1
|
Han G, Leem J, Lee H, Lee J. Electroacupuncture to treat gastroesophageal reflux disease: study protocol for a randomized controlled trial. Trials 2016; 17:246. [PMID: 27188910 PMCID: PMC4869308 DOI: 10.1186/s13063-016-1371-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 04/28/2016] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Gastroesophageal reflux disease lowers the quality of life and increases medical costs. Electroacupuncture has been used to ease symptoms and improve gastrointestinal motility in patients with gastroesophageal reflux disease. The main purposes of this study are to evaluate the efficacy and safety of this procedure. METHODS/DESIGN This is a protocol for a randomized, patient-blinded, assessor-blinded, sham-controlled trial. Sixty participants with symptoms of gastroesophageal reflux disease, who have previously undergone standard treatment, will be recruited from August 2015 at Kyung Hee University Korean Medicine Hospital. The participants will be allocated to either the electroacupuncture (n = 30) or the sham electroacupuncture group (n = 30); the allocation will be concealed from both the participants and the assessors. The EA group will undergo penetrating acupuncture at 18 fixed points and two optional points chosen using the pattern identification for gastroesophageal reflux disease. Electrical stimulation will be applied at some of the acupoints. The sham electroacupuncture group will undergo nonpenetrating acupuncture without electrical stimulation at 18 nonspecific points, each of which will be only 2 cm away from the true acupoints used in the electroacupuncture group. In both groups, the procedure will be performed using the Park device. The treatment will last for 6 weeks (with two sessions each week), and the outcome will be evaluated at baseline, 3 weeks, and 6 weeks. The primary outcome will be the proportion of responders with adequate symptom relief, whereas the secondary outcomes will comprise the results of the Nepean dyspepsia index; the Korean gastrointestinal symptom rating scale; the EQ-5D™; levels of gastrin, motilin, and inflammatory cytokines; the perceived stress scale; the qi-stagnation questionnaire; the patient global impression of change; and the spleen qi deficiency questionnaire. DISCUSSION The results of this trial will provide information about the efficacy and safety of electroacupuncture in the treatment of gastroesophageal reflux disease symptoms, as well as evidence regarding the use of electroacupuncture to treat gastroesophageal reflux disease in real clinical practice. TRIAL REGISTRATION Clinical Research Information Service Identifier, KCT0001653 . Registered on 12 October 2015.
Collapse
Affiliation(s)
- Gajin Han
- Korean Medicine Clinical Trial Center, Kyung Hee University Korean Medicine Hospital, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea
- Department of Gastroenterology, College of Korean Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - Jungtae Leem
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - Hojung Lee
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - Junhee Lee
- Korean Medicine Clinical Trial Center, Kyung Hee University Korean Medicine Hospital, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea.
- Department of Sasang Constitutional Medicine, College of Korean Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea.
| |
Collapse
|
2
|
Changes of Esophagogastric Junctional Adenocarcinoma and Gastroesophageal Reflux Disease Among Surgical Patients During 1988-2012: A Single-institution, High-volume Experience in China. Ann Surg 2016; 263:88-95. [PMID: 25647058 PMCID: PMC4679348 DOI: 10.1097/sla.0000000000001148] [Citation(s) in RCA: 103] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
To evaluate the changes of esophagogastric junctional adenocarcinoma (EGJA) and gastroesophageal reflux disease (GERD) among surgical patients from 1988 to 2012 in a Chinese high-volume hospital.
