A novel endoscopic assessment of the gastroesophageal junction for the prediction of gastroesophageal reflux disease: a pilot study
This study aims to evaluate the feasibility of this method for the diagnostic prediction of GERD. Methods A retrospective analysis of patients with GERD symptoms who underwent gastroscopy and esophageal pH-impedance monitoring was conducted. The novel assessment evaluated the following in retroflex view: 1) Cardiac Opening (CO): diameter of the opening of the cardia, 2) Sliding Hernia (SH): length from the diaphragmatic crus to the squamocolumnar junction, 3) Scope Holding Time% (SHT%): the percentage of time that the Scope Holding Sign (SHS) was observed out of 30 seconds. The SHS is defined as the lower esophagus holding the endoscope under excessive insufflation. The results of this assessment and that of pH-impedance monitoring were compared. Results In total, 61 patients (mean age ± SD, 54.1 ± 16.4 years, 32 males) were enrolled. CO and SH were significantly correlated with acid exposure time (AET) (ρ = 0.36, P = 0.005, and ρ = 0.36, P = 0.004). The optimal cutoff of CO for AET> 6 % was 3 cm (Sensitivity = 72.4 %, Specificity = 46.9 %, AUC = 0.64) and that of SH was 2 cm (Sensitivity = 55.2 %, Specificity = 75.0 %, AUC = 0.70). When the population was stratified according to this cutoff, patients with CO > 3 cm and those with SH > 2 cm presented higher AET (15.1 vs 4.1 %, P = 0.037, and 23.0 vs 3.6 %, P = 0.026). Optimal cutoff of SHT% fo...
CONCLUSIONS: The paper demonstrates that the autonomic dysfunction of nervous system (on a par with insulin resistance) is the main link in the development of MetS. This provides the basis for including the mentioned states - cardiac autonomic neuropathy, lower urinary tract symptoms and gastroesophageal reflux disease - into the MetS cluster. PMID: 31589129 [PubMed - as supplied by publisher]
ConclusionESG is a feasible endobariatric option, but complications like gastric perforation can occur. For such complication, immediate surgical treatment is indicated.
Introduction: Laparoscopic sleeve gastrectomy (LSG) is one of the surgical procedures indicated in the treatment of obesity. The occurrence of gastroesophageal reflux (GER) in the postoperative period of this surgery is related to a reduction in the lower esophageal sphincter (LES) tone and the presence of gastric residual fundus (RF) associated with increased gastric intraluminal pressure. Fixation of the remaining gastric reservoir to the gastrosplenic and gastrocolic ligaments (omentopexy) has emerged as a technical option to avoid or decrease GER in the postoperative period of LSG. Objective: To evaluate the prese...
Augmentation of the lower esophageal sphincter (LES) is the primary goal of endoscopic or surgical therapy for gastroesophageal reflux disease (GERD). Aim of the study was to develop a new endoscopic treatment for GERD using intraluminal magnets referred to as a magnet closure device (MCD). The feasibility, efficacy, safety, and reversibility of the endoscopic procedure and device were evaluated in a porcine model.
Hiatal hernia (HH) and lower esophageal sphincter (LES) dysfunction are deemed to be factors contributing to the pathophysiology of gastroesophageal reflux disease (GERD). There have been limited number of reports to assess the changes in esophago-gastric junction (EGJ) of HH endoscopically. We recently developed a novel method to assess the morphological and functional changes of EGJ in HH using upper GI endoscopy.
Endoscopic pressure study integrated system (EPSIS) is a prototypic diagnostic system that allows continuous monitoring of changes in intragastric pressure (IGP) arising from gastric distention and cardia opening during gastroscopy. The ability of the cardia and lower esophageal sphincter to “contain” gastric content thus preventing reflux, can be assessed endoscopically by applying this newly-developed diagnostic tool.
Achalasia is a rare esophageal motility disorder, characterized by incomplete relaxation of the lower esophageal sphincter and aperistalsis of the esophageal body. Peroral endoscopic myotomy (POEM), is a minimally invasive procedure that leads to relief of symptoms and improvement in quality of life, with efficacy similar to surgical myotomy. However, gastroesophageal reflux disease (GERD) is common after POEM. The aim of this study is to identify predictors of GERD after POEM, with respect to procedure technique, patient characteristics, previous treatment, and type of achalasia.
Endoscopic pressure study integrated system (EPSIS) is a novel diagnostic tool for gastroesophageal reflux disease (GERD) by monitoring intragastric pressure (IGP). Evaluation of the lower esophageal sphincter (LES) function, one of the contributory factors in GERD, can be achieved endoscopically by utilizing this newly-developed diagnostic tool.
Obesity is a risk factor for gastroesophageal reflux disease (GERD). Studies have demonstrated an improvement in GERD symptoms with weight loss. The intra-gastric balloon (IGB) is approved for weight loss in patients with a body mass index (BMI) of 30-40 kg/m2. GERD can occur after Intra-gastric balloon (IGB) placement. Even though patients complain of worsening GERD symptoms and esophagitis has been documented after IGB insertion, its effect on the demeester score, upper and lower esophageal sphincter pressure is unknown.
ale M Abstract BACKGROUND: Gastro-oesophageal reflux disease (GERD) is one of the most common diseases, but is still a challenge to cure. Different medical treatments are used, first of all Proton pump inhibitors (PPIs), however these are sometimes ineffective and long-term intake can lead to underestimated complications. Recently, some studies investigated the role of inspiratory muscle training (IMT) in the medical treatment of GERD. It seems that IMT is able to increase the pressure generated by the lower oesophageal sphincter (LES), reduce spontaneous releases of LES, acid exposure, use of PPIs, and improve sy...