Reflux Oesophagitis (reflux + oesophagitis)

Distribution by Scientific Domains


Selected Abstracts


Fundal gastritis as a potential cause of reflux oesophagitis

DISEASES OF THE ESOPHAGUS, Issue 1 2000
M. Newton
The transient lower oesophageal sphincter relaxations which allow reflux may be due to altered afferent pathways from the fundus. We aimed to determine whether fundal inflammation is the underlying cause. Two endoscopic biopsies were taken from each of the gastric antrum and fundus in 25 asymptomatic controls with a normal endoscopy (median age 54 range 13,83 years), and 33 patients with erosive oesophagitis (median age 52, 11,78 years). No patient had taken acid suppression therapy or antibiotics for at least 1 month. Sections were stained with haematoxylin and eosin and Giemsa stain and examined in a blinded fashion by one pathologist for the presence of gastritis (Sydney classification) and Helicobacter pylori. Chronic gastritis was common in both groups, but was usually mild. In Helicobacter pylori -negative subjects, there was significantly less chronic gastritis in the antrum and the fundus in oesophagitis patients than in controls (p < 0.05). When present, gastric atrophy was usually antral and mild in severity. There was no difference in the incidence of gastric atrophy in patients with oesophagitis compared with controls (24% compared with 40%; p > 0.05). Chronic gastritis is not more common in patients with oesophagitis, and is unlikely to play a part in the pathogenesis of this disease. [source]


Pyloric stenosis with reflux oesophagitis in a Thoroughbred filly

EQUINE VETERINARY EDUCATION, Issue 4 2004
P. Heidmann
First page of article [source]


Heartburn and reflux oesophagitis

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 1 2000
John M Duggan
No abstract is available for this article. [source]


Fundoplication in children with gastro-oesophageal reflux disease

JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 2 2002
AW Norrashidah
Objectives: The associations between gastro-oesophageal reflux (GOR), chronic respiratory symptoms and gastrointestinal complications have been well described. The aim of this study was to compare the characteristics of children in whom the main indication for fundoplication was respiratory disease with children who had gastrointestinal indications for surgery. Methods: A retrospective review of 79 children who underwent fundoplication between January 1995 and December 1999. Results: Forty-nine of the children (62%) had a respiratory indication for fundoplication. Children with neurological impairment tended to have a respiratory rather than a gastrointestinal indication for surgery. Congenital anomalies were present in 47%. Fundoplication in older children was more likely to be for a gastrointestinal indication. Children with neurological impairment were more likely to have a gastrostomy compared to children with normal neurological status (P < 0.01). Children with a respiratory indication were more likely to have three or more diagnostic investigations (P < 0.001). Ninety-two per cent of children with a respiratory indication and 90% with a gastrointestinal indication for fundoplication had at least one positive test for GOR (barium meal or 24-h oesophageal pH monitoring). Oesophagoscopy showed reflux oesophagitis in 46/61. Eighty-five per cent of the children had complete resolution of their symptoms after fundoplication. Conclusions: Neurological comorbidity was common in children who had surgery for gastro-oesophageal reflux disease, whether for gastrointestinal or respiratory indications. The majority of fundoplications were performed for respiratory indications. [source]


Dyspepsia and irritable bowel syndrome in China: a population-based endoscopy study of prevalence and impact

