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Ma XX, Xiao ZH, Chen W, Zhao SY. The relationship between gastrointestinal symptoms in FGID patients and D-type personality and emotion regulation strategies. iScience 2024; 27:109867. [PMID: 38784000 PMCID: PMC11112364 DOI: 10.1016/j.isci.2024.109867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 04/01/2024] [Accepted: 04/29/2024] [Indexed: 05/25/2024] Open
Abstract
This study examines the relationship between gastrointestinal symptoms in patients with functional gastrointestinal disorders (FGIDs) and type D personality traits, as well as emotion regulation strategies. Analyzing a diverse group of FGID patients, we uncover significant effects of gender and age on gastrointestinal symptoms. Negative Affectivity emerges as a key predictor, positively associated with symptom severity, whereas Social Inhibition correlates negatively with Abdominal Pain. Additionally, our findings suggest that the expressive suppression strategy predicts heightened gastrointestinal symptoms, whereas cognitive reappraisal predicts lower levels of certain symptoms. These findings provide valuable insights for precise diagnosis and tailored treatments of FGIDs. Further research is warranted to explore underlying mechanisms and inform evidence-based interventions.
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Affiliation(s)
- Xin-Xin Ma
- School of Psychology, Guizhou Normal University, Guiyang, Guizhou 550025, China
| | - Zheng-Hua Xiao
- The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou 550003, China
| | - Wei Chen
- School of Psychology, Guizhou Normal University, Guiyang, Guizhou 550025, China
| | - Shou-Ying Zhao
- School of Psychology, Guizhou Normal University, Guiyang, Guizhou 550025, China
- Kaili University, Kaili, Guizhou 556011, China
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2
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Flores KA, Mazariegos Gutiérrez UE, Blaz Zavala RA, Gómez Arenas SR. Giant diaphragmatic hernia surgical treatment by laparoscopic repair: a case report. J Surg Case Rep 2024; 2024:rjae387. [PMID: 38832059 PMCID: PMC11146215 DOI: 10.1093/jscr/rjae387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 05/21/2024] [Indexed: 06/05/2024] Open
Abstract
Diaphragmatic hernias occur in up to 10%-50% of the general population. Treatment of hiatal hernias depends on the type of hernia and the severity of the symptoms. We report the case of a 52-year-old woman with no significant history who presented for 1 year with non-specific chest pain, dyspnea, dysphagia, and heartburn. A thoracoabdominal tomography with contrast was performed, showing a diaphragmatic hernia containing the stomach, portions of the duodenum, pancreas, small intestine, and colon with a sac of up to 20 cm, which was successfully repaired laparoscopically.
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Affiliation(s)
- Karen Aguirre Flores
- Department of General Surgery, Instituto Mexicano de Seguro Social, Northeast National Medical Center, High Specialty Medical Unit No. 25, Av Fidel Velázquez s/n, Mitras Nte, Monterrey Nuevo León, 64180, México
| | - Ulises E Mazariegos Gutiérrez
- Department of General Surgery, Instituto Mexicano de Seguro Social, Northeast National Medical Center, High Specialty Medical Unit No. 25, Av Fidel Velázquez s/n, Mitras Nte, Monterrey Nuevo León, 64180, México
| | - Rogelio A Blaz Zavala
- Department of General Surgery, Instituto Mexicano de Seguro Social, Northeast National Medical Center, High Specialty Medical Unit No. 25, Av Fidel Velázquez s/n, Mitras Nte, Monterrey Nuevo León, 64180, México
| | - Samuel R Gómez Arenas
- Department of General Surgery, Instituto Mexicano de Seguro Social, Northeast National Medical Center, High Specialty Medical Unit No. 25, Av Fidel Velázquez s/n, Mitras Nte, Monterrey Nuevo León, 64180, México
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Fangxu L, Wenbin L, Pan Z, Dan C, Xi W, Xue X, Jihua S, Qingfeng L, Le X, Songbai Z. Chinese expert consensus on diagnosis and management of gastroesophageal reflux disease in the elderly (2023). Aging Med (Milton) 2024; 7:143-157. [PMID: 38725699 PMCID: PMC11077342 DOI: 10.1002/agm2.12293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/01/2024] [Accepted: 02/02/2024] [Indexed: 05/12/2024] Open
Abstract
Gastroesophageal reflux disease (GERD) in the elderly is characterized by atypical symptoms, relatively severe esophageal injury, and more complications, and when GERD is treated, it is also necessary to fully consider the general health condition of the elderly patients. This consensus summarized the epidemiology, pathogenesis, clinical manifestations, and diagnosis and treatment characteristics of GERD in the elderly, and provided relevant recommendations, providing guidance for medical personnel to correctly understand and standardize the diagnosis and treatment of GERD in the elderly.
