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The Laryngoscope Oct 2016Antireflux therapy is incorporated in many treatment protocols for recurrent respiratory papillomatosis (RRP) because gastroesophageal reflux (GERD) is thought to worsen... (Review)
Review
OBJECTIVES/HYPOTHESIS
Antireflux therapy is incorporated in many treatment protocols for recurrent respiratory papillomatosis (RRP) because gastroesophageal reflux (GERD) is thought to worsen the disease course of RRP. It is unclear if GERD really aggravates the disease course. The aims of this systematic review were to 1) evaluate incidence of GERD among RRP patients and 2) report if GERD changes the clinical course or tissue properties of RRP.
STUDY DESIGN
A search was conducted in PubMed, Embase, and Google Scholar, following the methods of Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines.
METHODS
Articles with original data, published after January 1, 1990, on RRP with GERD as a determinant were eligible. There was no language restriction. Data on study design, study population, statistics, outcomes (incidence and influence of GERD), and risk of bias were collected and evaluated following PRISMA protocols.
RESULTS
Of 1,277 articles, 19 were selected. Gastroesophageal reflux was objectified in 25% to 100% of RRP patients. Subjective GERD was present in 0% to 70% of patients. There is no proof that GERD aggravated the clinical course or tissue properties of RRP, as measured by the number of surgeries, severity scoring systems, or dysplasia. One study did find a higher chance of web formation in patients with anterior or posterior glottic papillomas who did not receive antireflux therapy, but these results should be interpreted with care due to the study's quality.
CONCLUSION
There is insufficient proof that GERD does or does not aggravate the clinical course or tissue properties of RRP. Laryngoscope, 126:2330-2339, 2016.
Topics: Disease Progression; Female; Gastroesophageal Reflux; Humans; Male; Papillomavirus Infections; Respiratory Tract Infections; Severity of Illness Index
PubMed: 27113025
DOI: 10.1002/lary.25898 -
Expert Review of Gastroenterology &... Sep 2021: Dental erosion occurs by dissolving dental apatite when exposed to non-bacterial acids. One of the factors that predispose to dental erosion is gastroesophageal reflux...
: Dental erosion occurs by dissolving dental apatite when exposed to non-bacterial acids. One of the factors that predispose to dental erosion is gastroesophageal reflux disease (GERD) due to chronic regurgitation of gastric contents to the oropharynx. Thus, in addition to other extraesophageal symptoms, individuals with GERD may have erosive dental lesions.: The objective of this systematic review was to evaluate the association and prevalence of erosive wear in patients with GERD. The bibliographic search was performed in the Pubmed and Web of Science databases, using the descriptors 'gastroesophageal reflux disease' AND 'dental erosion', considering clinical studies recently published from 2012 to 2020.: GERD can be considered a risk factor for the development of erosive dental lesions, whose prevalence was significantly higher in this group. However, several other factors can be commonly associated with the prevalence and severity of dental erosion among the world population, such as dietary habits, lifestyle, abrasion and bruxism. Thus, the prevalence and distribution of erosive lesions among healthy and GERD subjects varied widely among studies, which denotes the etiological complexity of dental erosion and reinforces the importance of careful and detailed anamnesis in order to establish an accurate diagnosis.
Topics: Bruxism; Diet; Gastroesophageal Reflux; Humans; Life Style; Prevalence; Risk Factors; Tooth Abrasion; Tooth Erosion
PubMed: 33571021
DOI: 10.1080/17474124.2021.1890030 -
The Laryngoscope Oct 2014Our objective was to systematically identify and evaluate prospective studies providing evidence for and against the use of prokinetic agents in the treatment of... (Review)
Review
OBJECTIVES
Our objective was to systematically identify and evaluate prospective studies providing evidence for and against the use of prokinetic agents in the treatment of laryngopharyngeal reflux (LPR) disease.
DATA SOURCES
Our data sources were PubMed, Embase, BIOSIS, and Web of Science databases.
