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)

Gastroesophageal reflux was a fortuitous finding on a hepatobiliary scan in a patient who had a history of esophagogastrectomy and complained of regurgitation in the supine position.
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PMID:Esophageal reflux demonstrated on a hepatobiliary scan. 670 17

Ten patients with gastroesophageal reflux disease participated in a randomized, double-blind, crossover study in which they received a single 20-mg oral dose of metoclopramide or a placebo 15 minutes before a provocative test meal. All patients had previously been challenged with the test meal and had exhibited symptoms of heartburn and regurgitation. Metoclopramide reduced the severity of heartburn from the onset, its effect reaching statistical significance within two hours and persisting for at least five hours. Eighty percent of the patients who received metoclopramide, compared with only 30% of placebo-treated patients, were completely free of heartburn at the end of the trial. A significant reduction in regurgitation during the 1 1/2 to four hours after the test meal was also noted with metoclopramide. No adverse effects occurred. The ability of metoclopramide to prevent the symptoms of heartburn and regurgitation induced by a provocative meal in patients with gastroesophageal reflux was clearly demonstrated.
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PMID:Prevention of meal-induced heartburn and regurgitation with metoclopramide in patients with gastroesophageal reflux. 676 Sep 68

Forty adult patients have undergone a 7 to 10 cm cervical esophagomyotomy (from the superior cornu of the thyroid cartilage to behind the clavicle) for cricopharyngeal dysfunction. A Zenker's diverticulum was present in 12 patients (30%) and in five was recurrent. Preoperative symptoms included cervical dysphagia (85%), expectoration of saliva (40%), and intermittent hoarseness (30%). Four patients were being fed through tubes because of total inability to swallow. "Heartburn" was experienced by one half of the patients, but only 12 had acid or food regurgitation. The duration of symptoms ranged from 1 month to 11 years (average 3.9 years). Weight loss had occurred in 15 patients (38%) and ranged from 5.5 to 40.9 kg (average 16 kg). Barium swallows showed no abnormalities in 10 patients. Abnormal findings included a Zenker's diverticulum (12), prominent cricopharyngeal sphincter (11), nasopharyngeal reflux or incoordinated initiation of deglutition, or both (seven), a sliding hiatal hernia (11), and abnormal esophageal motility (seven). Esophageal manometry revealed abnormalities of upper esophageal sphincter (UES) function in only 16 patients. Of 36 patients undergoing standard acid reflux testing, one third had moderate-to-severe gastroesophageal reflux. Seven patients underwent staple resection of a Zenker's diverticulum at the time of cervical esophagomyotomy. Postoperative complications included transient vocal cord paresis (four), vocal cord paralysis (one), and salivary fistula (one). There were no postoperative deaths. After 2 to 48 months (average 16 months) of follow-up, 34 patients (85%) have had a good to excellent result, and six (15%) have not been benefited by operation.
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PMID:Extended cervical esophagomyotomy for cricopharyngeal dysfunction. 677 51

Twenty patients with bronchial asthma who also had gastro-oesophageal reflux were investigated. The severity of their reflux was graded using symptom score of heartburn and regurgitation and by the following investigations: barium swallow and meal, fibreoptic endoscopy and biopsy, manometry and pH monitoring of the distal oesophagus, and an acid infusion test. Full lung function studies were performed and patients were entered into a double-blind crossover study using cimetidine to control their reflux in order to assess beneficial effects with respect to their respiratory problems. Eighteen patients completed the study. Significant improvements were seen in reflux and night time asthmatic symptoms, both these indices being measured on a scoring system. Home monitoring of peak flow values showed a statistical improvement for th last peak flow reading of the day. Fourteen patients felt that their chest symptoms had significantly improved during the cimetidine period.
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PMID:Relationship between asthma and gastro-oesophageal reflux. 702 37

A zone of increased intraluminal pressure exists at the gastroesophageal junction in man and is believed to act as a physiologic sphincter. Increasing this lower esophageal sphincter (LES) tone is an accepted and useful method in preventing gastroesophageal reflux. The effects of LES tone were studied in 10 healthy volunteers receiving sequential intravenous injections of atropine, 0.6 mg, or domperidone, 10 mg, followed by domperidone, 10 mg, or atropine, 0.6 mg. The order of drug administration was randomized during the first study. Each volunteer was studied a second time, 1 week later, when the order of drug administration was reversed from the first. Administration of atropine decreased mean LES pressure by 12.6 cm H2O (p < 0.001). Subsequent injection of domperidone restored LES tone to near normal. In contrast, initial injection of domperidone approximately 1 week later in the same subjects, mean LES pressure increased by 18.5 cm H2O (p < 0.001). Intravenous injection of atropine, thereafter, failed to decrease mean LES pressure significantly, LES pressure being sustained at a mean of 14.8 cm H2O above basal control levels (p < 0.005). Results of this study suggest that domperidone given prior to atropine, before induction of general anesthesia, may counteract the potentially deleterious effect of atropine on LES tone, and thereby reduce the chances of regurgitation and pulmonary aspiration of acid gastric contents.
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PMID:Domperidone antagonizes the relaxant effect atropine on the lower esophageal sphincter. 719 11