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Affiliation(s)
- Liu Fangxu
- Department of Gastroenterology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric MedicineChinese Academy of Medical SciencesBeijingChina
| | - Li Wenbin
- Department of Gastroenterology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric MedicineChinese Academy of Medical SciencesBeijingChina
| | - Zhang Pan
- Department of Gastroenterology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric MedicineChinese Academy of Medical SciencesBeijingChina
| | - Chen Dan
- Department of Gastroenterology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric MedicineChinese Academy of Medical SciencesBeijingChina
| | - Wu Xi
- Department of Gastroenterology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric MedicineChinese Academy of Medical SciencesBeijingChina
| | - Xu Xue
- Department of Gastroenterology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric MedicineChinese Academy of Medical SciencesBeijingChina
| | - Shi Jihua
- Department of Gastroenterology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric MedicineChinese Academy of Medical SciencesBeijingChina
| | - Luo Qingfeng
- Department of Gastroenterology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric MedicineChinese Academy of Medical SciencesBeijingChina
| | - Xu Le
- Department of Gastroenterology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric MedicineChinese Academy of Medical SciencesBeijingChina
| | - Zheng Songbai
- Department of GeriatricsHuadong Hospital Affiliated to Fudan UniversityShanghaiChina
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Mancilla SZ, del Pilar Barón Hernández VA, Cuéllar JSS, Vázquez RF, Martínez MIJ, Delgado García A, Bustos AR, Guaicha GPM, Casas JAR, Cruz HA, Moreno SPO, Martínez Medina M, Escobar RCV. Giant hiatal hernia with intrathoracic spleen: A case report. Radiol Case Rep 2024; 19:1222-1227. [PMID: 38259720 PMCID: PMC10801143 DOI: 10.1016/j.radcr.2023.12.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 12/12/2023] [Accepted: 12/13/2023] [Indexed: 01/24/2024] Open
Abstract
Hiatal hernia is a frequent pathology in the population; however, the most frequent hiatal hernia is type I, which accounts for up to 95% incidence, types II, III, and IV being less frequent and representing between 5% and 15%, and even less common are giant hernias. The definition of the giant hernia is still not exact in the literature; some authors define giant or massive hiatal hernia as one in which the hernia occupies more than 30% of the stomach and/or passes from other abdominal structures to the thorax. We describe the case of a patient with gastrointestinal symptomology without response to a proton pump inhibitor, with base exacerbation that required imaging studies, showing a large hernia defect passing to the thorax from abdominal organs (stomach, spleen, mesenteric fat), as well as alteration of the gastric and spleen axis with ascent in pancreatic body and tail, which corresponds to a giant hiatal hernia. Said pathology is very infrequent, with recurrences and postoperative complications. Our patient recovered from the surgical procedure with therapeutic success.