REVIEW METHODS
A systematic literature review was conducted to identify studies prospectively evaluating the effectiveness of prokinetic agents in the treatment of LPR. Data from eligible studies were independently extracted from each study by two authors. The primary outcome of interest was the improvement of LPR symptoms among study participants. Secondary outcomes included resolution of LPR physical signs and the development of side effects from therapy.
RESULTS
Among 724 unique articles identified, four studies met inclusion criteria. These four investigations provided mixed evidence about the effectiveness of prokinetic agents in the treatment of LPR. The studies included in the review were deemed to be at high risk of bias. Three of the four investigations demonstrated a statistically significant difference in patient symptoms that favored the use of prokinetics in the management of LPR. The investigations were mixed in their report of improvement in physical examination findings among patients receiving and those not receiving prokinetic medical therapy. No significant adverse effects were described in any of these trials.
CONCLUSIONS
Prokinetic agents may be a viable treatment option for LPR. The current body of literature is inadequate to make a recommendation for their use in this disease process. Further research should be conducted to assess the use of prokinetic medications in the management of LPR.
Topics: Disease Management; Gastrointestinal Agents; Humans; Laryngopharyngeal Reflux; Proton Pump Inhibitors
PubMed: 24782414
DOI: 10.1002/lary.24738 -
Otolaryngology--head and Neck Surgery :... Dec 2016Patient-reported outcome (PRO) measures are often used to diagnose laryngopharyngeal reflux (LPR) and monitor treatment outcomes in clinical and research settings. The... (Review)
Review
OBJECTIVES
Patient-reported outcome (PRO) measures are often used to diagnose laryngopharyngeal reflux (LPR) and monitor treatment outcomes in clinical and research settings. The present systematic review was designed to identify currently available LPR-related PRO measures and to evaluate each measure's instrument development, validation, and applicability.
DATA SOURCES
MEDLINE via PubMed interface, CINAHL, and Health and Psychosocial Instrument databases were searched with relevant vocabulary and key terms related to PRO measures and LPR.
REVIEW METHODS
Three investigators independently performed abstract review and full text review, applying a previously developed checklist to critically assess measurement properties of each study meeting inclusion criteria.
RESULTS
Of 4947 studies reviewed, 7 LPR-related PRO measures (publication years, 1991-2010) met criteria for extraction and analysis. Two focused on globus and throat symptoms. Remaining measures were designed to assess LPR symptoms and monitor treatment outcomes in patients. None met all checklist criteria. Only 2 of 7 used patient input to devise item content, and 2 of 7 assessed responsiveness to change. Thematic deficiencies in current LPR-related measures are inadequately demonstrated: content validity, construct validity, plan for interpretation, and literacy level assessment.
CONCLUSION
Laryngopharyngeal reflux is often diagnosed according to symptoms. Currently available LPR-related PRO measures used to symptomatically identify suspected LPR patients have disparate developmental rigor and important methodological deficiencies. Care should be exercised to understand the measurement characteristics and contextual relevance before applying these PRO measures for clinical, research, or quality initiatives.
Topics: Checklist; Dimensional Measurement Accuracy; Evidence-Based Medicine; Gastroesophageal Reflux; Humans; Laryngopharyngeal Reflux; Patient Reported Outcome Measures; Psychometrics; Quality of Life; Reproducibility of Results; Risk Assessment; Risk Factors; Severity of Illness Index; Surveys and Questionnaires
PubMed: 27554511
DOI: 10.1177/0194599816664330 -
Clinical Gastroenterology and... Jan 2018Dyspepsia and gastroesophageal reflux are highly prevalent in the general population, but they are believed to be separate entities. We conducted a systematic review and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND & AIMS
Dyspepsia and gastroesophageal reflux are highly prevalent in the general population, but they are believed to be separate entities. We conducted a systematic review and meta-analysis to estimate the prevalence of dyspepsia in individuals with gastroesophageal reflux symptoms (GERS), and to quantify overlap between the disorders.
