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Strategy for treatment of nonerosive reflux disease in Asia

World Journal of Gastroenterology 2008年第20期14卷 3123-3128页

作者： Toru Hiyama Masaharu Yoshihara Shinji Tanaka Ken Haruma Kazuaki Chayama Health Service Center Hiroshima University Department of Endoscopy Hiroshima University Hospital Division of Gastroenterology Department of Internal Medicine Kawasaki Medical School Department of Medicine and Molecular Science Division of Frontier Medical Science Programs for Biomedical Research Graduate School of Biomedical Sciences Hiroshima University

The paper is to review the clinical and pathophysiologic differences between of nonerosive reflux disease (NERD) and reflux esophagitis (RE), and to propose a treatment strategy for NERD, especially for patients in Asia. A Medline search was performed regarding the clinical and pathophysiologic differences between NERD and RE, and treatment of NERD and RE. The characteristics of NERD patients in Asia are as follows: (1) high proportion of female patients, (2) low frequency of hiatal hernia, (3) high frequency of H pylori infection, (4) severe glandular atrophy of the gastric mucosa, and (5) frequent resistance to proton pump inhibitor (PPI) therapy. In Asian NERD patients, exposure of the esophagus to acid is not increased, and esophageal motility is normal. These characteristics are similar to those of patients in Western countries. Our recommended first-choice treatment is administration of PPI in combination with a prokinetic agent. However, at present, because there is limited evidence regarding effective treatments for NERD, it is best to try several different treatment strategies to find the best treatment for each patient.

关键词： nonerosive reflux disease Asia Treatment

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Technical problems produced by the Bravo pH test in nonerosive reflux disease patients

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World Journal of Gastroenterology 2010年第25期16卷 3183-3186页

作者： Andrés de Hoyos Edgar Alain Esparza Department of Gastroenterology Angeles Del Pedregal Hospital México City 10700 México Facultad Mexicana de Medicina Univer-sidad La Salle Internal Medicine México City 14000 México

AIM: To evaluate the technical failures of the Bravo pH test in a population with nonerosive gastroesophageal reflux disease. METHODS: Over the course of a year, we prospectively studied a population of 66 nonerosive reflux disease patients who received a Bravo pH test. The number and frequency of all technical failures were documented, quantified and analyzed. RESULTS: A total of 66 patients, with a mean age of 41.7 years, were studied. Technical failures occurred in 15.15% of the sample. The most frequent failures were due to poor data reception (4.5%), early dislodgement (4.5%) and capsule removal (6.1%). CONCLUSION: The Bravo capsule pH test involves a low but non-negligible rate of technical problems, a fact that must always be considered by physicians.

关键词： Bravo test Capsule dislodgement nonerosive reflux disease Poor data reception Technical problems

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Washed microbiota transplantation reduces proton pump inhibitor dependency in nonerosive reflux disease

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World Journal of Gastroenterology 2021年第6期27卷 513-522页

作者： Ya-Mei Zheng Xian-Yun Chen Jie-Yi Cai Yu Yuan Wen-Rui Xie Jia-Ting Xu Harry Hua-Xiang Xia Min Zhang Xing-Xiang He Li-Hao Wu Department of Gastroenterology The First Affiliated Hospital of Guangdong Pharmaceutical UniversityResearch Center for Engineering Techniques of Microbiota-Targeted Therapies of Guangdong ProvinceGuangzhou 510030Guangdong ProvinceChina Department of Science and Education The First Affiliated Hospital of Guangdong Pharmaceutical UniversityGuangzhou 510030Guangdong ProvinceChina Department of Epidemiology and Health Statistics Guangdong Pharmaceutical UniversityGuangzhou 510220Guangdong ProvinceChina

