Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0017168 (gastroesophageal reflux disease)
 11,783 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Lymphocytic esophagitis (LE) is characterized by intraepithelial lymphocytes (IELs) and spongiosis, resembling contact dermatitis. LE has been defined as high numbers of IELs and no or rare granulocytes and was found in young patients and in association with Crohn disease (CD). We reviewed the medical records of 42 LE cases. Cases were divided into severe (IELs in interpapillary and peripapillary fields) and mild (IELs in peripapillary fields) LE. The control group included specimens from 34 consecutive esophageal biopsy cases. Mean ages were similar (LE, 44 years; control subjects, 43 years). CD was present in 5 LE cases (12%) and 1 control case, an insignificant difference. Of patients with LE, 14 (33%) had an allergy; 11 (26%), gastroesophageal reflux disease (GERD); 4 (10%), Helicobacter pylori gastritis; and 18 (43%), dysphagia. No differences were found in clinical features between LE and control cases, except GERD was less common in severe LE (6/30 [20%]) than in control cases (17 [50%]). No patient with LE had celiac disease. No medications were common among LE cases. Patients with LE are statistically no more likely than control subjects to have CD. We found no association between LE and any clinical condition or symptom. Based on sequential biopsies in 7 patients, LE seems to be a chronic disease.
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PMID:Lymphocytic esophagitis: a chronic or recurring pattern of esophagitis resembling allergic contact dermatitis. 1879 41

Gastroesophageal reflux disease (GERD) is a common chronic disorder that is associated with a huge economic burden in the western countries and significantly decreased quality of life. This review focuses on the various multicultural issues in the epidemiology, pathophysiology, diagnosis, and treatment of GERD. The prevalence of GERD appears to be highest in North America and Europe, whereas epidemiologic data from the Indian subcontinent, Africa, South America, and the Middle East are sparse. A limited number of studies have elucidated ethnic differences in GERD in multiracial populations. African Americans and Asians appear to be at a lower risk for the development of complicated GERD including Barrett's esophagus (BE). Whether the pathophysiology of GERD differs among different populations remains to be answered satisfactorily. It appears that most of the factors involved in the pathogenesis of GERD, as described in western populations, are present in Asians but at a lower scale. The current recommendations for the management of GERD by the American College of Gastroenterology may not meet the need for different ethnic groups or for different geographic regions. Recognition of language barriers in understanding the common terms used to describe reflux symptoms should be borne in mind while treating GERD patients with different ethnic backgrounds. In addition, a universally accepted definition for treatment success in GERD patients is lacking. Given the negative impact on health-related quality of life, significant cost ramifications, and increased risk for BE and esophageal adenocarcinoma, the study of multicultural issues in GERD should be considered.
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PMID:Racial and geographic issues in gastroesophageal reflux disease. 1903 62

Gastroesophageal reflux disease (GERD) is an extremely common chronic disorder associated with impaired quality of life and huge economic burden. Recently, an International Consensus Group developed a global definition of GERD (The Montreal Definition): a condition that develops when the reflux of stomach contents causes troublesome symptoms and/or complications. The traditional endoscopy-based classification of GERD patients into one of three groups - non-erosive reflux disease, erosive esophagitis, and Barrett's esophagus - is fraught with several limitations. Due to the lack of a gold standard, GERD is a symptom-based diagnosis, and hence symptom evaluation will remain the primary means by which treatment decisions are made for patients with suspected GERD. We propose that patients reporting the predominant GERD-like symptoms (GERS) in the primary care setting be classified based upon their response to an empiric trial of acid suppressive therapy: complete response to acid suppressive therapy, partial response to acid suppressive therapy, and no response to acid suppressive therapy. Given the limitations of objective medical testing, implementation of our proposed new symptom-based classification of patients with GERS would guide primary care physicians on when to refer patients to a gastroenterologist, which in turn could help in better resource utilization. Validation of this proposed classification by well-designed prospective multicenter studies is awaited.
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PMID:Endoscopy of the esophagus in gastroesophageal reflux disease: are we losing sight of symptoms? Another perspective. 1919 51