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Affiliation(s)
| | | | | | - Rafael Figueroa Vázquez
- Hospital Regional 1° de Octubre del ISSSTE, Universidad Nacional Autónoma de México, CP 07300, Ciudad de México
| | | | | | - Angie Ramírez Bustos
- Hospital Regional “Gral. Ignacio Zaragoza”, Universidad Nacional Autónoma de México, CP 09100, Ciudad de México
| | | | | | - Hugo Alcaide Cruz
- Hospital Regional 1° de Octubre del ISSSTE, Universidad Nacional Autónoma de México, CP 07300, Ciudad de México
| | | | - Montserrat Martínez Medina
- Hospital General "Doctor Gaudencio González Garza" del Centro Médico Nacional la Raza, Universidad Nacional Autónoma de México, CP 02990, Ciudad de México
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Shehata MA, Malik TA, Alzaabi MHJ, Ali ABAA, Tenaiji KSAA, Singh Y, Wallace MB. Predictors of Pathological Gastroesophageal Reflux among Emirati Patients with Reflux Symptoms Who Undergo Wireless pH Monitoring. Middle East J Dig Dis 2023; 15:242-248. [PMID: 38523885 PMCID: PMC10955985 DOI: 10.34172/mejdd.2023.353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 08/25/2023] [Indexed: 03/26/2024] Open
Abstract
Background: Diagnosis of gastroesophageal reflux disease (GERD) relies on recognizing symptoms of reflux and mucosal changes during esophagogastroduodenoscopy. The desired response to acid suppression therapy is reliable resolution of GERD symptoms; however, these are not always reliable, hence the need for pH testing in unclear cases. Our objective was to identify potential predictors of a high DeMeester score among patients with potential GERD symptoms to identify patients most likely to have pathological GERD. Methods: We conducted a retrospective case-control study on patients who underwent wireless pH monitoring from January 2020 to April 2022. Cases were patients with a high DeMeester score (more than 14.7), indicating pathological reflux, and controls were those without. We collected clinical and demographic data, including age, sex, body mass index (BMI), smoking status, non-steroidal anti-inflammatory drugs (NSAIDs) use, and presence of atypical symptoms. Results: 86 patients were enrolled in the study. 46 patients with high DeMeester scores were considered cases, and 40 patients with DeMeester scores less than 14.7 were considered controls. Esophagitis (grade A) was found in 41.1% of the cases and in 22.5% of the control group. In our study, age of more than 50 years compared with age of 20-29 years and being overweight appeared to be predictors of true pathological reflux among patients with reflux symptoms who underwent wireless pH monitoring. Conclusion: Age above 50 years compared with age between 20-29 years and being overweight appeared to be predictors of true pathological reflux among patients with reflux symptoms who underwent wireless oesophageal pH monitoring. The presence of oesophagitis was approximately four times more likely to be associated with true pathological reflux.
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Affiliation(s)
| | - Talaha Aziz Malik
- Division of Gastroenterology and Hepatology, SSMC, Abu Dhabi, UAE
- Division of Gastroenterology and Hepatology, Mayo Clinic Arizona, USA
| | | | | | | | - Yashbir Singh
- Department of Radiology, Mayo Clinic Rochester in Minnesota, USA
| | - Michael Bradley Wallace
- Division of Gastroenterology and Hepatology, SSMC, Abu Dhabi, UAE
- Division of Gastroenterology and Hepatology, Mayo Clinic Florida, USA
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Kuze LS, Fornari F, Collares K, Della Bona A. Association between masticatory dysfunction and gastroesophageal reflux disease: A population-based study in the elderly. J Oral Rehabil 2023; 50:150-156. [PMID: 36478604 DOI: 10.1111/joor.13399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 11/27/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Caries and periodontal disease may cause tooth losses and chewing difficulty, especially in the elderly. Ingesting poorly chewed food may delay gastric emptying and favour the development of gastroesophageal reflux disease (GERD). OBJECTIVE This study investigated the association between masticatory dysfunction and GERD in the elderly from a rural area in southern Brazil. METHODS This census invited all 489 elderly from a city to participate. The study used a GERD symptoms questionnaire, followed by an oral examination. Masticatory dysfunction was analysed based on the chewing difficulty for some food groups. Tooth loss and chewing self-perception were also considered as exposure variables. Poisson regression determined the association among variables by calculating the prevalence ratio [PR (95% confidence interval)]. RESULTS The response rate was 93.1% (n = 455, average age of 70.9 years, 50.5% men). The prevalence of GERD in this population was 36.9%. GERD was associated with chewing difficulty for vegetables (PR = 1.54), meats (PR = 1.34) and cereals (PR = 1.43) but not with poor chewing self-perception (PR = 0.80) and tooth loss (PR = 1.22). GERD was also associated with xerostomia (PR = 1.63) and the female gender (PR = 1.35). CONCLUSION Elderly people from a rural area with a reduced number of teeth present chewing difficulty and a high prevalence of GERD, indicating an association between GERD and masticatory dysfunction.