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2010
Y. Zhao
Aliment Pharmacol Ther 2010; 32: 562,572 Summary Background, Dyspepsia and irritable bowel syndrome (IBS) are common in Western populations. Aim, To determine the epidemiology of dyspepsia and IBS in China. Methods, A representative sample of 18 000 adults from five regions of China were asked to complete the modified Rome II questionnaire; 20% were asked to complete the 36-item Short Form Health Survey (SF-36). Participants from Shanghai were invited to provide blood samples and undergo oesophagogastroduodenoscopy. Odds ratios (ORs) and 95% confidence intervals (CIs) were determined using a multivariate logistic regression model. Results, The survey was completed by 16 091 individuals (response rate: 89.4%). Overall, 387 participants (2.4%) had dyspepsia and 735 (4.6%) had IBS. All SF-36 dimension scores were at least five points lower in individuals with than without dyspepsia or IBS (P , 0.001). In Shanghai, 1030 (32.7%) of the 3153 respondents agreed to endoscopy; neither dyspepsia nor IBS was found to be associated with reflux oesophagitis, peptic ulcer disease or Helicobacter pylori infection. Conclusions, Prevalence estimates for dyspepsia and IBS in China are lower than in Western populations. In China, dyspepsia or IBS symptoms are generally not associated with underlying organic disease. [source]


Patients vote with their feet for ,On demand' rabeprazole in the maintenance treatment phase of reflux oesophagitis

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 2 2010
V. P. Y. Tan
No abstract is available for this article. [source]


Patients vote with their feet for ,On demand' rabeprazole in the maintenance treatment phase of reflux oesophagitis: author's reply

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 2 2010
R. Fass
No abstract is available for this article. [source]


The influence of environmental risk factors in hospitalization for gastro-oesophageal reflux disease-related diagnoses in the United States

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 8 2010
N. THUKKANI
Aliment Pharmacol Ther,31, 852,861 Summary Background, The impact of gastro-oesophageal reflux disease on hospitalization is unknown. Aim, To describe the characteristics of patients hospitalized for diagnoses related to gastro-oesophageal reflux disease (GERD) and find potential environmental influences that affect their hospitalization. Methods, Data from the Healthcare Cost and Utilization Project were used to study the demographic characteristics of hospitalizations associated with GERD during 2003,2006. Data from the Centers for Disease Control were used for information about the US prevalence of obesity. Results, During 2003,2006, 0.5 million patients with a primary and 14.5 million patients with a secondary GERD-related diagnosis became hospitalized in the US. Oesophageal reflux and hiatal hernia were more common in female than in male inpatients, whereas Barrett's oesophagus and oesophageal adenocarcinoma were more common in male than in female inpatients. All GERD-related diagnoses were more common in white people than non-white people. Hospitalizations associated with oesophageal reflux, reflux oesophagitis and Barrett's oesophagus showed resembling geographical distributions among different US states. The prevalence of obesity and the hospitalization for hiatal hernia or reflux oesophagitis were also characterized by similar geographical distributions. Conclusion, The large numbers of inpatients with a discharge diagnosis of GERD-related conditions attest to the frequent occurrence and relevance of GERD in contributing to hospitalization in the US. [source]


Diagnostic yield of oesophagogastroduodenoscopy in children with abdominal pain

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 6 2009
K. THAKKAR
Summary Background, Abdominal pain is the most common indication for oesophagogastroduodenoscopy (OGD) in children. However, existing studies examining the diagnostic outcomes of OGD in children with abdominal pain are limited. Aim, To examine the diagnostic yield of OGD with biopsy in the evaluation of abdominal pain and to describe the endoscopic and histological findings in patients undergoing OGD for abdominal pain of unclear aetiology. Methods, We performed a retrospective cross-sectional cohort study in children under 18 years of age who had OGD for the primary indication of abdominal pain, at Texas Children's Hospital and Children's Hospital of The King's Daughters from 1 January 2002 to 30 June 2005. Results, Overall, OGD was diagnostic in 454 (38.1%) of the 1191 procedures, including reflux oesophagitis (23%, n = 271), Helicobacter pylori infections (5%, n = 55), peptic ulcers (3%, n = 32), eosinophilic oesophagitis (2%, n = 25), celiac disease (1%, n = 9) and Crohn's disease (0.5%, n = 7). Male gender, older age, elevated C-reactive protein and vomiting were associated with increased diagnostic yield. Conclusions, Our findings suggest that OGD is valuable for the evaluation of chronic abdominal pain in children, with a diagnostic yield of 38%. The majority of alarm symptoms and routine laboratory tests are not significantly associated with diagnostic yield. [source]