METHODS
We searched MEDLINE, EMBASE, and EMBASE Classic databases to identify population-based studies reporting the prevalence of dyspepsia and GERS in adults, defined using specific symptom-based criteria or based on answers to questionnaires. We calculated pooled prevalence values, according to study location and criteria used to define weekly GERS or dyspepsia, as well as odds ratios (ORs) with 95% CIs. The degree of overlap between dyspepsia and GERS was examined.
RESULTS
Of 14,132 papers evaluated, 79 reported prevalence of weekly GERS. Nineteen of these study populations, comprising 111,459 participants, also reported the proportion of individuals with dyspepsia. The prevalence of dyspepsia in individuals with weekly GERS was 43.9% (95% CI, 35.1%-52.9%). The pooled OR for dyspepsia in individuals with weekly GERS, compared with those without, was 6.94 (95% CI, 4.33%-11.1%). The OR for dyspepsia in individuals with weekly GERS was significantly higher in all geographical regions studied and for all diagnostic criteria. The pooled degree of overlap between dyspepsia and GERS was 25.9% (95% CI, 19.9%-32.4%).
CONCLUSIONS
The odds of dyspepsia in individuals with weekly GERS is almost 7-fold that of individuals without GERS; dyspepsia and GERS overlap in more than 25% of individuals. Reasons for this remain speculative, but might include shared pathophysiological mechanisms or residual confounding factors. However, patients with GERS should be questioned about coexistent dyspepsia, to optimize treatment approaches.
Topics: Dyspepsia; Gastroesophageal Reflux; Humans; Prevalence
PubMed: 28782675
DOI: 10.1016/j.cgh.2017.07.041 -
The American Journal of Medicine Aug 2003This study was conducted to review and evaluate the published evidence for an association between gastroesophageal reflux (GER) and 3 supraesophageal pathologies:... (Review)
Review
This study was conducted to review and evaluate the published evidence for an association between gastroesophageal reflux (GER) and 3 supraesophageal pathologies: sinusitis, otitis media, and laryngeal malignancy. Relevant articles were located using MEDLINE (search limits: 1966-2001, English language, human studies). Only new data or new analyses of previous data were included. Relevant articles were designated by their level of evidence, based on published standards, and grouped by pathology. An overall grade was assigned to each group for the strength of evidence for or against an association. The search produced 152 articles, 42 of which met inclusion criteria and were reviewed in detail. There is grade C evidence for a positive association between GER and sinusitis (57 articles screened, 14 articles included); for a negative association between GER and otitis media (28 articles screened, 10 articles included); and for a positive association between GER and laryngeal malignancy (67 articles screened, 18 articles included). The published literature weakly supports a positive association between GER and both sinusitis and laryngeal malignancy, and a negative association between GER and otitis media.
Topics: Gastroesophageal Reflux; Humans; Laryngeal Neoplasms; Otitis Media; Sinusitis
PubMed: 12928081
DOI: 10.1016/s0002-9343(03)00203-1 -
Iranian Journal of Public Health Aug 2022We aimed to determine the plausible role of high body mass index (BMI) in the etiopathogenesis of coronary artery disease (CAD), erosive esophagitis (EE) and... (Review)
Review
BACKGROUND
We aimed to determine the plausible role of high body mass index (BMI) in the etiopathogenesis of coronary artery disease (CAD), erosive esophagitis (EE) and gastroesophageal reflux disease (GERD) and their complex associations.
METHODS
The published literature was retrieved from Cochrane, Google Scholar, Embase, PubMed and Scopus databases until August 2021 based on the inclusion and exclusion criteria. The Newcastle-Ottawa quality assessment scale was used for the risk of bias and publication bias with a funnel plot. Heterogeneity between studies underwent evaluation using the statistic and Q-test, and a random and fixed-effect model analysed studies with low to moderate heterogeneity.
