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)

Forty per cent of patients with heartburn may have no evidence of oesophagitis or of abnormal oesophageal acid exposure. The symptom index correlates symptoms that occur during pH monitoring with episodes of acid reflux, being the number of symptoms during reflux divided by the total number occurring during monitoring. This index was assessed in 61 patients with heartburn. In 39 patients with endoscopic evidence of oesophagitis or abnormal acid exposure times on pH monitoring, the symptom index had a sensitivity of 90 per cent. Of the 22 patients with no objective abnormality, the index was > or = 50 per cent in five (23 per cent) whose symptoms were presumably due to acid reflux despite results of other investigations being normal, suggesting an acid-sensitive oesophagus. The symptom index is a useful additional measure in the investigation of patients with suspected gastro-oesophageal reflux disease.
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PMID:Symptom index as a marker of gastro-oesophageal reflux disease. 142 18

Conventional oesophageal manometric studies are open to criticism in that they take place on fasted immobile subjects in the artificial setting of a motility laboratory. A new 24-h pH and motility recording system combined with computerized data analysis was used to study patients with gastro-oesophageal reflux disease and oesophageal motor abnormalities under ambulant conditions. Acid reflux episodes were found to be precipitated by a variety of events with recognizable pressure patterns. Acid clearance abnormalities were demonstrated in patients with erosive oesophagitis but were confined to those with abnormal oesophageal motor function. Improved diagnostic accuracy was demonstrated in the recognition of oesophageal motor disorders.
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PMID:Ambulatory measurement of oesophageal function: clinical use of a new pH and motility recording system. 142 19

Esophageal pH monitoring was carried out with self-made portable pH recorder in 21 subjects for 24 hours under normal conditions. The results were as follows: the number of physiological gastroesophageal reflux (GER, pH < 4) was less than 23 times; the percentage of GER duration calculated by dividing the cumulative time of pH less than 4 by the total monitoring time was less than 1.4; the percentage was about 2 in upright position and less than 0.2 in lying position; the duration of the longest reflux episode was less than 5 minutes; the physiological gastroesophageal reflux occurred more often in upright position; while the pathological GER took place both in upright and lying position. Our study also indicated that the degree of esophagitis had no relation with the type of GER.
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PMID:[24-hour esophageal pH monitoring. An analysis of 21 cases]. 142 2

Squamous cell carcinoma is the most common malignant tumor of the esophagus and it is one of the most common fatal cancers worldwide. There is great geographic variation in occurrence of these tumors. Especially high-risk areas have been identified in Northern Iran, Central Asian Republics, Northern China and South Africa. In some of these areas annual mortality rates reach 133/100,000 and over 20% of the population dies of esophageal cancer. The mortality in the US is considerably lower (3 to 8 per 100,000). In common with squamous dysplasias elsewhere eg the cervix, squamous dysplasia of the esophagus also appears to be a precancerous lesion. We have found that squamous dysplasia and early cancer are characterized by a number of distinctive endoscopic changes, namely, mucosal friability, erosions, plaques and nodules. Another finding of interest is the failure on our part to confirm the frequency of esophagitis in high risk areas. Barrett's esophagus is an epithelial metaplasia which replaces esophageal squamous epithelium for variable lengths from the lower esophageal sphincter region cephalad. It is a complication that occurs in approximately 12% of patients with prolonged gastroesophageal reflux. The importance of this disorder is that it is associated with an increased risk of adenocarcinoma of the esophagus. In assessing biopsies from patients with Barrett's esophagus, the main role of the pathologist is to be on the alert for histologic features of dysplasia and adenocarcinoma. Since dysplasia in Barrett's is endoscopically invisible, multiple biopsies are necessary if surveillance is to be successful in detecting dysplastic lesions and early carcinoma.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Malignant and premalignant lesions of the esophagus. 143 13

Eighty-two patients (median age, 51 years; range, 27-87 years) with refractory gastroesophageal reflux disease (GERD) underwent floppy Nissen/Rossetti fundoplication during the period 1980 to 1990. The median postoperative hospital stay was 5 days (3-16). Median follow-up was 72 months and included endoscopy and a clinical and a questionnaire assessment. Subjective symptoms of reflux were abolished in 98%, and 96% of the patients were satisfied with the results. Endoscopy showed healing of the esophagitis in 98%. There had been no disruption of the fundoplication. Twenty patients complained of gaseous distention and increased flatulence; only two of them had severe problems. Three patients were unable to belch. In conclusion, the floppy fundoplication has been an effective operation with no deaths, a low incidence of morbidity and adverse side effects, and without a tendency for late failure.
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PMID:Long-term results after 'floppy' Nissen/Rossetti fundoplication for gastroesophageal reflux disease. 143 56

