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Wang Y, Zhou B, Fang S, Zhu S, Xu T, Dilikumaer M, Li G. Dynorphin participates in interaction between depression and non-erosive reflux disease. Esophagus 2023; 20:158-169. [PMID: 36244036 PMCID: PMC9813039 DOI: 10.1007/s10388-022-00955-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 09/07/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND To explore the relationships between anxiety/depression and NERD, we focused on dynorphin (Dyn), an important member of visceral hypersensitivity, and its related pathways. METHODS Pearson's correlation analysis on patients with NERD and in vivo experiment on NERD rat model. Part 1: Pearson's correlation analysis among serum levels of Dyn, clinical symptoms and HADS scores of NERD patients were carried on. Part 2: Wistar rats were randomly divided into 2 groups: control group and model group. The data of pH value, immobility time, serum Dyn concentration, NMDAR1 and SP expression were, respectively, derived from automatic pH recorder, tail suspension test, enzyme-linked immunosorbent assay, immunohistochemistry and immunofluorescence. RESULTS Part 1: Pearson's correlation analysis showed that there was a linear correlation between Clinical Symptom (CS) score and HADS score (HAD-A, HAD-D), and the correlation coefficients were 0.385 and 0.273 respectively; the correlation coefficient between lg (Dyn) and lg (CS score) was r = 0.441, P = 0.002; the correlation coefficient between lg(Dyn) and lg (HAD-D score) was r = 0.447, P = 0.002. Part 2: The pH value of the lower esophagus in the model group was lower than that in the control group (P < 0.01). The tail suspension immobility time of model group was significantly longer than that of control group (P < 0.01). The serum Dyn concentration and the expression level of NMDAR1 in spinal cord and SP in lower esophageal mucosa of model group were significantly higher than those of control group (P < 0.05). CONCLUSION Increased serum dynorphin level may be a sign of correlation between depression and NERD.
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Affiliation(s)
- Yi Wang
- Department of Gastroenterology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Bingduo Zhou
- Department of Gastroenterology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shengquan Fang
- Department of Gastroenterology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shengliang Zhu
- Department of Gastroenterology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Tingting Xu
- Department of Gastroenterology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Makan Dilikumaer
- Department of Gastroenterology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Guanwu Li
- Department of Radiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
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Maev IV, Andreev DN, Ovsepyan MA, Barkalova EV. Gastroesophageal reflux disease: risk factors, current possibilities of diagnosis and treatment optimisation. MEDITSINSKIY SOVET = MEDICAL COUNCIL 2022:16-26. [DOI: 10.21518/2079-701x-2022-16-7-16-26] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/28/2024]
Abstract
Gastroesophageal reflux disease (GERD) is one of the most common causes of health care seeking at the primary care level in many countries. At an epidemiological level, GERD has been shown to be associated with a number of risk factors: obesity, tobacco smoking, alcohol abuse, certain patterns of eating behaviour, and the use of several medications. GERD is now regarded as a heterogeneous disease and includes different phenotypes (erosive reflux disease, non-erosive reflux disease, hypersensitive oesophagus, functional heartburn), the proper diagnosis of which improves the effectiveness of therapy in patients with heartburn symptoms. Daily impedance–pH monitoring is known to be an integral part of the diagnostic algorithm for GERD and is a functional diagnostic method to record all types of refluxes entering the oesophagus regardless of pH, to assess their association with symptoms, and to determine whether patients with heartburn symptoms belong to a particular phenotype. Esophageal manometry plays a key role in the evaluation of patients with heartburn symptoms, as it helps to rule out other conditions that may mimic GERD: achalasia cardia and scleroderma esophagus. This technique is used to assess thoracic esophageal motility and sphincter function and in the assessment of patients prior to antireflux surgery or in the refractory course of GERD. The article describes in detail GERD risk factors (triggers of heartburn), as well as diagnostic aspects, taking into account a differentiated approach to patients with heartburn based on daily impedance–pH monitoring data in accordance with the current guidelines and recommendations.
