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)

The European Epidemiologic Registry of Cystic Fibrosis began collecting longitudinal data on European cystic fibrosis patients in 1994. A cross-sectional analysis was performed to identify the factors associated with low values of % predicted forced expiratory volume in one second (FEV1) upon patient enrollment. Data from 7,010 patients aged > or =6 yrs were included. Clinical conditions, microbiological isolates and medications reported at enrollment or within the following 180 days were analysed for age-specific associations. Factors associated with FEV1 that were lower by >10% of pred values were: lower weight for age percentiles, haemoptysis, pneumothorax, pulmonary symptoms at presentation, Pseudomonas aeruginosa, Burkholderia cepacia, oral corticosteroids, nonsteroid anti-inflammatory drugs, dornase alfa, oxygen and assisted ventilation and, in patients >12 yrs old only, use of airway clearance techniques, inhaled bronchodilators, oral nutritional supplements, pancreatic enzymes and insulin or oral hypoglycaemics. Slightly impaired lung function (5-10%) was associated with: diabetes (> or = 18-yrs-old), gastro-oesophageal reflux, allergic bronchopulmonary aspergillosis, asthma-like symptoms, portal hypertension, Aspergillus spp. and Candida spp. Sex, Haemophilus influenzae and Staphylococcus aureus were not associated with impaired pulmonary status. Regular exercise (especially in older patients) and nasal polyposis were associated with slightly better FEV1. The results confirm those of previous studies and suggest selective prescribing in sicker patients.
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PMID:Factors associated with poor pulmonary function: cross-sectional analysis of data from the ERCF. European Epidemiologic Registry of Cystic Fibrosis. 1152 88

In patients with nasal polyps the colonisation of nasal polyps tissues by Helicobacter pylori was investigated using urease test (GUT plus). In this prospective clinical trials we enrolled 61 subjects who had undergone endoscopic nasal polyps surgery and 30 subjects who had undergone septoplasty (control group) were questioned and biopsy specimens of the removed polyps or the mucosal part of inferior turbinate were tested by the urease test GUT plus. In result Helicobacter pylori was not found in the nasal polyps and mucosal part of inferior turbinate tissue of any of patients including the 43 of 61 patients with nasal polyps and 7 of 30 patients with septum deviation who had symptoms of gastroesophageal reflux. In our study using the urease test GUT plus we were not able to confirm presence of Helicobacter pylori in the nasal polyps tissue. However, further epidemiologic studies using different diagnostic methods would be necessary to confirm presence of Helicobacter pylori as potential underlying pathogenetic mechanism of nasal polyposis.
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PMID:[Detection of Helicobacter pylori in nasal polyps specimens using urease test GUT plus]. 1635 53

Chronic polypoid rhinosinusitis (CRS) is a common disease, affecting approximately 16% of the adult population in the US every year. In addition to many well known predisposing factors, an association with reflux disease is hypothesized. Such an association might explain the recurrence of polyposis in the face of improved surgical techniques and postsurgical treatment of CRS. At present it is unclear whether extraesophageal reflux directly injures the sinus mucosa, whether gastroesophageal reflux leads to vagus-mediated neuroinflammatory changes, or whether both mechanisms occur separately or simultaneously. In patients suffering from recurrent CRS (n=20) and healthy volunteers (n=20), ambulatory 24 h two channel pH testing was performed. The number of reflux events, the fraction of the total time during which pH was below 4, and the reflux area index (RAI) were determined in the esophagus as well as in the hypopharynx. Patients with recurrent CRS had significantly more reflux events in the esophagus and the fraction of pH<4 and the RAI were increased up to 10-fold compared to healthy volunteers. In contrast to the esophagus, these differences were not observed in the hypopharynx. Recurrent CRS is often associated with GERD but not with EER. Recurrent disease or prolonged recovery after surgery should raise the suspicion of reflux disease as a possible triggering factor. Because GERD itself cannot be diagnosed by laryngoscopy, and because of the subjectivity of symptoms such as heartburn, the otolaryngologist should consider double-probe pH testing as the diagnostic procedure of choice.
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PMID:Gastroesophageal reflux disease (GERD), extraesophageal reflux (EER) and recurrent chronic rhinosinusitis. 1652 20

The presence of multiple esophageal polyps on endoscopy is a rare entity. Most of the literature cited on this phenomenon is based on case reports and small series. A large proportion of the literature describes one or two polyps, with the majority of polyps occurring in the area of the gastroesophageal junction. We present a case of a 66-year-old woman with a history of gastroesophageal reflux disease that was found to have extensive esophageal polyposis of the mid-esophagus on upper endoscopy. The patient underwent a transhiatal esophagectomy. Final pathology was consistent with extensive polypoid dysplasia in the presence of Barrett's esophagus.
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PMID:Diffuse esophageal polyposis: an uncommon occurrence. 1932 63

Rhinosinusitis is an extremely common disease that is often underreported, especially in children. Its clinical spectrum includes acute rhinosinusitis (ARS) which may present in the forms of ARS with persistent symptoms and ARS with severe symptoms and chronic rhinosinusitis (CRS), characterized by a duration longer than 12 weeks and prevalence of symptoms such as nasal congestion and cough. Moreover, rhinosinusitis may present with associated disorders, that are nasal polyposis and aspirin sensitivity, asthma, otitis media with effusion, and gastroesophageal reflux. A particular form is fungal rhinosinusitis, presenting in an invasive and noninvasive form, the latter including allergic fungal sinusitis, which is the most common form of fungal rhinosinusitis and should be suspected in children with nasal polyposis and atopy.
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PMID:The clinical spectrum of rhinosinusitis in children. 2015 75

