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 objective of this study was to evaluate the reliability and validity of the gastrointestinal Symptom Rating Scale (GSRS) in US patients with gastroesophageal reflux disease (GERD). Five hundred and sixteen adults with predominant heartburn symptoms of GERD were recruited from gastroenterologist and family physician practices and treated with 6 weeks of 150 mg ranitidine twice daily to identify poorly responsive symptomatic GERD. The GSRS, the Medical Outcomes Study Short Form-36 (SF-36) Health Survey and the Psychological General Well-being (PGWB) scale were administered at baseline and after 6 weeks of treatment. Reported ratings of GERD-related symptoms from physician and patient diaries were measured. The GSRS contains five scales: reflux syndrome, abdominal pain, constipation syndrome, diarrhoea syndrome and indigestion syndrome. The internal consistency reliabilities for the GSRS scales ranged from 0.61 to 0.83 and the intraclass correlation coefficients ranged from 0.42 to 0.60. The GSRS scale scores were correlated with the SF-36 and PGWB scales and with the number and severity of heartburn symptoms. Patients with two or three clinician-rated GERD-related symptoms reported worse GSRS scale scores compared with patients with fewer symptoms (p < 0.0001). Statistically significant differences in the mean GSRS scale scores were observed between treatment responders and non-responders (p < 0.0001) and patients showing a response to treatment had larger mean changes in their GSRS scales than patients not showing a response to treatment (p < 0.0001). The standardized response means ranged from 0.42 to 1.43 for the GSRS scale scores. It was concluded that the GSRS is a brief, fairly comprehensive assessment of common gastrointestinal symptoms. The GSRS has good reliability and construct validity and the GSRS scales discriminate by GERD symptom severity and are responsive to treatment. The GSRS is a useful patient-rated symptom scale for evaluating the outcomes of treatment for GERD.
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PMID:Reliability and validity of the Gastrointestinal Symptom Rating Scale in patients with gastroesophageal reflux disease. 948 Nov 53

Recurrent abdominal pain has been reported to occur in 10 to 15% of children between the ages of 5 and 15 years, and is considered to be one of the most encountered symptoms in childhood. It is important to avoid a shotgun approach to rule out all potential infectious, inflammatory, structural, and biochemical causes, that leads to an excess of diagnostic tests, as well as to avoid considering every abdominal pain as functional, which leads to a risk of misdiagnosing the rare organic causes of chronic abdominal pain. Careful history and clinical examination, completed if necessary by minimal laboratory investigation, allow either finding clues to the diagnosis of organic causes [represented most often by gastrointestinal diseases (constipation, gastroesophageal reflux) or nephro-urologic diseases] or suggesting that chronic abdominal pain may be of functional origin. Distinguishing between psychosomatic and functional chronic abdominal pain can be sometimes difficult.
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PMID:[Chronic abdominal pain in children]. 978 Oct 91

This paper provides a comprehensive review of the current knowledge on cisapride in different clinical conditions in children: different manifestations of gastro-oesophageal reflux, such as (excessive) regurgitation, oesophagitis, chronic respiratory disease or uncontrolled asthma, cystic fibrosis, chronic dyspepsia, constipation and pseudo-obstruction, and as an aid to small bowel capsule-biopsy. It discusses, in depth, the safety profile of cisapride in paediatric patients.
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PMID:Clinical use of cisapride and its risk-benefit in paediatric patients. 983 11

Irritable bowel syndrome is the most frequent functional disorder of the digestive system. Patients with irritable bowel syndrome have motor disorders not only in the colon, but also in other parts of the digestive tract such as the oesophagus and small intestine; however, it is not known whether the stomach is also involved. We used a radiolabelled mixed solid-liquid meal (technetium-99m for the solid component, indium-111 for the liquid component) to study gastric emptying of solids (GES), liquids (GEL) and indigestible solids (GER) in 50 patients diagnosed as having irritable bowel syndrome (30 with predominant constipation and 20 with predominant diarrhoea). GER was measured by counting the number of indigestible solids remaining in the stomach 4 h after they were swallowed. In patients with irritable bowel syndrome, GES and GEL were slower than in control subjects (P<0.05). GER was normal in all patients except for two women. Thirty-two patients (64%) showed delayed GES, 29 (58%) delayed GEL, and 2 (4%) delayed GER. Among patients with irritable bowel syndrome, GES was slower in those with predominant constipation than in those with predominant diarrhoea (P<0.05); GEL and GER were similar in both groups. Gastroparesis was found in a large proportion of patients with irritable bowel syndrome, suggesting the presence of a more generalised motor disorder of the gut.
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PMID:Altered gastric emptying in patients with irritable bowel syndrome. 1019 47