Collapse
|
3
|
Seo AY, Shin CM, Kim N, Yoon H, Park YS, Lee DH. Correlation between hypersensitivity induced by esophageal acid infusion and the baseline impedance level in patients with suspected gastroesophageal reflux. J Gastroenterol 2015; 50:735-43. [PMID: 25479939 DOI: 10.1007/s00535-014-1013-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 11/03/2014] [Indexed: 02/04/2023]
Abstract
OBJECTIVES To evaluate the relevance between the pH parameters and baseline impedance level or esophageal hypomotility in patients with suspected gastroesophageal reflux. METHOD The recordings of 51 patients with heartburn, acid regurgitation, globus or noncardiac chest pain were analyzed. Evaluation included a 24-h multichannel intraluminal impedance-pH test while on off-proton pump inhibitor therapy over 1 week, high-resolution manometry and Bernstein test. Mean baseline impedance level at the most distal portion of the impedance channel was assessed manually. Esophageal hypomotility was evaluated using transitional zone defect (TZD) and distal break (DB) length measurement. RESULT In the study subjects (n = 51), 6 had a DeMeester score of more than 14.7 and 14 had a positive symptom index. The Bernstein test was positive in ten patients. The baseline impedance level was inversely correlated with the acid exposure time % (r = -0.660, P < 0.001). Also, all reflux and weakly acid reflux time % measured by impedance monitoring showed a weak correlation with TZD + DB length (r = 0.327 and 0.324, P = 0.019 and 0.020, respectively). Although a positive Bernstein test has no relevance for the acid exposure time or acid-related symptoms as represented by the DeMeester score or symptom index, the baseline impedance level was significantly lower in patients with a positive Bernstein test than in those with a negative one (2,628.4 ± 862.7 vs. 1,752.2 ± 611.1 Ω, P = 0.004). CONCLUSION A lower baseline impedance level is closely related to increased esophageal acid exposure. Hypersensitivity induced by esophageal acid infusion might be attributed to acid-induced mucosal changes of the esophagus.
Collapse
Affiliation(s)
- A Young Seo
- Department of Internal Medicine, Seoul National University Bundang Hospital, 173-82, Gumi-ro, Bundang-gu, Seongnam, Gyeonggi-do, 463-707, South Korea
| | | | | | | | | | | |
Collapse
|
4
|
Kang JHE, Kang JY. Lifestyle measures in the management of gastro-oesophageal reflux disease: clinical and pathophysiological considerations. Ther Adv Chronic Dis 2015; 6:51-64. [PMID: 25729556 DOI: 10.1177/2040622315569501] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Several lifestyle and dietary factors are commonly cited as risk factors for gastro-oesophageal reflux disease (GORD) and modification of these factors has been advocated as first-line measures for the management of GORD. We performed a systematic review of the literature from 2005 to the present relating to the effect of these factors and their modification on GORD symptoms, physiological parameters of reflux as well as endoscopic appearances. Conflicting results existed for the association between smoking, alcohol and various dietary factors in the development of GORD. These equivocal findings are partly due to methodology problems. There is recent good evidence that weight reduction and smoking cessation are beneficial in reducing GORD symptoms. Clinical and physiological studies also suggest that some physical measures as well as modification of meal size and timing can also be beneficial. However, there is limited evidence for the role of avoiding alcohol and certain dietary ingredients including carbonated drinks, caffeine, fat, spicy foods, chocolate and mint.
Collapse
Affiliation(s)
- J H-E Kang
- Green Templeton College, University of Oxford, Oxford, UK
| | - J Y Kang
- Department of Gastroenterology, St George's Hospital, Blackshaw Road, London SW17 0QT, UK
| |
Collapse
|
5
|
Goh KL, Choi KD, Choi MG, Hsieh TY, Jung HY, Lien HC, Menon J, Mesenas S, Park H, Sheu BS, Wu JC. Factors influencing treatment outcome in patients with gastroesophageal reflux disease: outcome of a prospective pragmatic trial in Asian patients. BMC Gastroenterol 2014; 14:156. [PMID: 25200403 PMCID: PMC4176852 DOI: 10.1186/1471-230x-14-156] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Accepted: 08/08/2014] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Predicting response to proton pump inhibitor (PPI) treatment can aid the effective management of gastroesophageal reflux disease (GERD). The aim was to investigate the predictors of symptomatic response to pantoprazole in Asian patients with GERD; the first study of its kind in Asian patients. METHODS Asian patients with GERD symptoms (N = 209) received pantoprazole 40 mg daily for 8 weeks in a multinational, prospective, open-label study. Response was assessed using ReQuest™. Baseline and demographic factors were examined using logistic regression to determine if they were related to treatment response. RESULTS Response rates were 44.3% (Week 4) and 63.6% (Week 8) in Asian patients versus 60.7% (P < 0.001) and 72.2% (P = 0.010) for the rest of the world. Higher response rates at 8 weeks occurred in patients with erosive reflux disease (ERD; 71.3%) versus those with non-erosive reflux disease (NERD) at baseline (48.5%). The presence of ERD (P = 0.0143) and lower ReQuest™-GI scores at baseline (P = 0.0222) were associated with response. Improvements in quality of life (QoL) and anxiety and depression at 4 and 8 weeks were associated with treatment response (both P < 0.0001). Patient satisfaction correlated with treatment response (P < 0.0001), and improvement in anxiety and depression (P < 0.0001) and QoL (P < 0.0001). CONCLUSIONS Asian patients with GERD, especially those with NERD, may have lower response rates to PPIs than Western populations. ERD and less severe gastrointestinal symptoms may help to predict symptomatic responses to PPIs in Asian patients. TRIAL REGISTRATION ClinicalTrial.gov identifier: NCT00312806.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Justin Cy Wu
- The Chinese University of Hong Kong, Shatin, Hong Kong SAR, Republic of China.