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Affiliation(s)
- I. V. Maev
- Yevdokimov Moscow State University of Medicine and Dentistry
| | - D. N. Andreev
- Yevdokimov Moscow State University of Medicine and Dentistry
| | - M. A. Ovsepyan
- Yevdokimov Moscow State University of Medicine and Dentistry
| | - E. V. Barkalova
- Yevdokimov Moscow State University of Medicine and Dentistry
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Rogers J, Eastland T. Understanding the most commonly billed diagnoses in primary care: Gastroesophageal reflux disease. Nurse Pract 2021; 46:50-55. [PMID: 33739328 DOI: 10.1097/01.npr.0000737196.69218.b6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Gastroesophageal reflux disease (GERD) is a chronic, relapsing condition encountered commonly in primary care with an estimated worldwide prevalence of up to 33%. GERD affects all age groups, races, and genders with 25% of the population in the Western world experiencing heartburn at least once a month.
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Batista ADO, Dotti AZ, Aprile LRO, Dantas RO. Intra-Esophageal pH Monitoring on Two Consecutive Days in Patients With Gastroesophageal Reflux Symptoms. Gastroenterology Res 2019; 12:198-202. [PMID: 31523329 PMCID: PMC6731039 DOI: 10.14740/gr1189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 06/20/2019] [Indexed: 12/03/2022] Open
Abstract
Background The best method to measure the frequency and duration of gastroesophageal reflux is 24-h pH or 24-h pH/impedance monitoring. However, the detection of reflux can vary when measured on different days. Our aim was to evaluate the possibility that the severity of gastroesophageal reflux is different even under similar conditions on two consecutive days. Methods We performed a 48-h pH monitoring in 12 subjects, aged 25 - 63 years, who complaint of heartburn and regurgitation, ten with esophagitis and two with non-erosive disease. The pH measurement was conducted at 5 cm from the lower esophageal sphincter. The patients stayed at the Clinical Investigation Ward of the hospital for 48 h. On each day, they consumed a 2,000 calorie diet. The results obtained on the first day were compared with those on the second day. Results Mean reflux index in the upright position was different between the two days. Results of the pH-monitoring within the 2 h after the meal revealed differences in the number of acidic reflux and reflux index episodes. Three patients had abnormal DeMeester score on one day and normal score on the other day. Considering the upper limit of 6.0% of the test duration with esophageal pH < 4 as indicative of gastroesophageal reflux disease, two patients showed abnormal results on one day and normal results on the other day. Conclusions The 24-h pH monitoring, performed on two consecutive days under similar conditions, can lead to different diagnosis of gastroesophageal reflux disease in symptomatic patients.
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Affiliation(s)
- Andrea de Oliveira Batista
- Department of Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Adriana Zanoni Dotti
- Department of Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Lilian Rose Otoboni Aprile
- Department of Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Roberto Oliveira Dantas
- Department of Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
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Abrosimov VN, Ponomareva IB, Nizov AA, Solodun MV. On respiratory manifestations of gastroesophageal reflux disease. TERAPEVT ARKH 2019. [PMID: 30701948 DOI: https://doi.org/10.26442/terarkh2018908131-136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
One of the manifestations of gastroesophageal reflux disease (GERD) is extraesophageal symptoms, in particular, from the upper and lower respiratory tract. Gastroesophageal reflux is capable of both causing respiratory symptoms independently and aggravating the course of already existing diseases of the respiratory system. The article presents available in the literature current information on the pathogenesis of GERD respiratory symptoms, their clinical course, considerations of diagnosis and treatment.
