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Respiratory Investigation Jul 2024The association between reflux esophagitis and pulmonary function remains controversial. Thus, evaluating the relationship between endoscopic reflux esophagitis and...
BACKGROUND
The association between reflux esophagitis and pulmonary function remains controversial. Thus, evaluating the relationship between endoscopic reflux esophagitis and changes in pulmonary function over time in a nonsmoking population is an important clinical issue.
METHODS
In this single-center retrospective cohort study, a medical examination database at Kameda Medical Center Makuhari was employed to identify nonsmokers who underwent upper gastrointestinal endoscopy and spirometry in 2010 and were followed up in 2015. Gastroenterologists carefully double-checked the diagnosis of reflux esophagitis. Multiple linear regression analyses were performed to compare the decline in the percentage of predicted vital capacity (%VC), forced vital capacity (%FVC), and forced expiratory volume in 1 s (%FEV) between participants with reflux esophagitis and those without. Furthermore, using multivariable logistic regression analyses, we evaluated the factors associated with rapid decline in %VC, %FVC, and %FEV, which is defined as a decrease of >10% in each parameter over the 5-year observation period.
RESULTS
We identified 3098 eligible subjects, including 72 and 44 participants who had a Los Angeles classification grade A and B-C (severe) reflux esophagitis in 2010, respectively. The decline in %VC was significantly larger in the participants with severe reflux esophagitis than in the control subjects (standardized coefficient, -0.037; 95% confidence interval, -0.071 to -0.004). Moreover, reflux esophagitis was significantly associated with a rapid decline in %VC and %FVC but not in %FEV (P for trend: 0.009, 0.009, and 0.276, respectively).
CONCLUSIONS
Severe reflux esophagitis among nonsmokers had clinical disadvantages in terms of a decline in %VC.
Topics: Humans; Esophagitis, Peptic; Retrospective Studies; Male; Middle Aged; Female; Vital Capacity; Non-Smokers; Cohort Studies; Forced Expiratory Volume; Adult; Lung; Aged; Respiratory Function Tests
PubMed: 38696950
DOI: 10.1016/j.resinv.2024.04.017 -
Helicobacter Dec 2023It is 40 years since the discovery of Helicobacter pylori infection. Over that time major changes have occurred in esophagogastroduodenoscopy (EGD) findings. The aim... (Review)
Review
BACKGROUND
It is 40 years since the discovery of Helicobacter pylori infection. Over that time major changes have occurred in esophagogastroduodenoscopy (EGD) findings. The aim of this review is to describe these changes, and the important role H. pylori infection has played in their evolution.
METHODS
References were identified through searches of PubMed using the search terms-endoscopy time trends, peptic ulcer disease, gastroesophageal reflux disease, upper gastrointestinal cancer, gastric polyps, H. pylori, eosinophilic gastrointestinal disorders, and celiac disease, from 1970 through December 2021.
RESULTS
The prevalence of H. pylori infection has fallen and consequently, H. pylori-positive peptic ulcer disease has become rare. Gastroesophageal reflux disease is now the commonest disorder diagnosed at EGD, and Barrett's esophagus has increased in parallel. Cancer of the distal stomach has fallen while esophageal adenocarcinoma and reflux-related cardia cancer have risen. Gastric polyps have changed from hyperplastic and adenomas to sporadic fundic gland polyps. Antimicrobial resistance has made H. pylori infection more difficult to eradicate. Eosinophilic gastrointestinal disorders, particularly eosinophilic esophagitis, have emerged as important new allergic disorders. Celiac disease has changed and increased.
CONCLUSIONS
EGD findings appear to have changed from features suggesting a H. pylori-positive "phenotype" 40 years ago to a H. pylori-negative "phenotype" today. These changes have major implications for the management of gastrointestinal disorders.
Topics: Humans; Helicobacter pylori; Helicobacter Infections; Celiac Disease; Barrett Esophagus; Gastroesophageal Reflux; Peptic Ulcer; Endoscopy, Digestive System
PubMed: 37818739
DOI: 10.1111/hel.13026 -
International Journal of Medical... 2023No study on the relationship between common abnormalities of the upper digestive tract and colorectal polyps (CPs) has been conducted. 33439 patients were enrolled in...