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Affiliation(s)
- Luana Soares Kuze
- Postgraduate Program in Dentistry, Dental School, University of Passo Fundo, Passo Fundo, Brazil
| | - Fernando Fornari
- Postgraduate Program in Dentistry, Dental School, University of Passo Fundo, Passo Fundo, Brazil
| | - Kauê Collares
- Postgraduate Program in Dentistry, Dental School, University of Passo Fundo, Passo Fundo, Brazil
| | - Alvaro Della Bona
- Postgraduate Program in Dentistry, Dental School, University of Passo Fundo, Passo Fundo, Brazil
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Eroglu E, Altinli E. Poor Metabolic Profile Is an Independent Risk Factor for Recurrence After Hiatal Hernia Repair When Using Tension-Free Mesh. J Laparoendosc Adv Surg Tech A 2023; 33:32-37. [PMID: 35671514 DOI: 10.1089/lap.2022.0154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Purpose: The effect of metabolic risk factors on the recurrence rate of hiatal hernia (HH) after the initial repair is still controversial. In this study, we evaluated whether a poor preoperative metabolic profile is a risk factor for the recurrence of a HH after surgery. Methods: Perioperative patient data were obtained from hospital records. A poor metabolic profile was defined as having two or more metabolic conditions such as diabetes, hypertension, hyperlipidemia, or being overweight. The recurrence rates of HH were measured at 6 months, and again at 12 months after surgery. Results: Data were collected from a total of 221 patients. While 87 (39.4%) patients underwent tension-free mesh (TFM) repair, 137 (60.6%) were treated with suture repair. The poor metabolic profile has no effect on the recurrence rates in the suture-repair group. However, patients who underwent TFM repair displayed a significantly higher recurrence rate at the 12-month time point if they had poor metabolic profile, compared to the healthy group (respectively, 20.7% and 3.4%, P < .01). The logistic regression analysis showed that having a poor metabolic profile was an independent risk factor for recurrence after 12 months in the same group (odds ratio: 8.04 confidence interval [CI: 1.2-53.5] P = .03). Conclusion: The poor metabolic profile was found to be responsible for high recurrence rates only in patients who underwent TFM HH repair.
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Affiliation(s)
- Ersan Eroglu
- Department of General Surgery, Memorial Hospital, Istanbul, Turkey
| | - Ediz Altinli
- Department of General Surgery, Memorial Hospital, Istanbul, Turkey
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Jeong JY, Ahn JH, Shim JG, Lee SH, Ryu KH, Lee SH, Cho EA. Gastric emptying of preoperative carbohydrate in elderly assessed using gastric ultrasonography: A randomized controlled study. Medicine (Baltimore) 2021; 100:e27242. [PMID: 34664868 PMCID: PMC8448003 DOI: 10.1097/md.0000000000027242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 08/23/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Preoperative carbohydrate loading enhances postoperative recovery and reduces patient discomfort. However, gastric emptying of liquids can be delayed in elderly populations. Therefore, this study aimed to evaluate the gastric emptying of 400 mL of a carbohydrate drink ingested 2 hours before surgery in elderly patients. METHODS In this prospective, randomized controlled study, patients aged >65 years were allocated to either fast from midnight (nil per os [NPO] group, n = 29) or drink 400 mL of a carbohydrate drink 2 hours before surgery (carbohydrate group, n = 29). The gastric antrum was assessed using ultrasonography in the supine position, followed by the right lateral decubitus (RLD) position. The gastric antrum was graded as grade 0 (fluid not seen in both positions), grade 1 (fluid only seen in the RLD position), and grade 2 (fluid seen in both positions). The gastric antral cross-sectional area (CSA) and aspirated residual gastric volume were measured. RESULTS In 58 patients, the incidence of grade 2 stomach was 13.8% in NPO group and 17.2% in carbohydrate group (P = .790). The gastric antral CSA in the supine position was larger in carbohydrate group than in NPO group (4.42 [3.72-5.18] cm2 vs 5.31 [4.35-6.92] cm2, P = .018). The gastric antral CSA in the RLD position was not different in NPO and carbohydrate groups (P = .120). There was no difference in gastric volume (2 [0-7.5] vs 3 [0-13.4], P = .331) in NPO group versus carbohydrate group. CONCLUSION The incidence of grade 2 stomach was not different between NPO group and carbohydrate group in elderly patients.