Medical options other than antibiotics or corticosteroids for treating rhinosinusitis include non-specific treatments such as nasal decongestants, naso-sinusal washings, antihistamines, antileukotrienes, mucolytic agents, immunomodulators and immunostimulants, as well as specific agents such as antimycotics in fungal sinusitis or antireflux agents in sinusitis associated to gastroesophageal reflux. In subjects with chronic sinusitis and/or nasal polyposis related to aspirin hypersensitivity protocols of desensitization are available. The available scientific evidence is good for naso-sinus washings with saline solutions, antihistamines in acute allergic rhinosinusitis, antileukotrienes in chronic sinusitis, bacterial lysates for prevention of recurrent sinusitis, and aspirin desensitisation in subjects with aspirin-exacerbated respiratory disease with chronic sinusitis and nasal polyposis. The other treatment options are still in search of scientific demonstration.
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PMID:Treatment of rhinosinusitis: other medical options. 2015 86

Difficult to control severe asthma is characterized by the persistence of inacceptable symptoms of asthma despite a continuous treatment with at least high doses of inhaled steroids and long acting bronchodilators. The diagnosis is done after a period of observation and some investigations that will allow confirm the diagnosis of asthma, eliminate alternative diagnosis and etiological forms that would be difficult to treat intrinsically (allergic broncho-pulmonary aspergillosis, Churg and Strauss disease, chronic eosinophilic pneumonia, occupational asthma). At the end of this period devoted to diagnosis a systematic approach is set up to take care of these patients. Therapeutic education includes action plans and measures for triggering factors avoidance in order to prevent exacerbations. Comorbidities such as rhinitis, nasal polyposis, gastro-oesophageal reflux and obesity are taken into account. Lastly, the treatment must be adapted according to the patient's preferences and aims, and to the asthma severity. Ultimately in steroid-dependent asthma, the lowest efficient dose is tracked continuously. For these patients, new molecules are needed.
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PMID:[Difficult to control severe asthma]. 2156 12

Chronic rhinosinusitis (CRS) affects 12.5% of the US population. On epidemiologic grounds, some association has been found between CRS prevalence and air pollution, active cigarette smoking, secondhand smoke exposure, perennial allergic rhinitis, and gastroesophageal reflux. The majority of pediatric and adult patients with CRS are immune competent. Data on genetic associations with CRS are still sparse. Current consensus definitions subclassify CRS into CRS without nasal polyposis (CRSsNP), CRS with nasal polyposis (CRSwNP), and allergic fungal rhinosinusitis (AFRS). Evaluation and medical management of CRS has been the subject of several recent consensus reports. The highest level of evidence for treatment for CRSsNP exists for saline lavage, intranasal steroids, and long-term macrolide antibiotics. The highest level of evidence for treatment of CRSwNP exists for intranasal steroids, systemic glucocorticoids, and topical steroid irrigations. Aspirin desensitization is beneficial for patients with aspirin-intolerant CRSwNP. Sinus surgery followed by use of systemic steroids is recommended for AFRS. Other modalities of treatment, such as antibiotics for patients with purulent infection and antifungal drugs for patients with AFRS, are potentially useful despite a lack of evidence from controlled treatment trials. The various modalities of medical treatment are reviewed in the context of recent consensus documents and the author's personal experience.
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PMID:Chronic rhinosinusitis: epidemiology and medical management. 2189 Jan 84

The aim of this study was to identify the presence of Helicobacter pylori in nasal polyp specimens of patients with nasal polyposis. A cross-sectional study with control group was performed on fresh tissue samples from 25 patients with nasal polyps, and 25 persons with concha bollusa (control group). Patients with symptoms of gastroesophageal reflux (GERD) were not enrolled. Samples were studied by three methods: polymerase chain reaction (PCR), culture, and urease test. All the diagnostic tests were negative for H. pylori in both the case and control groups. In conclusion, there was no association between H. pylori and nasal polyposis in patients without GERD signs or symptoms in our study, and further studies are needed to assess other potential factors that may influence the development of nasal polyposis.
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PMID:Investigating Helicobacter pylori in nasal polyposis using polymerase chain reaction, urease test and culture. 2211 83

Chronic rhinosinusitis (CRS) is a common disease with a significant impact on quality of life, which is seen across all age groups. There are differences in symptomatology, histopathology and associated diseases when comparing pediatric versus adult patients with CRS. Nasal polyposis tends to be less commonly seen in pediatric CRS compared with adults except in children with cystic fibrosis or allergic fungal rhinosinusitis. The differences in histopathology of CRS in different age groups include higher cellularity and more prominent lymphocytic infiltration in children compared with adults who tend to have a stronger eosinophilic infiltration and more prominent glandular hyperplasia. There are data supporting a stronger association of gastroesophageal reflux disease and otitis media with CRS in children compared with adults. Adenoids may play a role in pediatric, but not adult CRS. Immunodeficiencies and asthma are strongly associated with CRS in all age groups. There is a paucity of data on pathophysiology of disease on elderly CRS.
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PMID:Chronic rhinosinusitis and age: is the pathogenesis different? 2407 78


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