No study on the relationship between common abnormalities of the upper digestive tract and colorectal polyps (CPs) has been conducted. 33439 patients were enrolled in this cross-sectional study, of which 7700 had available () information. All participants underwent colonoscopy and esophagogastroduodenoscopy (EGD) simultaneously or within six months at Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2015 to November 2021. The study assessed whether the risk of CPs was affected by the following gastroesophageal diseases: atrophic gastritis (AG), gastric polyps, Barrett's esophagus and reflux esophagitis, bile reflux, gastric ulcer, gastric mucosal erosion, superficial gastritis, and gastric infection. The crude and adjusted odds ratios (ORs) of on the occurrence of CPs were computed by logistic regression. Additionally, we also evaluated whether AG had an impact on the relationship between infection and CPs. A total of 10600 cases (31.7%) were diagnosed as CPs. Multivariate logistic analysis showed that age, male (OR, 1.80; 95% confidence interval [CI], 1.61 to 2.02), gastric polyps (OR, 1.61; 95% CI, 1.05 to 2.46 for hyperplastic polyps; OR, 1.45; 95% CI, 1.09 to 1.94 for fundic gland polyps), infection (OR, 1.21; 95% CI, 1.07 to 1.37) and atrophic gastritis (OR, 1.38; 95% CI, 1.21 to 1.56) were independent risk factors for colorectal polyps. Moreover, the combined effect of infection and AG was slightly greater than the sum of their individual effects on the risk of CPs, but there was no additive interaction between them. Gastric conditions including gastric polyps, infection, and AG increased the risk of CPs. However, Barrett's esophagus and reflux esophagitis, bile reflux, erosive gastritis, gastric ulcer, and superficial gastritis might not have relationship with CPs occurrence.
Topics: Humans; Male; Barrett Esophagus; Cross-Sectional Studies; Esophagitis, Peptic; Gastritis, Atrophic; Colonic Polyps; Stomach Ulcer; Bile Reflux; East Asian People; Gastritis; Helicobacter Infections; Helicobacter pylori
PubMed: 36794160
DOI: 10.7150/ijms.80543 -
International Journal of Environmental... Jun 2021This cross-sectional study investigated the relationship between shift work and reflux esophagitis verified by endoscopic findings. Participants underwent a...
This cross-sectional study investigated the relationship between shift work and reflux esophagitis verified by endoscopic findings. Participants underwent a comprehensive health examination and esophagogastroduodenoscopy between January 2011 and December 2018. We examined endoscopic findings and performed multivariate-adjusted regression analysis of the association between shift work and reflux esophagitis using multiple demographic and clinical factors. Among the 247,450 participants, 49,767 (20.1%) had reflux esophagitis; Los Angeles (LA)-M (31,132, 12.6%) was most common, followed by LA-A (16,213, 6.6%), LA-B (2333, 0.9%), and ≥LA-C (89, 0.04%). The multivariate-fully adjusted odds ratio (OR) of overall reflux esophagitis for shift work compared to fixed day work was 1.15 (95% confidence interval [CI]: 1.11-1.19). When classified according to shift work type and severity of reflux esophagitis, the ORs of LA-A for regular day and night, and irregular shifts compared to fixed day works were 1.14 (95% CI: 1.03-1.26) and 1.26 (95% CI: 1.11-1.44), respectively. However, there was no significant association between any shift work schedule and ≥LA-B. Overall, we demonstrated the cross-sectional association between shift work (especially rotating and irregular shifts) and mild reflux esophagitis (≤LA-A) compared with daily fixed time shifts.