BACKGROUND The pathogenesis of gastroesophageal reflux disease(GERD)is closely associated with the intestinal bacteria composition and their *** To investigate whether washed microbiota transplantation(WMT)improves symptoms of nonerosive reflux disease(NERD)with proton pump inhibitor(PPI)*** Patients with recurrent NERD and PPI dependency at the First Affiliated Hospital of Guangdong Pharmaceutical University from 2017 to 2018 were included and divided into a WMT or PPI group treated with PPI with/without *** endpoint was NERD symptom frequency evaluated 1 mo after WMT using reflux disease questionnaire(RDQ)and GERD questionnaire(GERDQ)scores,remission time,PPI dose,and the examination of intestinal mucosal barrier *** In the WMT(n=15)and PPI(n=12)groups,the total remission rate at 1 mo after treatment was 93.3%vs 41.7%.Compared with the PPI group,the WMT group showed better results in GERDQ(P=0.004)and RDQ(P=0.003)and in remission months(8 vs 2,P=0.002).The PPI dose was reduced to some extent for 80%of patients in the WMT group and 33.3%in the PPI *** 24 patients,intestinal mucosal barrier function was examined before treatment,and changes in the degree of damage were observed in 13 of these patients after *** one of the 15 patients had minor side effects,including a mushy stool two or three times a day,which resolved on their own after 1 *** This study is the first to demonstrate that WMT may be safe and effective for relieving NERD symptoms and reducing PPI dependency and recurrence.

关键词： nonerosive reflux disease Washed microbiota transplantation Proton pump inhibitor dependency Intestinal bacteria Lipopolysaccharide Small intestinal bacterial overgrowth

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Gastroesophageal reflux disease in pediatric esophageal atresia:Assessment of clinical symptoms and pH-impedance data

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World Journal of Clinical Pediatrics 2020年第2期9卷 29-43页

作者： Marina Aksionchyk Kirill Marakhouski Aliaksandr Svirsky Department of Pediatric Gastroenterology Diagnostic DivisionRepublican Scientific and Practical Center for Pediatric SurgeryMinsk 220013Belarus Department of Endoscopy Republican Scientific and Practical Center of Pediatric SurgeryMinsk 220013Belarus Department of Pediatric surgery Republican Scientific and Practical Center of Pediatric SurgeryMinsk 220013Belarus

BACKGROUND Esophageal atresia(EA)is the most common congenital anomaly of the gastrointestinal *** reflux disease(GERD)is a frequent and lifelong problem in these *** can be asymptomatic and the incidence of esophageal gastric and intestinal metaplasia(Barrett’s esophagus)is increased in adults with EA compared with the general *** and accurate diagnosis of GERD is important to reduce long-term problems and this may be achieved by pH-impedance *** To assess symptoms and pH-impedance data in children after EA,in order to identify their specific features of *** This study was conducted from November 2017 to February 2020 and involved 37 children who had undergone EA via open surgical repair(51.35%boys,48.65%girls;age range:1-14 years,median:4.99 years).GERD diagnosis was made based on multichannel intraluminal impedance/pH study and two groups were established:EA without GERD,n=17;EA with GERD,n=20.A control group was established with 66 children with proven GERD(68.18%boys,31.82%girls;median age:7.21 years),composed of a nonerosive reflux disease(referred to as NERD)group(n=41)and a reflux esophagitis group(n=25).Upper gastrointestinal endoscopy with a mucosal esophageal biopsy was performed on all *** The most frequently observed symptom in EA patients with GERD and without GERD was cough(70%and 76.5%respectively).The number of patients with positive symptom association probability in the EA groups was significantly larger in the EA without GERD group(P=0.03).In the control reflux esophagitis group,prevalence of gastrointestinal symptoms was significantly higher than in the NERD group(P=0.017).For both EA groups,there was strong correlation with index of proximal events(IPE)and total proximal events(EA with GERD:0.96,P<0.001;EA without GERD:0.97,P<0.001)but level of IPE was significantly lower than in GERD patients without any surgical treatment(P<0.001).Data on distal mean nocturnal baseline i

关键词： Esophageal atresia Gastroesophageal reflux disease pH-impedance testing Mean nocturnal baseline impedance Proximal reflux reflux esophagitis nonerosive reflux disease Pediatric

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