| |
Collapse
|
6
|
Lee HS, Jeon SW. Barrett esophagus in Asia: same disease with different pattern. Clin Endosc 2014; 47:15-22. [PMID: 24570879 PMCID: PMC3928486 DOI: 10.5946/ce.2014.47.1.15] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Revised: 12/16/2013] [Accepted: 01/02/2014] [Indexed: 12/12/2022] Open
Abstract
Barrett esophagus (BE) is considered to develop as a result of chronic gastroesophageal reflux disease (GERD) and to predispose to esophageal adenocarcinoma (EAC). However, the disease pattern of BE in Asia differs from that observed in the West. For example, in the West, the prevalence rates of BE and EAC have progressively increased, whereas although the prevalence rate of GERD is increasing in Asia, the prevalence rates of BE and EAC have remained low in most Asian countries. GERD, hiatal hernia, old age, male sex, abdominal obesity (visceral obesity), smoking, alcohol consumption, and kyphosis are known risk factors for BE in Asia, and most Asian patients have short-segment BE. Helicobacter pylori infection is more prevalent in Asia than in the West. We suggest larger studies with a prospective design be conducted to elaborate further the different patterns of BE in Asia.
Collapse
Affiliation(s)
- Hyun Seok Lee
- Department of Internal Medicine, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Seong Woo Jeon
- Department of Internal Medicine, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| |
Collapse
|
7
|
Lee SB, Jeon KM, Kim BS, Kim KC, Jung HY, Choi YB. Early experiences of minimally invasive surgery to treat gastroesophageal reflux disease. JOURNAL OF THE KOREAN SURGICAL SOCIETY 2013; 84:330-7. [PMID: 23741690 PMCID: PMC3671001 DOI: 10.4174/jkss.2013.84.6.330] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Revised: 03/19/2013] [Accepted: 04/05/2013] [Indexed: 12/23/2022]
Abstract
Purpose There are fewer patients with gastroesophageal reflux disease (GERD) in Korea compared with Western countries. The incidence of GERD has increased in recent years however, concerning many physicians. Here, we report our early experiences of using a recently introduced method of laparoscopic antireflux surgery for the treatment of GERD in Korean patients. Methods Fifteen patients with GERD were treated using antireflux surgery between May 2009 and February 2012 at the University of Ulsan College of Medicine and Asan Medical Center. Laparoscopic Nissen fundoplication with 360° wrapping was performed on all patients. Results Eleven male and four female patients were evaluated and treated with an average age of 58.1 ± 14.1 years. The average surgical time was 118.9 ± 45.1 minutes, and no complications presented during surgery. After surgery, the reflux symptoms of each patient were resolved; only two patients developed transient dysphagia, which resolved within one month. One patient developed a 6-cm hiatal hernia that had to be repaired and reinforced using mesh. Conclusion The use of laparoscopic surgery for the treatment of GERD is safe and feasible. It is also an efficacious method for controlling the symptoms of GERD in Korean patients. However, the use of this surgery still needs to be standardized (e.g., type of surgery, bougienage size, wrap length) and the long-term outcomes need to be evaluated.
