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Digestive Diseases and Sciences Feb 2013The prevalence of reflux esophagitis is increasing in Korea. Reflux esophagitis aggravates the stress and fatigue level of daily life, but less is known about the...
BACKGROUND
The prevalence of reflux esophagitis is increasing in Korea. Reflux esophagitis aggravates the stress and fatigue level of daily life, but less is known about the association with stress and fatigue, which could be bi-directional.
AIM
To evaluate the impact of reflux esophagitis on stress and fatigue and to compare the stress level of people with reflux esophagitis with that of controls with peptic ulcer disease and healthy controls.
METHODS
Among a total of 9,033 subjects who underwent a comprehensive medical check-up including upper endoscopy, 6,834 subjects (75.7 %) were enrolled. Stress and fatigue scores were measured by a validated Korean version of the Brief Encounter Psychosocial Instrument and the Fatigue Severity Scale.
RESULTS
Among 6,834 subjects, 13.2 % were in the high-stress group, and reflux esophagitis was found in 6.0 %. After adjustment for confounders, reflux esophagitis was significantly associated with high stress (odds ratio 1.94, 95 % confidence interval 1.25-3.02). Subjects with reflux esophagitis had significantly higher BEPSI-K scores compared with healthy controls (p = 0.027); and however, there was no significant difference in BEPSI-K scores between reflux esophagitis group and peptic ulcer disease controls. Fatigue severity scale was highly correlated with BEPSI-K (p < 0.001); however, there was no significant difference in fatigue severity scale level between the reflux esophagitis group and controls. The severity of reflux esophagitis was significantly correlated with BEPSI-K score (p = 0.008).
CONCLUSIONS
Reflux esophagitis is significantly associated with psychosocial stress, and the severity of reflux esophagitis correlates with the degree of stress.
Topics: Adult; Endoscopy, Gastrointestinal; Esophagitis, Peptic; Fatigue; Female; Humans; Male; Middle Aged; Multivariate Analysis; Prevalence; Republic of Korea; Risk Factors; Severity of Illness Index; Stomach Ulcer; Stress, Psychological
PubMed: 23001402
DOI: 10.1007/s10620-012-2377-z -
Cancer Research and Treatment Jul 2021The aim of the present study was to compare the difference between double tract reconstruction and esophagogastrostomy. (Comparative Study)
Comparative Study
Double Tract Reconstruction Reduces Reflux Esophagitis and Improves Quality of Life after Radical Proximal Gastrectomy for Patients with Upper Gastric or Esophagogastric Adenocarcinoma.
PURPOSE
The aim of the present study was to compare the difference between double tract reconstruction and esophagogastrostomy.
MATERIALS AND METHODS
Patients who underwent radical proximal gastrectomy with esophagogastrostomy or double tract reconstruction were included in this study.
RESULTS
Sixty-four patients were included in this study and divided into two groups according to reconstruction method. The two groups were well balanced in perioperative safety and 3-year overall survival (OS). The rates of postoperative reflux esophagitis in the double tract reconstruction group and esophagogastrostomy group were 8.0% and 30.8%, respectively (p=0.032). Patients in the double tract reconstruction group had a better global health status (p < 0.001) and emotional functioning (p < 0.001), and complained less about nausea and vomiting (p < 0.001), pain (p=0.039), insomnia (p=0.003), and appetite loss (p < 0.001) based on the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire. Regarding the EORTC QLQ-STO22 questionnaire, patients in the double tract reconstruction group complained less about dysphagia (p=0.030), pain (p=0.008), reflux (p < 0.001), eating (p < 0.001), anxiety (p < 0.001), dry mouth (p=0.007), and taste (p=0.001). The multiple linear regression analysis showed that reconstruction method, postoperative complications, reflux esophagitis, and operation duration had a linear relationship with the global health status score.
CONCLUSION
Double tract reconstruction could better prevent reflux esophagitis and improve quality of life without scarifying perioperative safety or 3-year OS.
Topics: Adenocarcinoma; Aged; Esophagitis, Peptic; Esophagogastric Junction; Esophagostomy; Female; Gastrectomy; Gastrostomy; Humans; Male; Middle Aged; Postoperative Complications; Prospective Studies; Quality of Life; Plastic Surgery Procedures; Retrospective Studies; Stomach Neoplasms; Treatment Outcome
PubMed: 33421979
DOI: 10.4143/crt.2020.1064 -
Digestive Diseases and Sciences Aug 2016Esophageal adenocarcinoma and its precursor Barrett's esophagus have been rapidly increasing in incidence for half a century, for reasons not adequately explained by... (Review)
Review
Esophageal adenocarcinoma and its precursor Barrett's esophagus have been rapidly increasing in incidence for half a century, for reasons not adequately explained by currently identified risk factors such as gastroesophageal reflux disease and obesity. The upper gastrointestinal microbiome may represent another potential cofactor. The distal esophagus has a distinct microbiome of predominantly oral-derived flora, which is altered in Barrett's esophagus and reflux esophagitis. Chronic low-grade inflammation or direct carcinogenesis from this altered microbiome may combine with known risk factors to promote Barrett's metaplasia and progression to adenocarcinoma.
