the regurgitation of acidic stomach contents into the esophagus. However, a certain number of patients do not respond to standard therapy, and in these cases, it is necessary to resort to other treatment methods, such as laparoscopic fundoplication or electrostimulation of the lower esophageal sphincter. The aim of our work was to design and m...
Source: Gastroenterology Research and Practice - Category: Gastroenterology Tags: Gastroenterol Res Pract Source Type: research
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
This study suggests that perception may be short-sighted in that insurance plans can provide better care for their GERD patients at a similar cost to laparoscopic Nissen fundoplication when you factor in the greater reductions in medical costs after the procedure.”  The study, presented this week at the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) meeting in Baltimore, MD, found that the reduced medical costs associated with the Linx procedure compared to LNF more than offset the higher cost the cost difference. The study was partially funded by Ethicon, part of Johnson...
Source: MDDI - Category: Medical Devices Authors: Tags: Implants Source Type: news
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
Abstract As per-oral endoscopic myotomy (POEM) is not followed by any anti-reflux procedure, a common concern is the risk of postoperative gastro-esophageal reflux disease (GERD). Electrical stimulation of the lower esophageal sphincter (LES-EST) could be an option for post-POEM GERD. A 68-year old male obese patient underwent successful POEM but developed GERD not responsive to proton pump inhibitors. Consecutively, the patient had implanted an electrical LES stimulation device, consisting of bipolar LES-electrodes connected to a subcutaneous pulse generator. POEM reduced the Eckardt score (9 vs. 0), the LES rest...
Source: Surgical Innovation - Category: Surgery Authors: Tags: Surg Innov 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
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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