Collapse
Affiliation(s)
- Sae Byul Lee
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | | | | | | | | | | |
Collapse
|
8
|
Huang CC, Chan WL, Luo JC, Chen YC, Chen TJ, Chung CM, Huang PH, Lin SJ, Chen JW, Leu HB. Gastroesophageal reflux disease and atrial fibrillation: a nationwide population-based study. PLoS One 2012; 7:e47575. [PMID: 23077642 PMCID: PMC3471851 DOI: 10.1371/journal.pone.0047575] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Accepted: 09/12/2012] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES Precise mechanisms of atrial fibrillation (AF) are uncertain, but their association with esophageal disorders has been recently proposed. The association between gastroesophageal reflux disease (GERD), the most common gastroesophageal disorder, and AF remains undetermined. We therefore aimed to investigate the association between GERD and later development of AF. METHODS AND RESULTS Patients with GERD were identified from the 1,000,000-person cohort dataset sampled from the Taiwan National Health Insurance database. The study cohort comprised 29,688 newly diagnosed adult GERD patients; 29,597 randomly selected age-, gender-, comobidity-matched subjects comprised the comparison cohort. Cox proportional hazard regressions were performed as a means of comparing the AF-free survival rate for the two cohorts. During a maximum three years of follow-up, a total of 351 patients experienced AF, including 184 (0.62%) patients in the GERD cohort and 167 (0.56%) in the control group. The log-rank test showed that patients with GERD had significantly higher incidence of AF than those without GERD (p = 0.024). After Cox proportional hazard regression model analysis, GERD was independently associated with the increased risk of AF (hazard ratio, 1.31; 95% confidence interval, 1.06-1.61, p = 0.013). CONCLUSION GERD was independently associated with an increased risk of future AF in a nationwide population-based cohort.
Collapse
Affiliation(s)
- Chin-Chou Huang
- Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
- Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan, Republic of China
- Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan, Republic of China
| | - Wan-Leong Chan
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
- Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
| | - Jiing-Chyuan Luo
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
- Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China
| | - Yu-Chun Chen
- Department of Medical Research and Education, National Yang-Ming University Hospital, Yi-Lan, Taiwan, Republic of China
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
- Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan, Republic of China
| | - Chia-Min Chung
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan, Republic of China
| | - Po-Hsun Huang
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
- Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan, Republic of China
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China
| | - Shing-Jong Lin
- Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
- Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan, Republic of China
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China
| | - Jaw-Wen Chen
- Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
- Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan, Republic of China
- Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan, Republic of China
| | - Hsin-Bang Leu
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
- Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
- Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan, Republic of China
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China
| |
Collapse
|
9
|
Kwon JH, Choi MG, Lee SW, Shu XX, Bae SH, Choi JY, Yoon SK, Cho YK, Park JM, Lee IS, Kim SW, Chung IS. Trends of Gastrointestinal Diseases at a Single Institution in Korea over the Past Two Decades. Gut Liver 2009; 3:252-8. [PMID: 20431757 PMCID: PMC2852723 DOI: 10.5009/gnl.2009.3.4.252] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2009] [Accepted: 07/21/2009] [Indexed: 12/20/2022] Open
Abstract
Background/Aims The lifestyle changes that have accompanied economic growth have influenced disease patterns in Korea. Changing patterns of gastrointestinal (GI) diseases over the past two decades were investigated in the present study. Methods Data from inpatients with specific GI diseases, as defined by the International Classification of Diseases code, were extracted from the database at a tertiary medical facility for 1990, 1996, and 2006. Results Admission rates for GI diseases increased between 1990 and 2006. The most prevalent disease in 1990 was gastric cancer, followed by appendicitis and colorectal cancer. However, by 2006, gastric cancer, colon cancer, and colon adenoma or polyps had become the most prevalent diseases. Although gastric cancer showed a decreasing trend, the rate of colon cancer doubled over two decades. Furthermore, rates of detection and endoscopic treatment of early gastric cancer and adenoma of the stomach and colon have increased noticeably. Newly emerging diseases include inflammatory bowel disease and gastroesophageal reflux. There was no change in the incidence of peptic ulcer, but ulcer-related complications and the numbers treated surgically decreased. Conclusions The findings of this study indicate that the clinical trends of GI diseases in Korea have changed in a similar way to those in the West. Early detection of a GI neoplasm will continue to increase with the establishment of cancer-screening programs, resulting in a rising need for minimally invasive treatments.