Clinical trial: factors associated with resolution of heartburn in patients with reflux oesophagitis , results from the EXPO study

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 9 2009
J. LABENZ
Summary Background, The ability to predict symptom response to reflux oesophagitis-healing therapy may optimize treatment decisions. Aim, To identify factors associated with heartburn resolution in patients receiving acid-suppressive therapy for reflux oesophagitis. Methods, In this multicentre, randomized, double-blind trial (EXPO; AstraZeneca study code: SH-NEG-0008), patients with endoscopically confirmed reflux oesophagitis and reflux symptoms received once-daily proton pump inhibitor therapy [esomeprazole 40 mg (n = 1562) or pantoprazole 40 mg (n = 1589)] for ,4 weeks. Factors associated with heartburn resolution after 4 weeks were identified by multiple logistic regression analysis. Results, Esomeprazole therapy, positive Helicobacter pylori status and greater age were associated with an increased likelihood of heartburn resolution [odds ratio (95% confidence interval): 1.31 (1.12, 1.54), 1.44 (1.19, 1.74) and 1.013 (1.007, 1.019) per year, respectively; all P < 0.001]. Men and patients with no acid regurgitation or epigastric pain pre-treatment were also more likely to achieve heartburn resolution (all P < 0.05). Conclusions, The use of esomeprazole rather than pantoprazole increases the probability of achieving resolution of heartburn during reflux oesophagitis-healing therapy. Other factors, including H. pylori status, age, gender and symptom profile may be helpful in determining the likelihood of heartburn resolution in such patients. [source]


Time trends in peptic ulcer, erosive reflux oesophagitis, gastric and oesophageal cancers in a multiracial Asian population

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 7 2009
K.-L. GOH
Summary Background, Dramatic changes in the prevalence and pattern of gastrointestinal disease has taken place in Asia in recent years. Aim, To compare the prevalence of duodenal (DU) and gastric ulcers (GU), erosive oesophagitis (EO), gastric cancer (GCA) and oesophageal cancer (OCA) and Helicobacter pylori infection over a 10-year interval of time in a multiracial South-East Asian population. Methods, Endoscopy records of first time gastroscopy in the University of Malaya Medical Centre, Kuala Lumpur, Malaysia were reviewed for 1989/1990 and 1999/2000. Results, In the period of 1989,1990, 3252 records and in 1999,2000, 4615 records were analysed. Both DU (21.1,9.5%) and GU (11.9,9.4%) had decreased significantly (P < 0.001). EO had increased significantly from 2.0% to 8.4% (P < 0.001). Both GCA and OCA had declined in the 10-year interval. Helicobacter pylori prevalence had decreased from 51.7% to 30.3% (P < 0.001). The decrease in DU and GU was seen in all racial groups. The increase in EO was most marked in Indians and the decrease in GCA in Chinese. The proportion of H. pylori- associated DU and GU had also decreased with time. Conclusions, Peptic ulcers and H. pylori infection had declined over a 10-year period of time and showed an opposing time trend with EO, which had increased dramatically. Both GCA and OCA had declined in prevalence. [source]


Efficacy of rabeprazole on heartburn symptom resolution in patients with non-erosive and erosive gastro-oesophageal reflux disease: a multicenter study from Japan