Topics: Adenocarcinoma; Barrett Esophagus; Dysbiosis; Esophageal Neoplasms; Esophagitis, Peptic; Esophagus; Gastroesophageal Reflux; Humans; Microbiota; Obesity; Precancerous Conditions; Risk Factors
PubMed: 27068172
DOI: 10.1007/s10620-016-4155-9 -
World Journal of Gastroenterology May 2015The occurrence of gastroesophageal reflux disease is common in the human population. Almost all cases of esophageal adenocarcinoma are derived from Barrett's esophagus,... (Review)
Review
The occurrence of gastroesophageal reflux disease is common in the human population. Almost all cases of esophageal adenocarcinoma are derived from Barrett's esophagus, which is a complication of esophageal adenocarcinoma precancerous lesions. Chronic exposure of the esophagus to gastroduodenal intestinal fluid is an important determinant factor in the development of Barrett's esophagus. The replacement of normal squamous epithelium with specific columnar epithelium in the lower esophagus induced by the chronic exposure to gastroduodenal fluid could lead to intestinal metaplasia, which is closely associated with the development of esophageal adenocarcinoma. However, the exact mechanism of injury is not completely understood. Various animal models of the developmental mechanisms of disease, and theoretical and clinical effects of drug treatment have been widely used in research. Recently, animal models employed in studies on gastroesophageal reflux injury have allowed significant progress. The advantage of using animal models lies in the ability to accurately control the experimental conditions for better evaluation of results. In this article, various modeling methods are reviewed, with discussion of the major findings on the developmental mechanism of Barrett's esophagus, which should help to develop better prevention and treatment strategies for Barrett's esophagus.
Topics: Adenocarcinoma; Animals; Barrett Esophagus; Cell Transformation, Neoplastic; Disease Models, Animal; Disease Progression; Esophageal Neoplasms; Esophagitis, Peptic; Esophagus; Humans; Mucous Membrane; Precancerous Conditions; Risk Factors; Species Specificity
PubMed: 25954094
DOI: 10.3748/wjg.v21.i17.5210 -
The American Journal of Gastroenterology Mar 2019The Montreal definition of gastroesophageal reflux disease (GERD) provided a rationale for acid suppression medication without investigation, thus enhancing the... (Review)
Review
The Montreal definition of gastroesophageal reflux disease (GERD) provided a rationale for acid suppression medication without investigation, thus enhancing the management of the substantial symptom burden in these patients. Increased proton-pump inhibitor use has also highlighted their limitations, with one third of "typical" symptoms known to be refractory. Most refractory symptoms are ascribed to reflux hypersensitivity (RH) and functional heartburn (FH). RH may be caused by impaired esophageal mucosal barrier function and sensitization of peripheral esophageal receptors. Central sensitization may also contribute to the perception of non-pathologic reflux in RH, and the perception of physiological stimuli in FH. Importantly, mechanisms underlying GERD, RH, and FH are (in theory) not mutually exclusive, further complicating patient management. Methods used to distinguish GERD from RH and FH are impractical for use in epidemiological studies and pragmatic care and may have limited diagnostic accuracy. This is impeding accurate prevalence estimates and risk factor determination and the identification of new therapies. Direct assessment of mucosal barrier function by measuring impedance is a promising candidate for improved diagnosis. Ultimately though the concept of GERD as a composite, symptom-based entity needs re-evaluation, so that new understandings of upper GI symptoms can direct more precise management.
Topics: Central Nervous System Sensitization; Electric Impedance; Esophageal Mucosa; Esophageal pH Monitoring; Esophagitis, Peptic; Gastroesophageal Reflux; Heartburn; Humans; Proton Pump Inhibitors
PubMed: 30323266
DOI: 10.1038/s41395-018-0287-1 -
Mystery Solving: Acid Reflux and Cell Mobility in Barrett's Esophagus and Esophageal Adenocarcinoma.Cellular and Molecular Gastroenterology... 2020
Topics: Adenocarcinoma; Barrett Esophagus; Esophageal Neoplasms; Esophagitis, Peptic; Humans; RNA, Small Interfering
PubMed: 32598898
DOI: 10.1016/j.jcmgh.2020.06.002 -
The Turkish Journal of Gastroenterology... Jun 2014This study was designed to investigate risk factors related to asymptomatic erosive esophagitis and the natural history of both endoscopic findings and reflux-related...
BACKGROUND/AIMS
This study was designed to investigate risk factors related to asymptomatic erosive esophagitis and the natural history of both endoscopic findings and reflux-related symptoms in subjects with asymptomatic erosive esophagitis.
MATERIALS AND METHODS
On a retrospective basis, data were gathered from patients with erosive esophagitis (Los Angeles classification 3A) who had undergone endoscopic follow-up at St. Vincent Hospital. Data from 313 subjects with erosive esophagitis were investigated.