Gastroesophageal reflux disease has become recently an important question, especially in developed countries. Untreated or improperly treated could in chronic disease or can lead to serious complications including esophageal cancer. Early diagnosis establishment basing on clinical symptoms and diagnosing methods. Typical signs of gastroesophageal reflux diseases are acidity, regurgitation, especially after heavy meals or body position change. Those signs are basic for diagnosing establishment. It is recommended to introduce empiric treatment and more diagnostics should be employed if the treatment is not successful. Among diagnosing methods constant development is taking place what is associated with technology progress along with clinical trials. Authors in the paper basic diagnosing tools are presented showing their possibilities and limitations. Proper use of those diagnosing tools that should lead to quick diagnosis establishment.
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PMID:[The importance of functional tests in gastroesophageal reflux disease diagnosing, monitoring and treatment]. 1960 14

Occasional acid reflux occurs frequently in the general population but gastroesophageal reflux disease (GERD), a chronic disease that affects millions of adults and children, is diagnosed if persistent reflux occurs more than twice a week. The development of proton pump inhibitors (PPIs) dramatically improved the treatment of GERD; however, the treatment of patients with refractory GERD remains a challenge. Dexlansoprazole (TAK-390MR, Kapidex), a pure enantiomer of lansoprazole, is a PPI that, with a novel dual delayed release formulation, provides prolonged inhibition of gastric acid secretion resulting in marked improvements in symptoms of GERD with high maintenance rates and good tolerability. Dexlansoprazole recently received Food and Drug Administration approval for the once-daily oral treatment of heartburn associated with symptomatic nonerosive GERD, the healing of erosive esophagitis (EE) and the maintenance of healed EE.
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PMID:Dexlansoprazole for the treatment of esophagitis and GERD. 2039 35

Anticholinergic effects of medications are factors in autonomic control of the lower esophageal sphincter function. Changes in sphincter control often lead to gastroesophageal reflux disease (GERD), a chronic disease with a prevalence of up to 25% for adults. This effect is a consideration in the treatment of depression, the fourth-leading disease burden. Lower esophageal-sphincter changes are well documented in association with tricyclic antidepressants. The newer medications, selective serotonin-reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors, are often used as first-line agents. This case report reviews the emergence of GERD in association with the use of newer agents. The patient, a 55-year-old woman, presented to her primary care physician with complaints of low energy, dysphoric mood, and anhedonia of several months' duration. Trials of citalopram and escitalopram were associated with reports of persistent nausea and gastric reflux unresolved by changes in dosing schedule or positioning. Over-the-counter omeprazole on an as-needed basis was added. Ultimately, the patient was successfully managed with desvenlafaxine for dysphoric mood and low energy and scheduled administration of omeprazole for GERD. The adverse drug reaction was evaluated using the Naranjo Adverse Drug Reaction Probability Scale. This methodology indicated a probable relationship (score of 7 out of 12) between initiation of antidepressant therapy and the presentation of GERD symptoms. When evaluating patient response to medication, inquiring about new-onset symptoms may help assess pharmacotherapy, identify potential medication-related effects such as the anticholinergic profile, evaluate the need to add an antisecretory/antispasmodic agent, or consider an alternative treatment strategy.
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PMID:Antidepressant-mediated gastroesophageal reflux disease. 2148 38

Asthma is the most common chronic disease in children. Prevalence has increased in the past 2 decades and has reached a plateau of approximately 9% of children in the United States, affecting about 6.7 million children. The increased prevalence of childhood asthma has paralleled the increased prevalence in childhood obesity. Changes in diet have also been implicated in the increased prevalence of asthma, among other risk factors. The main symptoms of asthma (ie, wheezing, coughing, and chest tightness) require medical evaluation and monitoring. The cornerstone of asthma management is medication therapy, frequently consisting of inhaled bronchodilators and corticosteroids and, when needed, therapy of corticosteroids by mouth. As part of the multidisciplinary management of this chronic disease, nutrition assessment and follow-up in childhood asthma is necessary to identify and address relevant nutrition-related problems. These problems can involve food-medication interactions, obesity, gastroesophageal reflux disease, food allergies, and other issues; therefore, individualized medical nutrition therapy is warranted. Finally, counseling to achieve a healthy balanced diet is recommended for overall health and weight management. A recent but small number of descriptive investigations agree that adherence to a Mediterranean dietary pattern can be associated with a decreased risk of current asthma symptoms in children. Although this evidence is promising, food interventions are required to substantiate an evidence-based foundation for medical nutrition therapy in childhood asthma. At this time, there is no known health risk if a Mediterranean diet is adopted.
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PMID:A medical nutrition therapy primer for childhood asthma: current and emerging perspectives. 2170 84