RESULTS
Out of 3819 studies extracted, 20 studies were studied based on the inclusion and exclusion criteria. The study corroborated the direct association of GERD symptoms and EE among obese Odds Ratio (OR) = 4.25) and overweight subjects (OR 9.75). Separate analyses of the link between GERD symptoms and EE was conducted among the overweight (OR 4.11, OR 4.61) and obesity subjects was statistically significant (OR 12.07, OR 9.95). The corresponding adjusted OR was noted for the association of CAD with overweight and obesity amounted to 3.41 and 3.01, respectively. Separate subgroup analysis was analyzed based on different ethnic populations for the association between GERD symptoms and EE in obesity (OR of 9.38) and over-weight (OR of 4.21) subjects were statistically significant (<0.05). For population subgroup analyses the overall OR of 3.32 was noted on the association between CAD and obesity.
CONCLUSION
Moderate to severe BMI has bene considered as an independent risk factor for GERD symptoms, EE and CAD.
PubMed: 36249094
DOI: 10.18502/ijph.v51i8.10250 -
Neurogastroenterology and Motility Dec 2022Nocturnal gastroesophageal reflux symptoms have a major impact on sleep quality and are associated with complicated gastroesophageal reflux disease (GERD). We performed... (Review)
Review
BACKGROUND
Nocturnal gastroesophageal reflux symptoms have a major impact on sleep quality and are associated with complicated gastroesophageal reflux disease (GERD). We performed a systematic review to assess the data on the effectiveness of the currently available interventions for the treatment of nocturnal reflux symptoms.
METHODS
We searched PubMed, EMBASE, and the Cochrane Library. All prospective, controlled, and uncontrolled clinical trials in adult patients describing interventions (lifestyle modifications, surgical and pharmacological) for nocturnal gastroesophageal reflux symptoms were assessed for eligibility. A narrative descriptive summary of findings is presented together with summary tables for study characteristics and quality assessment.
KEY RESULTS
The initial reference search yielded 3067 citations; 66 citations were screened in full text, of which 31 articles were included. Studies on lifestyle modifications include head of bed elevation (n = 5), prolonging dinner-to-bed time (n = 2), and promoting left lateral decubitus position (n = 2). Placebo-controlled clinical trials investigating proton pump inhibitors (PPIs) (n = 11) show success rates ranging from 34.4% to 80.8% in the PPI group versus 10.4%-51.7% in the placebo group. Laparoscopic fundoplication is reserved for severe disease only. There is insufficient evidence for a recommendation on the use of nasal continuous positive airway pressure (nCPAP), hypnotics, baclofen and adding bedtime H2 receptor antagonists for reducing nocturnal reflux. CONCLUSION INFERENCES: A sequential treatment strategy, including head of bed elevation, prolonging dinner-to-bed time, promoting left lateral decubitus position and treatment with acid-suppressive medication is recommended for nocturnal gastroesophageal reflux symptoms. Currently, there is insufficient evidence for the use of nCPAP, hypnotics, baclofen and adding bedtime H2 receptor antagonists.
Topics: Adult; Humans; Histamine H2 Antagonists; Baclofen; Prospective Studies; Gastroesophageal Reflux; Proton Pump Inhibitors; Treatment Outcome; Hypnotics and Sedatives
PubMed: 35445777
DOI: 10.1111/nmo.14385 -
International Journal of Surgery... Apr 2018Laparoscopic Nissen and Toupet fundoplication (LF) are currently considered gold-standard surgical treatment for Gastroesophageal Reflux Disease (GERD). Magnetic... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Laparoscopic Nissen and Toupet fundoplication (LF) are currently considered gold-standard surgical treatment for Gastroesophageal Reflux Disease (GERD). Magnetic Sphincter Augmentation (MSA) is an innovative surgical procedure that has been showed to be effective to control GERD symptoms and to reduce esophageal acid exposure. The aim of this systematic review and meta-analysis was to compare early outcomes of LF and MSA.
