-
Journal of the National Medical... Dec 1987Since esophagitis is increasing in frequency, the authors reviewed case histories of patients with this disorder. The importance of radiographic examination of the...
Since esophagitis is increasing in frequency, the authors reviewed case histories of patients with this disorder. The importance of radiographic examination of the stomach and duodenum in patients with esophagitis (heartburn) is stressed.
Topics: Adult; Aged; Duodenum; Esophagitis, Peptic; Female; Heartburn; Humans; Male; Middle Aged; Radiography; Stomach
PubMed: 3430645
DOI: No ID Found -
BioMed Research International 2014Esophagitis was induced in rats within 3 h by ligating both the pylorus and transitional region between the forestomach and glandular portion under ether anesthesia.... (Review)
Review
Esophagitis was induced in rats within 3 h by ligating both the pylorus and transitional region between the forestomach and glandular portion under ether anesthesia. This esophageal injury was prevented by the administration of acid suppressants and antipepsin drug and aggravated by exogenous pepsin. Damage was also aggravated by pretreatment with indomethacin and the selective COX-1 but not COX-2 inhibitor, whereas PGE2 showed a biphasic effect depending on the dose; a protection at low doses, and an aggravation at high doses, with both being mediated by EP1 receptors. Various amino acids also affected this esophagitis in different ways; L-alanine and L-glutamine had a deleterious effect, while L-arginine and glycine were highly protective, both due to yet unidentified mechanisms. It is assumed that acid/pepsin plays a major pathogenic role in this model of esophagitis; PGs derived from COX-1 are involved in mucosal defense of the esophagus; and some amino acids are protective against esophagitis. These findings also suggest a novel therapeutic approach in the treatment of esophagitis, in addition to acid suppressant therapy. The model introduced may be useful to test the protective effects of drugs on esophagitis and investigate the mucosal defense mechanism in the esophagus.
Topics: Amino Acids; Animals; Cyclooxygenase Inhibitors; Disease Models, Animal; Esophagitis, Peptic; Humans; Pepsin A; Prostaglandins
PubMed: 24672789
DOI: 10.1155/2014/532594 -
Alimentary Pharmacology & Therapeutics Oct 2022Optimal ambulatory reflux monitoring methodology in symptomatic reflux patients continues to be debated.
BACKGROUND
Optimal ambulatory reflux monitoring methodology in symptomatic reflux patients continues to be debated.
AIMS
To utilise published literature and expert opinion to develop recommendation statements addressing use of ambulatory reflux monitoring in clinical practice METHODS: The RAND Appropriateness Method (RAM) was utilised among 17 experts with discussion, revision and two rounds of ranking of recommendation statements. Ambulatory reflux monitoring protocol, methodology and thresholds ranked as appropriate by ≥80% of panellists met the criteria for appropriateness.
RESULTS
Prolonged (96-h recommended) wireless pH monitoring off proton pump inhibitor (PPI) was identified as the appropriate diagnostic tool to assess the need for acid suppression in patients with unproven gastro-oesophageal reflux disease (GERD) and persisting typical reflux symptoms despite once-daily PPI. Acid exposure time (AET) <4.0% on all days of monitoring with negative reflux-symptom association excludes GERD and does not support ongoing PPI treatment. Conversely, AET >6.0% across ≥2 days is conclusive evidence for GERD and supports treatment for GERD, while AET >10% across ≥2 days identifies severe acid burden that supports escalation of anti-reflux treatment. In previously proven GERD, impedance-pH monitoring on PPI is helpful in defining refractory GERD and mechanisms of continued symptoms; the presence of <40 reflux events, AET <2.0% and a negative reflux-symptom association does not support escalation of anti-reflux treatment. In contrast, AET > 4.0% and positive reflux-symptom association support escalation of anti-reflux treatment, including use of invasive therapeutics.
CONCLUSIONS
Statements meeting appropriateness for average clinical care have been identified when utilising reflux monitoring in patients with typical reflux symptoms and PPI non-response.
Topics: Humans; Esophageal pH Monitoring; Esophagitis, Peptic; Gastroesophageal Reflux; Proton Pump Inhibitors
PubMed: 35971888
DOI: 10.1111/apt.17180 -
The Indian Journal of Medical Research Dec 2013
Topics: Animals; Esophagitis, Peptic; Female; Panax; Plant Preparations
PubMed: 24672833
DOI: No ID Found -
Digestion 2012Obesity has become a major concern among gastroenterologists due to its large influence on gastrointestinal and hepatic diseases: reflux esophagitis, pancreatitis,... (Review)
Review
Obesity has become a major concern among gastroenterologists due to its large influence on gastrointestinal and hepatic diseases: reflux esophagitis, pancreatitis, gallstone disease, liver fibrosis, and neoplastic tumors of the esophagus, pancreas, and colon. Studies of morbid obese subjects undergoing bariatric surgery have revealed that obesity is related with an increased prevalence of endoscopic and histologic gastritis. A recent study of health check-up subjects demonstrated an association of obesity with endoscopic gastritis and gastric ulcers. We recently investigated the underlying mechanisms of the effects of obesity on endoscopic gastritis in subjects undergoing health check-up examination, and demonstrated that adiponectin, a bioactive molecule released from visceral fat, could be a protective factor of endoscopic gastritis. We would like to propose a new category of gastritis, obesity-related gastritis, which could become dominant in the near future.