Topics: Cross-Sectional Studies; Esophagitis, Peptic; Humans; Los Angeles; Odds Ratio; Shift Work Schedule
PubMed: 34201073
DOI: 10.3390/ijerph18126189 -
Journal of Gastroenterology Oct 2019This report explores two hypotheses regarding eosinophilic esophagitis (EoE): (1) that the use of proton pump inhibitors (PPIs) might contribute to the pathogenesis of... (Review)
Review
This report explores two hypotheses regarding eosinophilic esophagitis (EoE): (1) that the use of proton pump inhibitors (PPIs) might contribute to the pathogenesis of EoE by preventing peptic digestion of food allergens, by increasing gastric mucosal permeability to enable gastric absorption of those undegraded food allergens, and by causing microbial dysbiosis, and (2) that EoE, like eosinophilic gastroenteritis, might have mucosal-predominant and muscle-predominant forms, and that the muscle-predominant form of EoE might cause a variety of esophageal motility disorders including achalasia.
Topics: Animals; Eosinophilic Esophagitis; Eosinophils; Esophageal Motility Disorders; Food Hypersensitivity; Humans; Proton Pump Inhibitors
PubMed: 31342146
DOI: 10.1007/s00535-019-01604-7 -
European Archives of... Jul 2022To evaluate the prevalence of insomnia in patients with laryngopharyngeal reflux (LPR) and to analyze the relationship between the severity of insomnia and LPR-related...
OBJECTIVES
To evaluate the prevalence of insomnia in patients with laryngopharyngeal reflux (LPR) and to analyze the relationship between the severity of insomnia and LPR-related symptoms.
METHODS
We analyzed 69 patients with LPR and 61 healthy controls. The LPR was confirmed via the 24-h hypopharyngeal-esophageal multichannel intraluminal impedance pH monitoring. Reflux symptoms and sleep disturbances were assessed using the Reflux Symptom Index and Insomnia Severity Index. We compared the prevalence of insomnia between the two groups. We analyzed the relationship between reflux symptoms and severity of insomnia.
RESULTS
The prevalence of insomnia was significantly higher in patients with LPR than in healthy controls (46.3% vs. 29.5%; p = 0.049). The severity of reflux-related symptoms was correlated with insomnia severity (rho = 0.44; p < 0.001). Patients with LPR with nighttime reflux were more likely to have sleep disturbances than patients with LPR without nighttime reflux.
CONCLUSION
Patients with LPR are more likely to experience insomnia than healthy controls, and the severity of reflux symptoms was related to the severity of insomnia.
Topics: Electric Impedance; Esophageal pH Monitoring; Esophagitis, Peptic; Humans; Hypopharynx; Laryngopharyngeal Reflux; Sleep Initiation and Maintenance Disorders
PubMed: 35129631
DOI: 10.1007/s00405-022-07280-3 -
Gastroenterology Jan 2023
Topics: Humans; Gastric Acid; Potassium; Esophagitis; Esophagitis, Peptic; Proton Pump Inhibitors
PubMed: 36341738
DOI: 10.1053/j.gastro.2022.10.022 -
Journal of Clinical Gastroenterology Jul 2021Gastroesophageal reflux disease (GERD) is steadily increasing in incidence and now affects 18% to 28% of the population in the United States. A thorough understanding of...
Gastroesophageal reflux disease (GERD) is steadily increasing in incidence and now affects 18% to 28% of the population in the United States. A thorough understanding of the pathophysiology underlying this disease is necessary to improve the current standard of care. Most GERD pathophysiology models focus on the lower esophageal sphincter (LES) as the key element which prevents esophageal reflux. More recent research has highlighted the crural diaphragm (CD) as an additional critical component of the GERD barrier. We now know that the CD actively relaxes when the distal esophagus is distended and contracts when the stomach is distended. Crural myotomy in animal models increases esophageal acid exposure, highlighting the CD's vital role. There are also multiple physiological studies in patients with symptomatic hiatal hernia that demonstrate CD dysfunction is associated with GERD. Finally, computer models integrating physiological data predict that the CD and the LES each contribute roughly 50% to the GERD barrier. This more robust understanding has implications for future procedural management of GERD. Specifically, effective GERD management mandates repair of the CD and reinforcement of the LES. Given the high rate of hiatal hernia recurrences, it seems that novel antireflux procedures should target this essential component of the GERD barrier. Future research should focus on methods to maintain crural integrity, decrease hiatal hernia recurrence, and improve long-term competency of the GERD barrier.