Respiratory fungal infections are usually found in immunocompromised individuals who have received either long-term steroid therapy or broad-spectrum anti-microbial therapy or have a non-resolving underlying chronic disease. These infections are seen as a part of bronchopulmonary fungal infections, and their isolated and primary occurrence as laryngeal diseases is highly uncommon. Laryngeal fungal infections can also mimic various diseases, such as gastroesophageal reflux disease, granulomatous diseases, leukoplakia, and carcinoma, thereby misleading the treating team from correct diagnosis and management. It is therefore important to identify the lesion at the earliest point possible to avoid morbid or life-threatening consequences. We report a case of isolated laryngeal candidiasis in an immunocompetent Indian male with an unusual presentation mimicking laryngeal carcinoma. The clinical and histological features are highlighted with a review of relevant literature to demonstrate the possibility of such an isolated fungal lesion, even in an immunocompetent individual.
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PMID:A case of isolated laryngeal candidiasis mimicking laryngeal carcinoma in an immunocompetent individual. 2213 5

Gastroesophageal reflux disease (GERD) is a frequent chronic disorder occurring in two forms: on the one hand, typical symptoms such as heartburn and acid regurgitation are seen, while on the other hand atypical (extraesophageal) symptoms such as chronic cough, hoarseness, recurrent sinusitis, globus sensations in the throat, a burning feeling on the tongue, dental erosions and the constant need to clear the throat can be associated with gastroesophageal reflux. The standard therapeutic medical procedure comprises the administration of acid-suppressive agents, proton pump inhibitors (PPI). However, this therapy has proved to be ineffective in a number of patients, especially in atypical GERD. Only after reliable identification of the GERD patient by using valid diagnostic tools medical or interventional therapeutic options can be applied individually. In the absence of atypical GERD symptoms, the diagnosis of GERD becomes very unlikely and other causes of the symptoms need to be taken into consideration.
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PMID:[Diagnosis and therapy of atypical reflux symptoms when PPI therapy fails]. 2240 99

Gastroesophageal reflux disease (GERD) is a chronic disorder of the upper gastrointestinal tract with global distribution. The incidence is on the increase in different parts of the world. In the last 30 to 40 years, research findings have given rise to a more robust understanding of its pathophysiology, clinical presentation, and management. The current definition of GERD (The Montreal definition, 2006) is not only symptom-based and patient-driven, but also encompasses esophageal and extraesophageal manifestations of the disease. The implication is that the disease can be confidently diagnosed based on symptoms alone. Nonerosive reflux disease (NERD) remains the predominant form of GERD. Current thinking is that NERD and erosive reflux disease (ERD) are distinct phenotypes of GERD rather than the old concept which regarded them as components of a disease spectrum. Non erosive reflux disease is a very heterogeneous group with significant overlap with other functional gastrointestinal disorders. There is no gold standard for the diagnosis of GERD. Esophageal pH monitoring and intraluminal impedance monitoring have thrown some light on the heterogeneity of NERD. A substantial proportion of GERD patients continue to have symptoms despite optimal PPI therapy, and this has necessitated research into the development of new drugs. Several safety concerns have been raised about chronic use of proton pump inhibitors but these are yet to be substantiated in controlled studies. The debate about efficacy of long-term medical treatment compared to surgery continues, however, recent data indicate that modern surgical techniques and long-term PPI therapy have comparable efficacy. These and other issues are subjects of further research.
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PMID:Current trends in the management of gastroesophageal reflux disease: a review. 2284 7


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