The hallmark of gastroesophageal reflux disease (GERD) is an increase in esophageal exposure to gastric juice. This exposure can result in complications such as esophagitis, stricture, and Barrett's esophagus. The aim of this study is to determine if there are specific pH exposure patterns that are associated with the development of these complications. The 24-hour esophageal pH data for 50 normal subjects and 154 patients with proven GERD were analyzed for time spent at different pH intervals. Increased esophageal acid exposure at a given interval occurred when the cumulative time of exposure exceeded the 95th percentile of that measured in the 50 normal subjects for that interval. The greatest prevalence of mucosal damage was found in the those patients with increased esophageal exposure to pH 0 to 2, corresponding to the known pKa of pepsin. This exposure was not related to a hypersecretory state. In addition, mucosal injury was associated with an increased esophageal exposure to pH 7 to 8. We conclude that mucosal injury in patients with GERD is related to the exposure time to gastric juice with a pH of less than 2 or greater than 7.
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PMID:Concentration of refluxed acid and esophageal mucosal injury. 144 81

Tardive dyskinesia is a chronic, often permanent, movement disorder that has been reported in elderly patients receiving metoclopramide. We describe an 8-year-old boy with tardive dyskinesia that developed when he received metoclopramide as part of therapy for gastroesophageal reflux and erosive esophagitis.
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PMID:Tardive dyskinesia associated with use of metoclopramide in a child. 144 72

Between September 1983 and March 1991, 251 consecutive patients with gastro-oesophageal reflux resistant to medical treatment underwent posterior hemifundoplication (modified Toupet procedure). One hundred and seventy-seven patients (71 percent) had peptic oesophagitis. pH monitoring showed a mean Kaye's score of 278 +/- 245 with a 29 percent part of total recording time at pH < 4. The mean low oesophageal sphincter pressure was 8.5 +/- 6.5 cm H2O. No patient died in the postoperative period. Morbidity consisted of 8 splenic injuries, as well as 8 pulmonary and 23 thromboembolic complications. Assessment of 199 patients (79 percent) with a mean follow-up of 32 +/- 21 months showed complete symptomatic relief in 96.5 percent, and complete endoscopic healing of oesophagitis was noted in 96 percent. Restoration of the pH profile to normal levels was obtained in 86 percent of the cases. The mean low oesophageal sphincter pressure had risen to 17 +/- 6 cm H2O. Early postoperative dysphagia was noted in 46 patients (18 percent); one of them required reoperation. Reflux symptoms persisted in 9 patients (4.5 percent). pH monitoring revealed abnormal levels in 3 patients. The results of this study demonstrate that effective gastro-oesophageal reflux control can be achieved with the modified Toupet procedure.
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PMID:[Gastroesophageal reflux treated by posterior hemifundoplication. 251 cases]. 145 66

We have studied the clinical profile, cause and outcome of 105 infants with the diagnosis of gastroesophageal reflux. In most cases, pharmacological treatment managed to control the symptoms in 9 out of 10 infants followed in our series. Complications were described in 26.2%, of which esophagitis and chronic respiratory disease were the most common. Corrective surgery of the reflux was indicated in those cases in which pharmacological treatment was not successful. This managed to control the reflux in 90% of all cases. Morbidity was scarce. In all, 75% of the infants were considered to be medically cured within 15.5 months from the time that they were diagnosed and within 18.5 months after the appearance of the first symptoms.
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PMID:[Clinical profile, course and outcome of gastroesophageal reflux in 10 infants under active medical treatment]. 145 20

Barrett's oesophagus or columnar lined epithelium of the oesophagus (CLO) is a metaplastic condition associated with excessive gastro-oesophageal reflux. It is found in 15% of patients with reflux oesophagitis. In a detailed study of 115 CLO patients dysplasia was found in 46%; 13.9% were moderate or severe dysplasia, usually found in intestinal type CLO. Fifty patients were endoscoped annually to determine the natural history of the disease. The incidence of adenocarcinoma was 1 in 52 patient-years, a 125-fold excess risk. A dysplasia-carcinoma sequence was seen in the five who developed carcinoma. Patients with early carcinoma were treated surgically with 12% postoperative mortality and 100% survival for 24-70 months.
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PMID:Barrett's oesophagus. 146 82


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