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Query: UMLS:C0017168 (gastroesophageal reflux disease)
 11,783 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Gastro-oesophageal reflux disease is a chronic disorder. The most important therapeutic measure is long-term pharmacological acid inhibition. Anti-reflux surgery plays a role in cases where pharmacological treatment fails. A new development is endoluminal treatment for reflux disorders. The various methods used are based on one of the following principles: radiofrequency ablation, gastroplication and implantation of a bulking agent. Short-term results with endoluminal treatment are not very positive and longer-term results have been disappointing so far. Results from randomised studies are still largely unavailable. Longer follow-up and controlled randomised studies are needed before a well-founded judgment can be made regarding the place of endoluminal treatment in the therapeutic armamentarium.
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PMID:[Endoluminal treatment of gastro-oesophageal reflux disease: too early to determine a clear role]. 1673 81

The prevalence of gastroesophageal reflux disease (GERD) is increasing. GERD is a chronic disease and its treatment is problematic. It may present with various symptoms including heartburn, regurgitation, dysphagia, coughing, hoarseness or chest pain. The aim of this study was to investigate if a dietary supplementation containing: melatonin, l-tryptophan, vitamin B6, folic acid, vitamin B12, methionine and betaine would help patients with GERD, and to compare the preparation with 20 mg omeprazole. Melatonin has known inhibitory activities on gastric acid secretion and nitric oxide biosynthesis. Nitric oxide has an important role in the transient lower esophageal sphincter relaxation (TLESR), which is a major mechanism of reflux in patients with GERD. Others biocompounds of the formula display anti-inflammatory and analgesic effects. A single blind randomized study was performed in which 176 patients underwent treatment using the supplement cited above (group A) and 175 received treatment of 20 mg omeprazole (group B). Symptoms were recorded in a diary and changes in severity of symptoms noted. All patients of the group A (100%) reported a complete regression of symptoms after 40 days of treatment. On the other hand, 115 subjects (65.7%) of the omeprazole reported regression of symptoms in the same period. There was statiscally significant difference between the groups (P < 0.05). This formulation promotes regression of GERD symptoms with no significant side effects.
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PMID:Regression of gastroesophageal reflux disease symptoms using dietary supplementation with melatonin, vitamins and aminoacids: comparison with omeprazole. 1694 79

Clinical practice guidelines for the management of acute bacterial rhinosinusitis in children were published by the American Academy of Pediatrics in 2001. Changes in the antibiotic susceptibility patterns for the common pathogens causing both acute and chronic rhinosinusitis warrant a reevaluation and update of these recommendations. In addition, there was only a very brief discussion of chronic disease in this publication, with the conclusion that the pathogenesis and management of recurrent or prolonged infection were essentially unknown. Although there are still insufficient data in the literature to develop evidence-based clinical guidelines, a careful review of recent literature and the clinical experience of experts who manage pediatric chronic sinusitis are presented in an effort to provide some specific recommendations and to offer practical treatment options. Factors associated with chronic rhinosinusitis should be addressed individually and include environmental pollution, recurrent viral upper respiratory infections, allergic and nonallergic rhinitis, ciliary dyskinesia, cystic fibrosis, immunodeficiency, gastroesophageal reflux, and anatomic abnormalities.
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PMID:Rhinosinusitis in children. 1702 77

Gastroesophageal reflux disease (GERD) is a common chronic disorder affecting millions of people worldwide. This is a review of a number of published studies in the past year that increase current understanding or raise important issues about this disorder. Among the areas covered are the epidemiology and role of genetics in GERD; its pathogenesis with respect to duodenogastric reflux and impaired epithelial barrier function; the effects of atropine on transient lower esophageal sphincter relaxations; the role of acid suppression, heat shock proteins, and the enzyme cyclooxygenase-2 in Barrett esophagus and esophageal adenocarcinoma; the complication rates in laparoscopic fundoplication; and the results of ablation therapy for the treatment of Barrett esophagus and esophageal adenocarcinoma. These investigations reinforce a sense of the complexity of GERD and provide optimism that modern technology will continue to be used to develop more effective treatments.
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PMID:Gastroesophageal reflux disease. 1703 Nov 1

Gastroesophageal reflux disease (GERD) is a chronic disorder that affects millions of people worldwide and has the potential to lead to serious consequences, including cancer of the esophagus. It for this reason that there is such intense interest in the topic, this emphasized by the identification of some 341 articles published in the English language in the year 2000 alone. The present report highlights the results of a number of studies that either increase our understanding of the condition or raise important issues about its diagnosis and treatment. Included in the areas covered are (1) the role of genetics in GERD; (2) the mechanism for transient lower esophageal sphincter relaxations and their association with hiatal hernias; (3) the role of Helicobacter pylori in GERD and Barrett esophagus; (4) efficacy and safety of proton pump inhibitors in GERD; and (5) the mechanism for chronic cough in patients with GERD, among others.
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PMID:Gastroesophageal reflux disease. 1703 Nov 84