Collapse
Affiliation(s)
- Jung Hyun Kwon
- Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Lee SK, Kim EK. Laparoscopic Nissen fundoplication in Korean patients with gastroesophageal reflux disease. Yonsei Med J 2009; 50:89-94. [PMID: 19259354 PMCID: PMC2649869 DOI: 10.3349/ymj.2009.50.1.89] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2008] [Accepted: 10/22/2008] [Indexed: 12/19/2022] Open
Abstract
PURPOSE Although the prevalence of gastroesophageal reflux disease (GERD) is relatively low in Korean population, the number is increasing. The aim of this study is to analyze our experience with laparoscopic Nissen fundoplication. PATIENTS AND METHODS From Sep. 2003 to Mar. 2008, 31 adult Korean patients diagnosed with GERD underwent laparoscopic Nissen fundoplication. A 360 degrees fundoplication was carried out in all patients. RESULTS There were 19 males and 12 females with an average age of 46.8 +/- 17.0 years. Typical symptoms were present in 15 (48%) of patients, and atypical symptoms in 16 (51.6%). Both typical and atypical symptoms were present in 4 of patients (12.9%). Preoperative studies showed hiatal hernias in 13 patients (41.9%), Barrett's esophagus in 10 (32.3%), and reflux esophagitis in 18 (58.1%). Mean DeMeester score was 17.4 +/- 16.7, mean operative time 206.1 +/- 47.8 min and mean hospital stay 5.2 +/- 2.1 days. Perioperative complications occurred in 5 patients (16.1%), including gastric perforation, subcutaneous emphysema, atelectasis, and prolonged ileus. Gastroesophageal junction stenoses with subsequent endoscopic balloon dilations were required in 5 patients (16.1%). After surgery, symptoms were completely controlled in 17 patients (54.8%), partially improved in 12 patients (38.7%) and not controlled in 2 patients (6.5%). CONCLUSION In our series, 93.5% of patients had either complete or partial remission of symptom after laparoscopic Nissen fundoplication. Atypical symptoms were more predominant in our Korean patients. Laparoscopic Nissen fundoplication is an efficacious method of controlling symptoms of GERD, even for those who have atypical symptoms.
Collapse
Affiliation(s)
- Sang Kuon Lee
- Department of Surgery, The Catholic University of Korea, Seoul, Korea.
| | | |
Collapse
|
11
|
Abstract
Gastro-oesophageal reflux disease (GORD) is one of the most common gastrointestinal diseases in the Western world and imposes a heavy burden on society. Although its prevalence in Asia is much lower, there is evidence that this is rapidly rising in Asia. The reported population prevalence of GORD in Eastern Asia ranges from 2.5% to 6.7% for at least weekly symptoms of heartburn and/or acid regurgitation. In general, Asians tend to have a milder spectrum of the disease. Most Asian patients have non-erosive GORD; erosive oesophagitis is less commonly seen than in the Western population. Complicated GORD, such as oesophageal stricture and Barrett's oesophagus, is seldom encountered. The mechanisms of GORD may be different in the Chinese population compared with the Western population. Chest pain is the most predominant extra-oesophageal manifestation of GORD in China, whereas an association with asthma has been shown in Japanese patients. The prevalence of GORD appears to be increasing and possible factors for GORD in Asian populations include Helicobacterpylori infection, obesity and increasing dietary fat intake. The adoption of a Western lifestyle in many developing Asian countries may account for the increasing prevalence of GORD. Proton pump inhibitors remain the most effective medical treatment for GORD. GORD will undoubtedly be a great challenge to clinicians both in primary care and in gastroenterology practice in the Asia-Pacific region in the coming years.
Collapse
Affiliation(s)
- Ting K Cheung
- Department of Medicine, University of Hong Kong, Hong Kong.
| | | | | |
Collapse
|