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 1 2007
H. MIWA
Summary Background, Few studies have compared the efficacy of proton pump inhibitors in resolving the symptoms of non-erosive reflux disease (NERD) and of erosive gastro-oesophageal reflux disease (GERD) in Japan. Aim, To investigate and compare the efficacy of 4-week course of rabeprazole 10 mg/day on symptom resolution in NERD and erosive GERD in Japan. Methods, The modified Los Angeles classification was used to grade endoscopically GERD in patients with heartburn (Grades N and M: NERD, Grades A and B: mild reflux oesophagitis (RO), and Grades C and D: severe RO). Rabeprazole 10 mg/day was administered for 4 weeks to 180 patients who kept symptom diaries. Results, Complete relief of the symptoms was achieved in 35.8% of the NERD group and 55.4% of the erosive GERD group (mild RO: 51.1% and severe RO: 77.8%). Rabeprazole was significantly more effective in erosive GERD than in NERD patients. Among the NERD subgroups (Grades N and M), no difference in symptom improvement was observed. Conclusions, Four-week, rabeprazole 10 mg/day acid suppression therapy was effective in resolving symptoms in Japanese GERD patients. This therapy was more effective in erosive GERD than in NERD patients, and in those with severe RO than in those with mild RO. [source]


Gastric motility and autonomic activity during obstructive sleep apnea

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 2006
M. URATA
Summary Background Patients with Obstructive Sleep Apnea Syndrome (OSAS) often experience gastroesophageal reflux disease (GERD). Aim To investigate gastric motility and autonomic nervous activity during sleep apnea. Methods The subjects of this study were 20 individuals with OSAS who experienced 10 or more sleep apnoea events per hour, as measured with a portable sleep polygraph. A percutaneous electrogastrography (EGG) and fast Fourier transformation analysis was carried out on the results. The mean amplitude was compared for bradygastria, normogastria and tachygastria. Spectral analysis of heart rate variability was performed, and low-frequency (LF) power, high-frequency (HF) power and the LF/HF ratio were measured. Oesophagogastroduodenal endoscopy was performed on each subject, and the presence of reflux oesophagitis (RE) was diagnosed according to the Los Angeles (LA) grade classification. Moreover, questionnaire for the diagnosis of reflux disease (QUEST) was carried out. Results Normogastria was significantly decreased, and brady-, tachygastria, or both were increased during sleep apnea (P < 0.01). There was no significant relation between LA grade classification of RE and severity of OSAS. The LF/HF ratio was significantly higher during sleep apnea for patients with RE and OSAS, but the opposite for those with RE without OSAS. Decreased percutaneous arterial oxygen saturation and normogastria were independent risk factors for the severity of RE. Conclusions The present study suggested that, in addition to decreased pressure on the pleural cavity, factors affecting the development of RE might include abnormal gastric motility, low oxygen, and increased sympathetic nervous activity during sleep apnea. [source]


Evaluation of gastro-oesophageal flap valve is useful for diagnosing gastro-oesophageal reflux disease

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 2006
M. IWAMOTO
Summary Background Gastro-oesophageal flap valve (GEFV) grade correlated with endoscopic reflux oesophagitis (RE) prevalence. Aim To investigate relationships among gastro-oesophageal reflux disease (GERD) symptoms, RE and/or non-erosive reflux disease (NERD) and GEFV grades in subjects undergoing endoscopy. Methods We enrolled 1305 subjects from whom endoscopic results and the results of a self-administered questionnaire (QUEST) were available. Subjects were evaluated for GERD symptoms (QUEST score), GEFV grade, RE and gastric mucosal atrophy. Results Total GERD prevalence, including symptomatic GERD (QUEST score , 4) and/or RE, was 27%. RE grade and prevalence increased with GEFV grade. QUEST scores and GEFV grades showed a positive correlation. NERD prevalence was 14% and increased with GEFV grade, but the relationship was weaker than that between RE and GEFV. Comparing RE-negative subjects by GEFV grade, GERD symptoms were noted in 10%, 19%, 36% and 52% with GEFV grades I, II, III and IV, respectively. Neither type of gastric mucosal atrophy correlated with GEFV grade. Conclusions Total GERD, NERD and RE prevalences increased with GEFV grade. Subjects with high GEFV grades often complain of GERD symptoms, even without RE. Our findings suggest that endoscopic GEFV evaluation provides a useful clinical index for diagnosing GERD. [source]


Review article: from 1906 to 2006 , a century of major evolution of understanding of gastro-oesophageal reflux disease