MATERIALS AND METHODS
PubMed, MEDLINE, Embase, and Cochrane databases were consulted matching the terms "Gastroesophageal reflux or heartburn", "LINX or magnetic sphincter augmentation" and "fundoplication". Pooled effect measures were calculated using an inverse-variance weighted or Mantel-Haenszel in random effects meta-analysis. Heterogeneity was evaluated using I-index and Cochrane Q-test. Meta-regression was used to address the effect of potential confounders.
RESULTS
Seven observational cohort studies, published between 2014 and 2017, matched the inclusion criteria. Overall, 1211 patients, 686 MSA and 525 LF, were included. Postoperative morbidity ranged from 0 to 3% in the MSA group and from 0 to 7% in the LF group, and there was no mortality. Dysphagia requiring endoscopic dilatation occurred in 9.3% and 6.6% of patients respectively (OR = 1.56, 95% CI = 0.61-3.95, p = 0.119). The pooled OR of gas/bloat symptoms, ability to vomit, and ability to belch were 0.39 (95% CI 0.25-0.61; p < 0.001), 10.10 (95% CI 5.33-19.15; p < 0.001), and 5.53 (95% CI 3.73-8.19; p < 0.001), respectively. The postoperative GERD-HRQL was similar (p = 0.101). The pooled OR of PPI suspension, endoscopic dilation, and reoperation were similar in the two patients groups (p = 0.548, p = 0.119, p = 0.183, respectively).
CONCLUSION
Both anti-reflux procedures are safe and effective up to 1-year follow-up. PPI suspension rate, dysphagia requiring endoscopic dilatation, and disease-related quality of life are similar in the two patient groups. MSA is associated with less gas/bloat symptoms and increased ability to vomit and belch.
Topics: Adult; Esophageal Sphincter, Lower; Female; Fundoplication; Gastroesophageal Reflux; Humans; Laparoscopy; Magnets; Male; Middle Aged; Postoperative Complications; Quality of Life; Treatment Outcome
PubMed: 29471155
DOI: 10.1016/j.ijsu.2018.02.041 -
Clinical Gastroenterology and... Apr 2009More than half of patients with chronic gastroesophageal reflux (GERD) report nocturnal symptoms. We performed systematic literature review to define nocturnal heartburn... (Review)
Review
BACKGROUND & AIMS
More than half of patients with chronic gastroesophageal reflux (GERD) report nocturnal symptoms. We performed systematic literature review to define nocturnal heartburn and to determine potential causality between nocturnal reflux and extraesophageal manifestations.
METHODS
We performed a search of literature published from 1974-2007. Each study was examined by 2 reviewers and rated on the basis of study type and outcome.
RESULTS
Screening of 445 trials identified 59 (13%) studies relevant for analysis. Twenty-two (5%) of the trials described potential changes in sleep parameters resulting from treatment of heartburn. In most studies, nocturnal reflux was defined as heartburn symptoms that impacted sleep quality and duration. On the basis of 5 large population studies, the mean +/- standard deviation prevalence of nocturnal heartburn was 54% +/- 22%. Consequences of nocturnal reflux included poor sleep quality, daytime fatigue, difficulty initiating sleep or arousals from sleep, and impaired work productivity. The strength of the association between the occurrence of nocturnal reflux and late evening meals was flawed as a result of the confounding effect of the evening meal content. There was no evidence supporting causality between nocturnal heartburn and asthma or obstructive sleep apnea. Subjective, but not objective, measures of sleep improved with antireflux therapy. Head of bed elevation, proton pump inhibitor therapy, H(2)-receptor antagonists, and Nissen fundoplication alleviated nocturnal heartburn and associated sleep disturbances.
CONCLUSIONS
Nocturnal GERD is common and is associated with adverse sleep parameters. It can be effectively managed with medical and surgical therapy.
Topics: Female; Fundoplication; Gastroesophageal Reflux; Histamine H2 Antagonists; Humans; Male; Prevalence; Proton Pump Inhibitors; Sleep Wake Disorders; Treatment Outcome
PubMed: 19111949
DOI: 10.1016/j.cgh.2008.11.021