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Affiliation(s)
- Jae Yong Jeong
- Department of Urology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jin Hee Ahn
- Department of Anaesthesiology and Pain Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jae-Geum Shim
- Department of Anaesthesiology and Pain Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sung Hyun Lee
- Department of Anaesthesiology and Pain Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyoung-Ho Ryu
- Department of Anaesthesiology and Pain Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sung-Ho Lee
- Department of Anaesthesiology and Pain Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Eun-Ah Cho
- Department of Anaesthesiology and Pain Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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de Carvalho JPV, Pivetta LGA, Dias ERM, Antunes PDSL, Amaral PHDF, Roll S. Reversal of unstable atrial fibrillation after surgical correction of hiatus hernia: A case report. Int J Surg Case Rep 2021; 86:106316. [PMID: 34454212 PMCID: PMC8397886 DOI: 10.1016/j.ijscr.2021.106316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/10/2021] [Accepted: 08/13/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION The presence of Atrial Fibrillation (AF) with herniation of abdominal content through the esophageal hiatus can be explained by the compression of the cardiac tissue by the viscera and, consequently, of its electrical transmission network, compromising the correct propagation of stimuli. Due to the causal relationship, hernia correction is almost always able to reverse the arrhythmic picture. PRESENTATION OF THE CASE A 75-year-old male with atrial fibrillation with a large hiatal hernia causing clinical decompensation was successfully treated after a laparocopic correction- primary closure of the defect was made with barbed surgical thread plus and placing a biological mesh (porcine small intestine submucosa, non-cross-linked), fixed with cyanoacrylate; after the procedure, he was discharged asymptomatic and with sinus heart rhythm. DISCUSSION It is noticed that for cases in which the patient presents with a type IV hiatal hernia associated with atrial fibrillation, the laparoscopic correction of hernia using a mesh for the correction of the defect has good results in the literature. In the present case, it is noted that despite the severity of the condition denoted by hemodynamic instability and the need for electrical cardioversion, the surgical correction of the hiatal hernia was able to reverse the arrhythmic picture definitively. CONCLUSION the concomitance of AF and hiatal hernia can explain the difficulty to control the arrhythmic picture and is necessary to consider, as soon as possible, the surgical correction of the defect as part of the treatment.
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Affiliation(s)
| | | | | | | | | | - Sergio Roll
- Hernia Center, Gastrointestinal Surgery Service, Oswaldo Cruz German Hospital, São Paulo, SP, Brazil
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Madka V, Kumar G, Pathuri G, Panneerselvam J, Zhang Y, Ganta V, Lightfoot S, Lubet RA, Suen CS, Steele VE, Janakiram NB, Mohammed A, Rao CV. Proton pump inhibitor omeprazole suppresses carcinogen induced colonic adenoma progression to adenocarcinoma in F344 rat. Cancer Prev Res (Phila) 2021; 14:1009-1020. [PMID: 34341012 DOI: 10.1158/1940-6207.capr-21-0057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 05/25/2021] [Accepted: 07/09/2021] [Indexed: 11/16/2022]
Abstract
Colorectal cancer (CRC) causes over 53,000 deaths annually in the United States. Its rising incidences worldwide and particularly in young adults is a major concern. Here, we evaluated the efficacy of omeprazole (OME) that is clinically approved for treating acid-reflux, to enable its repurposing for CRC prevention. In the azoxymethane (AOM)-induced rat CRC model, dietary OME (250 and 500 ppm) was administered at early adenoma stage (8 weeks after AOM) to assess the progression of early lesions to adenocarcinoma. Administration of OME at 250 ppm or 500 ppm doses led to suppression of total colon adenocarcinoma incidence by 15.7% and 32% (p<0.01), respectively. Importantly, invasive carcinoma incidence was reduced by 59% (p<0.0005) and 90% (p<0.0001) in OME administered rats in a dose-dependent manner. There was also a strong and dose-dependent inhibition in the adenocarcinoma multiplicity in rats exposed to OME. Administration of 250 and 500 ppm OME inhibited total colon adenocarcinoma multiplicity by ~49% and ~65% (p<0.0001), respectively. While non-invasive adenocarcinomas multiplicity was suppressed by ~34% to ~48% (p<0.02), the invasive carcinomas multiplicity was reduced by ~74% to ~94% (p<0.0001) in OME exposed rats in comparison to the untreated rats. Biomarker analysis results showed a decrease in cell proliferation and anti-apoptotic/pro-survival proteins with an increase in apoptosis. Transcriptome analysis of treated tumors revealed a significant increase in adenocarcinoma inhibitory genes (Olmf4; Spink4) expression and down regulation of progression promoting genes (SerpinA1, MMP21, IL6). In summary, OME showed significant protection against the progression of adenoma to adenocarcinoma.