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 9 2006
J. DENT
Summary Background Our understanding of gastro-oesophageal reflux disease has undergone significant changes over the last century. Aim To trace the rise in understanding of gastro-oesophageal reflux disease and highlight remaining areas of uncertainty. Methods Literature review. Results In 1906, Tileston published his observations on ,peptic ulcer of the oesophagus'. Winkelstein, in 1934, first correlated symptoms of heartburn with acid regurgitation and reflux oesophagitis. In 1946, Allison described hiatus hernia as a causal factor in the development of gastro-oesophageal reflux disease. In 1958, Bernstein and Baker showed a direct relationship between oesophageal acidification and heartburn in patients with gastro-oesophageal reflux disease, irrespective of endoscopic findings, leading to the recognition of non-erosive gastro-oesophageal reflux disease. In the 1980s, continuous recordings of the lower oesophageal sphincter showed that episodes of reflux were related to transient relaxations of lower oesophageal sphincter tone. There is now increasing recognition that gastro-oesophageal reflux disease arises from the interaction of several anatomical and physiological factors. A turning point in the medical treatment of gastro-oesophageal reflux disease came with the introduction of the first proton pump inhibitor, omeprazole, in 1989. Conclusions Future efforts need to identify the multifactorial interactions of gastro-oesophageal junction anatomy and physiology in patients with gastro-oesophageal reflux disease. Increased understanding of the disease will guide development of new therapies. [source]


There are no reliable symptoms for erosive oesophagitis and Barrett's oesophagus: endoscopic diagnosis is still essential

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2002
B. Avidan
Aims: To evaluate the sensitivity and specificity of different symptoms in erosive reflux oesophagitis and Barrett's oesophagus. Methods: The presence of reflux symptoms was compared between a case population of 306 patients with endoscopically determined erosive reflux oesophagitis, 235 patients with biopsy-proven Barrett's oesophagus and a control population of 198 subjects without reflux disease. Results: Heartburn at any time and heartburn at night represented the only two symptoms to be simultaneously sensitive and specific. Symptoms that were induced by various foods, such as fat, tomato, chocolate, citrus or spices, tended to cluster in the same sub-group of patients. Similarly, heartburn induced by exercise, lying down or bending over tended to occur in the same sub-groups. The frequency of symptoms was influenced more by the presence of mucosal erosions than by the presence of Barrett's oesophagus. Reflux symptoms occurred more frequently in the presence rather than the absence of Barrett's oesophagus, and in long segment rather than short segment of Barrett's mucosa. Conclusions: Endoscopic inspection of the oesophageal mucosa remains the only certain method by which to reliably diagnose erosive reflux oesophagitis and Barrett's oesophagus. [source]


Dysfunction of oesophageal motility in Helicobacter pylori -infected patients with reflux oesophagitis

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 12 2001
J. C. Y. Wu
Background: Helicobacter pylori infection has been suggested to be protective against gastro-oesophageal reflux disease. However, a significant proportion of patients with gastro-oesophageal reflux disease are infected by H. pylori. Aim: To study oesophageal motor function in H. pylori -infected patients with reflux oesophagitis. Methods: Patients with erosive reflux oesophagitis were recruited prospectively for stationary oesophageal manometry and 24-h ambulatory oesophageal pH monitoring. H. pylori status was determined by biopsy urease test. Non-reflux volunteers were recruited as controls. Results: Seventy-four patients with erosive oesophagitis (34 H. pylori -positive, 40 H. pylori -negative) and 48 non-reflux patient controls (22 H. pylori -positive, 26 H. pylori -negative) were recruited. There was no difference in severity of oesophagitis (median grade, 1; P=0.53) or oesophageal acid exposure (total percentage time oesophageal pH < 4, 7.6% vs. 6.8%; P=0.57) between H. pylori -positive and H. pylori -negative groups. Compared to H. pylori -negative patients, H. pylori -positive patients had significantly lower basal lower oesophageal sphincter pressure (12.2 mmHg vs. 15.3 mmHg; P=0.03) and amplitude of distal peristalsis (56.9 mmHg vs. 68.4 mmHg; P=0.03). Ineffective oesophageal motility (14% vs. 7%; P=0.02) and failed oesophageal peristalsis were also significantly more prevalent in H. pylori -positive patients. Conclusions: Among patients with a similar degree of reflux oesophagitis, H. pylori -infected patients have more severe oesophageal dysmotility and lower oesophageal sphincter dysfunction. Oesophageal motor dysfunction probably plays a dominant role in the development of gastro-oesophageal reflux disease in patients with H. pylori infection. [source]