Topics: Esophageal Sphincter, Lower; Esophagitis, Peptic; Esophagogastric Junction; Gastroesophageal Reflux; Hernia, Hiatal; Humans
PubMed: 33883513
DOI: 10.1097/MCG.0000000000001547 -
Scandinavian Journal of Gastroenterology 2023is the leading cause of zoonotic gastroenteritis. The other emerging group of spp. are part of human oral commensal, represented by (CC), which has been recently... (Review)
Review
BACKGROUND
is the leading cause of zoonotic gastroenteritis. The other emerging group of spp. are part of human oral commensal, represented by (CC), which has been recently linked to non-oral conditions. Although long-term gastrointestinal (GI) complications from these two groups of have been previously reviewed individually, overall impact of infection on GI carcinogenesis and their inflammatory precursor lesions has not been assessed collectively.
AIMS
To evaluate the available evidence concerning the association between infection/colonization and inflammatory bowel disease (IBD), reflux esophagitis/metaplasia colorectal cancer (CRC) and esophageal cancer (EC).
METHODS
We performed a comprehensive literature search of PubMed for relevant original publications and systematic reviews/meta-analyses of epidemiological and clinical studies. In addition, we gathered additional information concerning microbiological data, animal models and mechanistic data from studies.
RESULTS
Both retrospective and prospective studies on IBD showed relatively consistent increased risk associated with infection. Despite lack of supporting prospective studies, retrospective studies based on tissue/fecal microbiome revealed consistent enrichment of in CRC samples. Studies on EC precursor lesions (esophagitis and metaplasia) were generally supportive for the association with while inconsistent observations on EC. Studies on both IBD and EC precursors suggested the predominant role of CC, but studies on CRC were not informative of species.
CONCLUSIONS
There is sufficient evidence calling for concerted effort in unveiling direct and indirect connection of this organism to colorectal and esophageal cancer in humans.
Topics: Animals; Humans; Campylobacter Infections; Retrospective Studies; Prospective Studies; Campylobacter; Inflammatory Bowel Diseases; Gastrointestinal Diseases; Esophageal Neoplasms; Esophagitis, Peptic; Metaplasia
PubMed: 37366241
DOI: 10.1080/00365521.2023.2228954 -
Medicine Nov 2022Proton-pump inhibitors (PPIs) and vonoprazan are recommended as first-line therapies for erosive esophagitis (EE). However, it is uncertain how the magnitude of efficacy... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Proton-pump inhibitors (PPIs) and vonoprazan are recommended as first-line therapies for erosive esophagitis (EE). However, it is uncertain how the magnitude of efficacy and safety of first-line therapy, the choice of individual PPIs or vonoprazan in the treatment of EE remains controversial. This study aimed to evaluate the efficacy and safety of vonoprazan and PPIs in healing esophageal mucosal injury in patients with EE.
METHODS
Relevant databases were searched to collect randomized controlled trials of proton pump inhibitors and vonoprazan in the treatment of reflux esophagitis up to December 2021. Studies on standard-dose PPIs or vonoprazan that were published in Chinese or English and assessed healing effects in EE were included in the analysis. Stata16.0 was used to conduct a network Meta-analysis to evaluate the efficacy and safety of the treatment.
RESULTS
A total of 41 literatures were included with 11,592 enrolled patients. For the endoscopic cure rate, all the PPIs and vonoprazan significantly improve compared to Placebo; Based on the surface under the cumulative ranking curve, Ilaprazole ranked first, followed by esomeprazole, vonoprazan, pantoprazole, lansoprazole, omeprazole, rabeprazole and placebo therapy ranked the last. For the rate of adverse events, there was no significant difference among all the PPIs, vonoprazan, and placebo.
CONCLUSIONS
Ilaprazole, esomeprazole and vonoprazan have more advantages in mucosal erosion healing, there was no significant difference in the comparative safety among all interventions.
Topics: Humans; Proton Pump Inhibitors; Esomeprazole; Network Meta-Analysis; Peptic Ulcer; Rabeprazole; Esophagitis, Peptic; Abdominal Injuries
PubMed: 36451489
DOI: 10.1097/MD.0000000000031807