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Affiliation(s)
- V N Abrosimov
- Acad. I.P. Pavlov Ryazan State Medical University, Ministry of Health of Russia, Ryazan, Russia
| | - I B Ponomareva
- Acad. I.P. Pavlov Ryazan State Medical University, Ministry of Health of Russia, Ryazan, Russia
| | - A A Nizov
- Acad. I.P. Pavlov Ryazan State Medical University, Ministry of Health of Russia, Ryazan, Russia
| | - M V Solodun
- Acad. I.P. Pavlov Ryazan State Medical University, Ministry of Health of Russia, Ryazan, Russia
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Chatila AT, Nguyen MTT, Krill T, Roark R, Bilal M, Reep G. Natural history, pathophysiology and evaluation of gastroesophageal reflux disease. Dis Mon 2019; 66:100848. [PMID: 30803725 DOI: 10.1016/j.disamonth.2019.02.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Gastroesophageal reflux disease (GERD) is one of the most common diseases encountered by both internists and gastroenterologists. GERD can cause a wide variety of symptoms ranging from heartburn and regurgitation to more atypical symptoms such as cough, chest pain, and hoarseness. The diagnosis is often times made on the basis of history and clinical symptomatology. The prevalence of GERD is currently estimated to be 8-33% with the incidence of disease only expected to increase over time. Although most cases of GERD can be diagnosed based on symptoms and clinical presentation, the diagnosis of GERD can be challenging when symptoms are atypical. In this review, we provide a comprehensive summary of the epidemiology, pathophysiology, evaluation and diagnosis of gastroesophageal reflux disease.
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Affiliation(s)
- Ahmed T Chatila
- Department of Internal Medicine, The University of Texas Medical Branch, Galveston, TX, United States
| | - Minh Thu T Nguyen
- The University of Texas Medical Branch School of Medicine, Galveston, TX, United States
| | - Timothy Krill
- Division of Gastroenterology & Hepatology, The University of Texas Medical Branch, Galveston, TX, United States
| | - Russell Roark
- Department of Internal Medicine, The University of Texas Medical Branch, Galveston, TX, United States
| | - Mohammad Bilal
- Division of Gastroenterology & Hepatology, The University of Texas Medical Branch, Galveston, TX, United States.
| | - Gabriel Reep
- Division of Gastroenterology & Hepatology, The University of Texas Medical Branch, Galveston, TX, United States
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Abrosimov VN, Ponomareva IB, Nizov AA, Solodun MV. On respiratory manifestations of gastroesophageal reflux disease. TERAPEVT ARKH 2018; 90:131-136. [PMID: 30701948 DOI: https:/doi.org/10.26442/terarkh2018908131-136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
One of the manifestations of gastroesophageal reflux disease (GERD) is extraesophageal symptoms, in particular, from the upper and lower respiratory tract. Gastroesophageal reflux is capable of both causing respiratory symptoms independently and aggravating the course of already existing diseases of the respiratory system. The article presents available in the literature current information on the pathogenesis of GERD respiratory symptoms, their clinical course, considerations of diagnosis and treatment.
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Affiliation(s)
- V N Abrosimov
- Acad. I.P. Pavlov Ryazan State Medical University, Ministry of Health of Russia, Ryazan, Russia
| | - I B Ponomareva
- Acad. I.P. Pavlov Ryazan State Medical University, Ministry of Health of Russia, Ryazan, Russia
| | - A A Nizov
- Acad. I.P. Pavlov Ryazan State Medical University, Ministry of Health of Russia, Ryazan, Russia
| | - M V Solodun
- Acad. I.P. Pavlov Ryazan State Medical University, Ministry of Health of Russia, Ryazan, Russia
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Abrosimov VN, Ponomareva IB, Nizov AA, Solodun MV. On respiratory manifestations of gastroesophageal reflux disease. TERAPEVT ARKH 2018. [DOI: 10.26442/terarkh2018908131-136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
One of the manifestations of gastroesophageal reflux disease (GERD) is extraesophageal symptoms, in particular, from the upper and lower respiratory tract. Gastroesophageal reflux is capable of both causing respiratory symptoms independently and aggravating the course of already existing diseases of the respiratory system. The article presents available in the literature current information on the pathogenesis of GERD respiratory symptoms, their clinical course, considerations of diagnosis and treatment.
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