Topics: Adiponectin; Endoscopy, Gastrointestinal; Esophagitis, Peptic; Esophagus; Gastritis; Humans; Obesity; Risk Factors
PubMed: 22269289
DOI: 10.1159/000334680 -
World Journal of Gastroenterology Jun 2009To determine the effect of ethnicity on the severity of reflux esophagitis (RE) and its complications.
AIM
To determine the effect of ethnicity on the severity of reflux esophagitis (RE) and its complications.
METHODS
A retrospective search of the endoscopy database at the University of Florida Health Science Center/Jacksonville for all cases of reflux esophagitis and its complications from January 1 to March 31, 2001 was performed. Inclusion criteria were endoscopic evidence of esophagitis using the LA classification, reflux related complications and self-reported ethnicity. The data obtained included esophagitis grade, presence of a hiatal hernia, esophageal ulcer, stricture and Barrett's esophagus, and endoscopy indication.
RESULTS
The search identified 259 patients with RE or its complications, of which 171 were non-Hispanic whites and 88 were African Americans. The mean ages and male/female ratios were similar in the two groups. RE grade, esophageal ulcer, stricture and hiatal hernia frequency were likewise similar in the groups. Barrett's esophagus was present more often in non-Hispanic whites than in African Americans (15.8% vs 4.5%; P < 0.01). Heartburn was a more frequent indication for endoscopy in non-Hispanic whites with erosive esophagitis than in African Americans (28.1% vs 7.9%; P < 0.001).
CONCLUSION
Distribution of RE grade and frequency of reflux-related esophageal ulcer, stricture and hiatal hernia are similar in non-Hispanic whites and African Americans. Heartburn was more frequently and nausea/vomiting less frequently reported as the primary endoscopic indication in non-Hispanic whites compared with African Americans with erosive esophagitis or its complications. African Americans have a decreased prevalence of Barrett's esophagus compared with non-Hispanic whites.
Topics: Adolescent; Adult; Black or African American; Aged; Aged, 80 and over; Barrett Esophagus; Esophagitis, Peptic; Esophagoscopy; Female; Heartburn; Humans; Male; Middle Aged; Retrospective Studies; White People; Young Adult
PubMed: 19533809
DOI: 10.3748/wjg.15.2878 -
Archives of Pathology & Laboratory... Jul 2009Esophagitis is a common cause of symptoms for which patients seek the advice of a physician. Esophagitis of differing etiologies often demonstrate overlapping... (Review)
Review
CONTEXT
Esophagitis is a common cause of symptoms for which patients seek the advice of a physician. Esophagitis of differing etiologies often demonstrate overlapping histopathologic features, making their distinction difficult. This is especially true in esophageal disorders associated with increased numbers of intraepithelial eosinophils, some of which have just recently been recognized.
OBJECTIVE
This review discusses the important clinical and pathologic features of the 2 most common disorders associated with esophageal eosinophilic infiltrates--reflux esophagitis and eosinophilic esophagitis--with special emphasis on features that allow the surgical pathologist to distinguish between these disorders. The various forms of drug-induced esophagitis are also discussed because these are frequently underrecognized by pathologists.
DATA SOURCES
Data were extracted from articles identified through PubMed-based research. Histologic figures have been taken from the personal case collection of the author.
CONCLUSIONS
Reflux and eosinophilic esophagitis demonstrate overlapping histologic features, which may make their distinction difficult. Drug-induced esophagitis is probably a common phenomenon but is underrecognized by pathologists.
Topics: Adult; Diagnosis, Differential; Drug Hypersensitivity; Drug-Related Side Effects and Adverse Reactions; Eosinophils; Esophagitis; Esophagitis, Peptic; Humans
PubMed: 19642735
DOI: 10.5858/133.7.1087 -
Journal of Korean Medical Science Feb 2021The impact of reflux esophagitis on the decline of lung function has been rarely reported. This study was performed to evaluate the association between erosive reflux...
BACKGROUND
The impact of reflux esophagitis on the decline of lung function has been rarely reported. This study was performed to evaluate the association between erosive reflux esophagitis and lung function changes.
METHODS
We included patients with normal lung function who underwent esophagogastroduodenoscopy for health screening from a health screening center. Patients with persistent erosive reflux esophagitis on two discrete endoscopic examinations were designated as the erosive reflux esophagitis group. We also selected patients without erosive reflux esophagitis and matched them 1:4 with patients from the erosive reflux esophagitis group. We estimated annual forced expiratory volume in 1 second (FEV₁) and forced vital capacity (FVC) changes from baseline and compared these estimates by the linear mixed regression model. We also estimated the biannual incidence of chronic obstructive pulmonary disease (COPD).