Gastro-oesophageal reflux disease is a common chronic disorder which has a severe effect on the patient's quality of life. In view of the high cost of medical therapy and the limitations of surgery, a variety of endoscopic techniques have been developed for the treatment of this condition, and these have shown apparently encouraging results, at least in the short- term. However, several inconsistencies have emerged between the efficacy of endoscopic treatment in improving symptoms and quality of life and a lack of improvement of objective parameters. Controlled studies are urgently needed in order to clarify the potential of endoscopic therapy. Currently, the use of endoscopic treatment should be limited to clinical trials.
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PMID:Endoscopic treatment of gastro-oesophageal reflux disease. 1734 33

In children, as in adults, gastroesophageal reflux disease (GERD), particularly erosive esophagitis, is now believed to be a chronic disease, probably requiring lifelong maintenance therapy. However, this assumption has not received adequate clinical testing, and the provocative article by Boccia et al. in this issue of the Journal challenges it. The strengths of this exceptional pediatric study lie in its prospective, controlled, randomized character, and in its relatively long duration of prospective follow-up. Weaknesses of the study include its limited power and lack of prior validation of outcome measures. The conclusions of the study are applicable only to children without chronic neurologic, respiratory, or congenital esophageal abnormalities, the children for whom chronic proton pump inhibitors (PPIs) are most often required. The study's provocative results might be explained by the fundamental lack of GERD chronicity in otherwise healthy children, combined with absence of the PPI dependence that can be produced when PPIs are used chronically for chronic disease.
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PMID:Pediatric erosive esophagitis maintenance: finally, some level 1 evidence! 1731 27

Gastroesophageal reflux disease (GERD) is a very common chronic disorder manifesting itself as heartburn, regurgitation, or dysphagia, possibly leading to esophagitis, Barrett's esophagus and adenocarcinoma, and has a major impact on the patient's quality of life. Both medical treatment and surgery are well-established methods with several limitations. Recently, three types of endoscopic methods in several modifications have been developed: (1) Radiofrequency therapy (Stretta procedure) is available both in Europe and USA and more than 5,000 patients have been treated to date. (2) Injection therapy requires the injection of bulking agents or implantation of bioprosthesis into the lower esophageal sphincter (LES) zone. Both Enteryx was withdrawn from the market in 2005, and Gatekeeper was suspended before FDA approval. (3) Suturing/plication therapy is based on the plication at the level of the LES, and most of all techniques resemble the principle of surgical treatment. Despite sophisticated technologies and promising short-term results, all these techniques are associated with inconsistencies, controversies, and relevant adverse affects. According to current practice, use of endoscopic methods is justifiable only as part of clinical trials. Many aspects, including commercial ones, will influence future developments in this area, which are difficult to predict.
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PMID:Treatment of gastroesophageal reflux disease: endoscopic aspects. 1782 37

Systemic sclerosis is a chronic disorder of connective tissue that affects the gastrointestinal tract in more than 80% of patients. Changes in neuromuscular function with progressive fibrosis of smooth muscle within the muscularis propria impair normal motor function, which may secondarily alter transit and nutrient absorption. Esophageal manifestations with gastroesophageal reflux and dysphagia are the most common visceral manifestation of the disease, often requiring more intense acid-suppressive medication. Gastric involvement may lead to gastroparesis, which can be found in up to 50% of patients. Severe small bowel disease can present as chronic intestinal pseudo-obstruction with distended loops of small intestine, bacterial overgrowth, impaired absorption and progressive development of nutritional deficiencies. While not studied as extensively, systemic sclerosis often also affects colorectal function resulting in constipation, diarrhea or fecal incontinence. Nutritional support and prokinetics have been used with some success to manage gastric and small or large bowel involvement in patients with systemic sclerosis. Despite advances in management, significant gastrointestinal manifestations of systemic sclerosis still carry a poor prognosis with a five-year mortality exceeding 50%.
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PMID:Gastrointestinal manifestations of systemic sclerosis. 1793 61

Gastroesophageal reflux disease (GERD) is a chronic disease deteriorating patient's quality of life. With the advent of proton pump inhibitors, treatment failures have decreased considerably. However, surgical therapy offers the potential for cure in more than 90% of patients with GERD. Specific indications for antireflux surgery are: incomplete response to medical therapy, frequent recurrences despite the medical treatment, laryngopharyngeal, and/or respiratory symptoms, and complications of GERD, such as esophageal stricture, erosive esophagitis, esophageal ulcer, and/or Barrett's esophagus. The introduction of laparoscopic surgery in early ninties had a profound impact on many surgical fields, including the treatment of GERD. In this review, laparoscopic Nissen fundoplication is described and controversial topics, such as total vs. partial fundoplication, and the natural history of Barrett's esophagus after antireflux surgery are addressed.
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PMID:[Minimally invasive surgery for gastroesophageal reflux disease]. 1815 85


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