Regurgitation of stomach contents is common in babies. One of the causes is gastro-oesophageal reflux due to an incompetent lower oesophageal sphincter, which may or may not be associated with a sliding hiatus hernia. Persistence of this defect will result in a pathological entity leading to reflux oesophagitis. If this symptom complex is not recognized, early disabling complications will result. The purpose of this study is to draw attention to the symptomatology of gastro-oesophageal reflux and hiatus hernia in infancy and childhood so as to improve our understanding of this entity and consequently allow earlier diagnosis, appropriate treatment and prevention of complications.
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PMID:Hiatus hernia in infancy and childhood. 722 55

The incidence and character of gastrointestinal reflux after truncal vagotomy and gastric resection or drainage were studied prospectively in 42 symptomatic patients. Gastroesophageal reflux, proven by 24-hour pH monitoring, occurred in 31 patients. Initial symptoms of heartburn, regurgitation, or dysphagia were similar in patients with and without reflux. Eighteen patients had pure acid, nine had acid-alkaline, and four had pure alkaline reflux. Reflux occurred predominantly in the supine position. Esophagitis occurred only in patients with reflux and was not dependent on the pH of refluxed material. Reflux was eventually controlled by antireflux repair in 19 and by colon interposition in three patients. Twenty-four-hour esophageal pH monitoring is beneficial in evaluating symptoms after gastric surgery. It quantifies both acid and alkaline reflux, provides an objective assessment of the patient's subjective complaints, and gives a rational basis for management.
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PMID:Twenty-four-hour pH monitoring of esophageal function. Its use in evaluation in symptomatic patients after truncal vagotomy and gastric resection or drainage. 723 49

Thirty-six (36) patients with symptomatic gastroesophageal reflux were studied. Symptoms of heartburn, regurgitation and dysphagia were scored as to their severity and compared to quantitative tests of gastroesophageal reflux. Patients were studied with the acid reflux test, fiberoptic endoscopy, esophageal mucosal biopsy with a pinch forceps, esophageal manometry and radioisotopic gastroesophageal scintigraphy. Symptoms were scored according to an arbitrary grading system as mild, moderate, or severe. There were significant correlations between symptoms scores and both the degree of endoscopic esophagitis and the gastroesophageal reflux indices as measured by the radioisotopic scintiscan, but not with the degree of histologic esophagitis or lower esophageal sphincter pressure. Review of the findings suggests the following profile for patients who might require antireflux surgery: severe symptoms, presence of endoscopic esophagitis; resting lower esophageal sphincter pressure below 10 mmHg; and gastroesophageal reflux index above 10%.
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PMID:Gastroesophageal scintigraphy to assess the severity of gastroesophageal reflux disease. 735 79

Thirty-nine patients with uncomplicated duodenal ulcer were divided into two groups, one with pathological acid gastro-oesophageal reflux and one with non-pathological acid gastro-oesophageal reflux, on the basis of the results of a 12-h pH recording in the lower part of the oesophagus. The duodenal ulcer patients with pathological acid gastro-oesophageal reflux had a longer history of the disease (p less than 0.05), but there was little correlation between the symptoms of heartburn and regurgitation and acid gastro-oesophageal reflux. The gastro-oesophageal sphincter pressure was lower (p less than 0.05) in the patients with pathological acid gastro-oesophageal reflux. Acid clearing was prolonged in both duodenal ulcer groups (p less than 0.05) compared with asymptomatic volunteers. At low pH, a reflux episode lasted longer in both duodenal ulcer groups than in asymptomatic volunteers. Clearing of a reflux episode with low pH needed longer duration and/or increased peristaltic activity than a reflux episode with higher pH in both duodenal ulcer groups. In conclusion, acid gastro-oesophageal reflux is not the only important factor in releasing the symptoms of heartburn and regurgitation. All the duodenal ulcer patiets in this investigation had changes in the peristaltic activity in the oesophageal body. Pathological acid gastro-oesophageal reflux is found in duodenal ulcer patients with a low gastro-oesophageal sphincter pressure and a long history of the disease.
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PMID:Acid gastro-oesophageal reflux pattern in duodenal ulcer patients related to dyspeptic symptoms. 738 38

The sensitivity of the string test for detection of gastroesophageal reflux was assessed in 15 infants and children, 5 months to 11 years of age (mean, 2.8 years), with vomiting, regurgitation, or lower respiratory tract symptoms, and compared with the barium esophagram, esophageal manometry, and the acid reflux test (pH probe). Barium esophagram showed reflux in 4/15 patients, pH probe in 7/15, and string test in 6/15. The string test is a simple, rapid, safe, and efficient screening method for patients with suspected gastroesophageal reflux.
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PMID:The string test for gastroesophageal reflux. 740 16


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