RESULTS
Most patients had mild esophagitis (grade A or B, Los Angeles classification); 198 (63.3%) had reflux symptoms, and 115 (36.7%) lacked typical or atypical symptoms. Asymptomatic erosive esophagitis was associated with non-smoking (odds ratio (OR), 2.4; 95% confidence interval (CI), 1.4-3.9) and lower body mass index (body mass index (BMI); OR, 1.5; 95% CI, 1.0-2.4), while 26% of subjects had recurring reflux-related symptoms. Younger subjects were more likely to have reflux-related symptoms (p<0.05).
CONCLUSION
Non-smoking and lower BMI are associated with asymptomatic reflux esophagitis. Most asymptomatic subjects with erosive esophagitis remained stable and exhibited unchanged endoscopic findings.
Topics: Adult; Asymptomatic Diseases; Disease Progression; Esophagitis, Peptic; Esophagoscopy; Female; Follow-Up Studies; Humans; Kaplan-Meier Estimate; Logistic Models; Male; Middle Aged; Multivariate Analysis; Prognosis; Proportional Hazards Models; Retrospective Studies; Risk Factors; Self Report; Severity of Illness Index
PubMed: 25141311
DOI: 10.5152/tjg.2014.5033 -
Gut Aug 2001
Topics: Anti-Ulcer Agents; Drug Design; Esophagitis, Peptic; Humans; Proton Pumps; Treatment Outcome
PubMed: 11454811
DOI: 10.1136/gut.49.2.309 -
Medicine Aug 2021The relationship between chronic obstructive pulmonary disease (COPD) and reflux esophagitis (RE) was controversial. We investigated the factors influencing RE...
The relationship between chronic obstructive pulmonary disease (COPD) and reflux esophagitis (RE) was controversial. We investigated the factors influencing RE development in patients with COPD and evaluated the association between RE and AECOPD.Patients with COPD who underwent esophagogastroduodenoscopy from January 2003 to December 2013 in St. Paul's Hospital, the Catholic University of Korea (Seoul, Korea) were enrolled retrospectively. The grade of RE was based on the Los Angeles classification and minimal change esophagitis. Body mass index, smoking history, medical history, AECOPD, pulmonary function test data, endoscopic findings, and comorbidities were reviewed.Of a total of 218 patients with COPD, 111 (50.9%) were diagnosed with RE. None of age, sex, smoking history, or the severity of airflow limitation was associated with RE. AECOPD was not related to either the presence or severity of RE. There was no significant correlation between RE grade by Los Angeles classification and severity of airflow limitation (P = .625). Those who had RE used theophylline (P = .003) and long-acting muscarinic antagonists (P = .026) significantly more often than did controls. The use of theophylline (OR 2.05; 95% CI, 1.16-3.65, P = .014) was associated with an increased incidence of RE.The use of theophylline might increase the risk of RE in COPD patients. RE may not be associated with airflow limitation or AECOPD.
Topics: Age Factors; Aged; Aged, 80 and over; Body Mass Index; Bronchodilator Agents; Comorbidity; Endoscopy, Digestive System; Esophagitis, Peptic; Female; Humans; Male; Middle Aged; Muscarinic Antagonists; Pulmonary Disease, Chronic Obstructive; Republic of Korea; Respiratory Function Tests; Retrospective Studies; Severity of Illness Index; Sex Factors; Smoking; Theophylline
PubMed: 34449512
DOI: 10.1097/MD.0000000000027091 -
Current Opinion in Pharmacology Dec 2017Traditionally, reflux esophagitis was assumed to develop as a caustic, chemical injury inflicted by refluxed acid. Recently, however, studies in rats and humans suggest... (Review)
Review
A new paradigm for GERD pathogenesis. Not acid injury, but cytokine-mediated inflammation driven by HIF-2α: a potential role for targeting HIF-2α to prevent and treat reflux esophagitis.
Traditionally, reflux esophagitis was assumed to develop as a caustic, chemical injury inflicted by refluxed acid. Recently, however, studies in rats and humans suggest that reflux esophagitis develops as a cytokine-mediated inflammatory injury, with hypoxia inducible factor (HIF)-2α playing a major role. In response to the reflux of acid and bile, HIF-2α in esophageal epithelial cells becomes stabilized, thereby increasing production of pro-inflammatory cytokines that attract T lymphocytes and other inflammatory cells to damage the esophagus. Recent studies have identified small molecule inhibitors of HIF-2α that demonstrate exquisite isoform selectivity, and clinical trials for treatment of HIF-2α-driven kidney cancers are ongoing. It is conceivable that a HIF-2α-directed therapy might be a novel approach to prevention and treatment of reflux esophagitis.
Topics: Animals; Basic Helix-Loop-Helix Transcription Factors; Cytokines; Esophagitis, Peptic; Gastroesophageal Reflux; Humans; Inflammation
PubMed: 29112883
DOI: 10.1016/j.coph.2017.10.004