Lansoprazole in children: pharmacokinetics and efficacy in reflux oesophagitis

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 9 2001
C. Faure
Background: Data on the proton pump inhibitor lansoprazole in paediatric patients are limited. Aim: To investigate the pharmacokinetics, optimal dosage and efficacy of lansoprazole in paediatric patients. Methods: A 24-h gastric pH recording and a pharmacokinetic study were performed after 7 days of lansoprazole, 17 mg/m2, in 23 patients with reflux oesophagitis (median age, 3.5 years). Response was defined as pH > 3 for > 65% of the recording. The dosage was doubled in non-responders. Patients with no response on day 14 were excluded. Responders underwent endoscopy after 4 weeks on the response-inducing dosage; abnormal findings led to a repeat endoscopy after four additional weeks. Results: Nine patients responded to 17 mg/m2 and six to 30.3 mg/m2. On day 7, time with pH > 3 was significantly correlated with the area under the plasma concentration,time curve (P=0.003). The area under the plasma concentration,time curve was significantly greater in the nine responders to 17 mg/m2 than in the 14 other patients. Pharmacokinetic parameters were similar in responders and non-responders to the higher dose. After 4 weeks, oesophagitis was healed in 80% of responders. Adverse events occurred in three patients and required treatment discontinuation in one. Conclusions: Lansoprazole is effective and safe in children. The optimal starting dosage is 30 mg/m2 or 1.4 mg/kg. [source]


Comparison of IY81149 with omeprazole in rat reflux oesophagitis

AUTONOMIC & AUTACOID PHARMACOLOGY, Issue 5-6 2000
B. J. Kil
1 This study was aimed at evaluating the effects of IY81149{2-[[(4methoxy-3-methyl)-2-pyridinyl]methylsulfinyl]-5-(1H-pyrrol-1-yl)-1H-benzimidazole}, a new proton pump inhibitor, on the development of the surgically induced reflux oesophagitis, on gastric secretion and on lipid peroxidation which is a marker of oxidative stress. Omeprazole was used as a reference drug. We furthermore investigated the influence of quercetin and desferrioxamine (DFO) on the development of the surgically induced reflux oesophagitis in rats on gastric secretion and on lipid peroxidation. 2 IY81149 and omeprazole significantly prevented the development of reflux oesophagitis and gastric secretion in a dose-dependent manner. The ED50 values of IY81149 for inhibition of oesophagitis and volume of gastric secretion were lower than of omeprazole (5.7 vs. 14.2 ,mol, 15.3 vs. 24.0 ,mol, respectively). IY81149 was also more potent in the acid output inhibition with an ED50 of 6.8 ,mol compared with 20.8 ,mol of omeprazole. 3 Malonyldialdehyde (MDA) content, the end product of lipid peroxidation, increased significantly in the oesophageal mucosa after the induction of reflux oesophagitis. IY81149 and omeprazole significantly and dose-dependently prevented lipid peroxidation. Quercetin (200 mg kg,1, p.o.) and DFO (800 mg kg,1, i.d.) significantly prevented the development of reflux oesophagitis and inhibited the lipid peroxidation independent of their actions on gastric secretion. 4 This result suggests that IY81149 is comparable with omeprazole in the treatment of reflux oesophagitis. [source]