Antacids are commonly used self-prescribed medications. They consist of calcium carbonate and magnesium and aluminum salts in various compounds or combinations. The effect of antacids on the stomach is due to partial neutralisation of gastric hydrochloric acid and inhibition of the proteolytic enzyme, pepsin. Each cation salt has its own pharmacological characteristics that are important for determination of which product can be used for certain indications. Antacids have been used for duodenal and gastric ulcers, stress gastritis, gastro-oesophageal reflux disease, pancreatic insufficiency, non-ulcer dyspepsia, bile acid mediated diarrhoea, biliary reflux, constipation, osteoporosis, urinary alkalinisation and chronic renal failure as a dietary phosphate binder. The development of histamine H2-receptor antagonists and proton pump inhibitors has significantly reduced usage for duodenal and gastric ulcers and gastro-oesophageal reflux disease. However, antacids can still be useful for stress gastritis and non-ulcer dyspepsia. The recent release of proprietary H2 antagonists has likely further reduced antacid use for non-ulcer dyspepsia. Other indications are still valid but represent minor uses. Antacid drug interactions are well noted, but can be avoided by rescheduling medication administration times. This can be inconvenient and discourage compliance with other medications. All antacids can produce drug interactions by changing gastric pH, thus altering drug dissolution of dosage forms, reduction of gastric acid hydrolysis of drugs, or alter drug elimination by changing urinary pH. Most antacids, except sodium bicarbonate, may decrease drug absorption by adsorption or chelation of other drugs. Most adverse effects from antacids are minor with periodic use of small amounts. However, when large doses are taken for long periods of time, significant adverse effects may occur especially patients with underlying diseases such as chronic renal failure. These adverse effects can be reduced by monitoring of electrolyte status and avoiding aluminum-containing antacids to bind dietary phosphate in chronic renal failure. Antacids, although effective for discussed indications of duodenal and gastric ulcer and gastro-oesophageal reflux disease, have been replaced by newer, more effective agents that are more palatable to patients. Antacids are likely to continue to be used for non-ulcer dyspepsia, minor episodes of heartburn (gastro-oesophageal reflux disease) and other clear indications. Although their wide-spread use may decline, these drugs will still be used, and clinicians should be aware of their potential drug interactions and adverse effects.
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PMID:Antacids revisited: a review of their clinical pharmacology and recommended therapeutic use. 1040 Apr 1

The prevalence of cow's milk allergy is stable, between 2% and 5%. Clinical symptoms are numerous. Gastroesophageal reflux and persistent constipation have been recently described. The main point is the increasing prevalence of multiple food allergens. Double blind placebo controlled milk challenges are mandatory for the diagnosis, sometimes eight days long. The proof of the IgE-dependent sensitization, or of lymphocyte activation is not always brought. ECP, methylhistamine and tryptase dosages coupled to challenges are not clearly informative tests. The eviction of dairy products is completed by substitution by casein hydrolysates or pork collagen or soy hydrolysates, or by formula made from amino acids. Tolerance protocols are not standardized, however valuable. Review documented by 98 references.
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PMID:Cow's milk allergy. 1044 1

The longitudinal intestinal lengthening, described by Bianchi in 1980, has been shown to be effective in improving intestinal function, absorption and transit time in patients with short-bowel syndrome. We report the long-term results of 18 survivors of a series of 25 intestinal lengthening procedures performed since 1984. Mean age of the patients was 18 months (range of 5 to 52 months), mean follow-up 6 years (0.9 to 12 years). Parenteral nutrition was progressively reduced in all patients and discontinued after 1 to 10 months (mean 5.1 months). Frequently encountered problems during long-term follow-up are hyperphagia, hyponatremia and hypochloremia, metabolic acidosis, including D-lactic acidosis, cholelithiasis and urolithiasis, gastro-esophageal reflux, dystrophy and symptoms caused by secondary dilatation of the lengthened bowel loops: a protruding abdomen, enteral stasis, leading to constipation or diarrhea with bacterial overgrowth. Overall performance has been acceptable in 13 out of 18 patients. Longitudinal intestinal lengthening is effective enabling patients with short-bowel syndrome to be weaned from parenteral nutrition, allowing for long-term survival. However, it is only one step on a long and difficult way. Multiple problems have to be searched for and adequately dealt with to achieve an acceptable and future worth living.
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PMID:What do children look like after longitudinal intestinal lengthening. 1053 72

Abdominal complaints during pregnancy are frequent. In most instances, nausea and vomiting are a consequence of pregnancy and are considered indicators of a well-developing pregnancy. The growing uterus and hormonal changes during pregnancy often lead to gastroesophageal reflux and constipation. Serious gastrointestinal diseases such as intestinal obstruction or the exacerbation of a chronic inflammatory bowel disease during pregnancy are rare, but if suspected, often warrant immediate confirmation and aggressive therapy. Unnecessary delays are associated with an increasing mortality and morbidity.
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PMID:[Gastrointestinal diseases in pregnancy]. 1054 32

We present 4 brothers with developmental delay, minor anomalies, and symptoms due to gastrointestinal dysmotility. There was some resemblance with FG syndrome, although none of the brothers had sufficient findings to make this diagnosis. The index case presented with at age 1 month with screaming episodes, mild gastro-esophageal reflux (GER), and severe constipation. Esophageal manometry studies were consistent with the diagnosis of "nutcracker esophagus." Symptomatic and manometric improvement followed treatment with oral calcium channel blockers. Two older and less severely affected brothers had similar manometric findings but did not require treatment. A fourth brother with symptoms in infancy now has normal esophageal manometry findings. These boys in all likelihood have an X-linked syndrome with manifestations of FG syndrome, in which treatment with calcium channel blockers, produces clinical and manometric improvement. The FG syndrome is an X-linked syndrome of multiple congenital anomalies/mental retardation with facultative manifestations of gastrointestinal dysmotility, including gastro-esophageal reflux, severe feeding difficulties, and constipation. Esophageal dysmotility, in particular "nutcracker esophagus," should be suspected in infants with the FG syndrome and screaming attacks.
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PMID:Esophageal dysmotility in brothers with an FG-like syndrome. 1075 39

Clinical studies of peristil demonstrated that this drug is effective in hypomotor and dysmotor gastroduodenal disturbances leading to reduction of clinical symptoms of primary and secondary duodenodyskinesias. A systemic prokinetic action of peristil is beneficial in patients with duodenodiskinesia combination with gastroesophageal reflux as well as hypomotor constipation syndrome. Also, peristil reduces depressive symptoms and improves quality of life in patients with primary and secondary duodenodyskinesias.
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PMID:[Efficacy of peristil treatment in primary and secondary duodenal dyskinesias]. 1101 31


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