RESULTS
In total, 1,050 patients (210 patients with erosive reflux esophagitis, and 840 matched controls) were included. The median follow-up duration for spirometry was six years. In patients with erosive reflux esophagitis, mild reflux esophagitis (A grade) was most common (165 patients, 78.6%). The adjusted annual FEV₁ change in patients with erosive reflux esophagitis was -51.8 mL/yr, while it decreased by 46.8 mL/yr in controls ( = 0.270). The adjusted annual FVC decline was similar between the two groups (-55.8 vs. -50.5 mL/yr, = 0.215). The estimated COPD incidence during the follow-up period was not different between the erosive reflux esophagitis and control groups.
CONCLUSION
In patients with normal lung function, the presence of erosive reflux esophagitis did not affect the annual declines in FEV₁ or FVC.
Topics: Adult; Case-Control Studies; Endoscopy, Digestive System; Esophagitis, Peptic; Female; Humans; Lung; Male; Middle Aged; Pulmonary Disease, Chronic Obstructive; Retrospective Studies; Severity of Illness Index; Spirometry; Vital Capacity
PubMed: 33527781
DOI: 10.3346/jkms.2021.36.e29 -
Medicine Aug 2020Gastroesophageal reflux disease is a common and troublesome condition. This paper reports a rare case of gastroesophageal reflux disease caused by ectopic biliary...
INTRODUCTION
Gastroesophageal reflux disease is a common and troublesome condition. This paper reports a rare case of gastroesophageal reflux disease caused by ectopic biliary drainage accompanying the absence of a pyloric channel and duodenal bulb in a female patient with multiple underlying malformations.
PATIENT CONCERNS
A 24-year-old female presented with acid regurgitation and abdominal pain for one month. She was born two weeks premature and with blindness of the right eye. Cardiac murmur was detected in the physical examination.
DIAGNOSIS
Gastroendoscopy was performed, and a class D reflux esophagitis and ectopic papilla complicated with the absence of a pyloric channel and duodenal bulb were found. Doppler echocardiography further confirmed the defects of atrial and ventricular septa. Trio-based whole exome sequencing was performed on the proband and her family to find the potential association of multiple variations. However, no putative pathogenic mutations were found.
INTERVENTIONS
The patient received proton pump inhibitors and prokinetic treatment and underwent surgical repair of septal defects.
OUTCOMES
The symptoms were quickly relieved, and the patient was kept stable upon follow-up.
CONCLUSION
The combination of an absent pylorus and ectopic papilla is a rare cause of reflux esophagitis. Unusual gastrointestinal anatomical variations may be accompanied by other malformations. Though no remarkable mutation were detected in this case, sequencing is an efficient technique worth full consideration.
Topics: Abnormalities, Multiple; Ampulla of Vater; Blindness; Esophagitis, Peptic; Female; Gastroscopy; Heart Septal Defects, Atrial; Heart Septal Defects, Ventricular; Humans; Proton Pump Inhibitors; Exome Sequencing; Young Adult
PubMed: 32871896
DOI: 10.1097/MD.0000000000021758 -
PloS One 2017To conduct a systematic review and meta-analysis of studies comparing the gastric-tube vs. whole-stomach for esophageal cancer in order to determine the optimal surgical... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To conduct a systematic review and meta-analysis of studies comparing the gastric-tube vs. whole-stomach for esophageal cancer in order to determine the optimal surgical technique of esophagectomy.
METHODS
A comprehensive literature search was performed using PubMed, EMBASE, ScienceDirect, Ovid MEDLINE, Cochrane Library, Web of Science, Google Scholar, and Scopus. Clinical trials that compared the gastric-tube versus whole-stomach for esophageal cancer were selected. The clinical endpoints included anastomotic leakage, anastomotic stenosis, reflux esophagitis, pneumonia, delayed gastric emptying, and thoracic stomach syndrome.
RESULTS
A total of 6 articles (1571 patients) were included. Compared to the whole-stomach approach, the gastric-tube approach was associated with a lower incidence of reflux esophagitis (95% confidence interval [CI]: 0.16 to 0.81, p = 0.01) and thoracic stomach syndrome (95% CI: 0.17 to 0.55, p < 0.0001). The rates of anastomotic leakage, anastomotic stenosis, pneumonia, and delayed gastric emptying did not significantly differ between the two groups.
CONCLUSIONS
The gastric-tube esophagectomy is superior to the whole-stomach approach, as it is associated with a lower incidence of postoperative reflux esophagitis and thoracic stomach syndrome. Our findings must be validated in large-scale randomized controlled trials.
Topics: Anastomotic Leak; Esophageal Neoplasms; Esophagectomy; Esophagitis, Peptic; Humans; Pneumonia; Publication Bias
PubMed: 28267808
DOI: 10.1371/journal.pone.0173416