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Affiliation(s)
- Venkateshwar Madka
- Center for Cancer Prevention and Drug Development, Department of Medicine, Hematology/Oncology Section, University of Oklahoma Health Sciences Center
| | - Gaurav Kumar
- Center for Cancer Prevention and Drug Development, Department of Medicine, Hematology/Oncology Section, University of Oklahoma Health Sciences Center
| | - Gopal Pathuri
- Center for Cancer Prevention and Drug Development, Department of Medicine, Hematology/Oncology Section, University of Oklahoma Health Sciences Center
| | - Janani Panneerselvam
- Center for Cancer Prevention and Drug Development, Department of Medicine, Hematology/Oncology Section, University of Oklahoma Health Sciences Center
| | - Yuting Zhang
- Center for Cancer Prevention and Drug Development, Department of Medicine, Hematology/Oncology Section, University of Oklahoma Health Sciences Center
| | - Vishal Ganta
- Center for Cancer Prevention and Drug Development, Department of Medicine, Hematology/Oncology Section, University of Oklahoma Health Sciences Center
| | - Stanley Lightfoot
- Pathology-Retired, Center for Cancer Prevention and Drug Development
| | - Ronald A Lubet
- Division of Cancer Prevention, National Cancer Institute
| | - Chen S Suen
- Cancer Prevention, National Cancer Institute
| | | | | | - Altaf Mohammed
- Division of Cancer Prevention, National Cancer Institute
| | - Chinthalapally V Rao
- Center for Cancer Prevention and Drug Development, Department of Medicine, Hematology/Oncology Section, University of Oklahoma Health Sciences Center
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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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Analysis of Pepsin Concentration and Influencing Factors in Saliva of Elderly Nasal Feeding Patients. BIOMED RESEARCH INTERNATIONAL 2021; 2021:4721812. [PMID: 33564676 PMCID: PMC7850846 DOI: 10.1155/2021/4721812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 11/12/2020] [Accepted: 12/18/2020] [Indexed: 12/05/2022]
Abstract
Background Elderly patients receiving nasal feeding have weaker physiological function, and placement of a nasogastric tube weakens the natural barrier of the cardia-esophageal sphincter; therefore, the risk of gastroesophageal reflux (GER) is higher. Many studies have shown that pepsin is extremely sensitive in predicting GERD, so this study intends to investigate the level of pepsin in saliva of elderly patients with nasal feeding and analyze its influencing factors. Methods This was a cross-sectional study. Patients admitted to the Chinese PLA General Hospital from April 2018 to October 2018 who received nasal feeding were included. One ml of saliva was collected from each patient in while sitting during fasting in the morning and 1 hour after lunch for 3 consecutive days. Pepsin was quantified by enzyme-linked immunosorbent assay (ELISA). The patients were predivided into two groups (≥7.75μg/ml or <7.75μg/ml) based on the median pepsin. Baseline and clinical factors were compared. Results The mean age of the patients was 91.09 ± 4.91 years. There were statistical differences in diabetes and feeding methods between the two groups. There was a positive correlation between the morning and postprandial pepsin levels (r = 0.442, P < 0.001), and has no statistical difference (P = 0.175). Multivariate analysis showed that the risk factors for higher pepsin levels were diabetes (odds ratio (OR): 2.67; 95% CI: 1.225-5.819, P = 0.013) and nasal feeding methods (OR: 2.475; 95% CI: 1.183-5.180, P=0.016). Conclusions For patients undergoing nasal feeding who are older than 80 years, the fasting and 1-hour postprandial pepsin concentration were consistent. Diabetes and feeding methods are risk factors for high pepsin levels. For the elderly over 80 years old, age has no influence on pepsin concentration.
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Nwokediuko SC, Adekanle O, Akere A, Olokoba A, Anyanechi C, Umar SM, Maiyaki A, Ijoma U, Obienu O, Uhunmwangho A, Ndububa D. Gastroesophageal reflux disease in a typical African population: a symptom-based multicenter study. BMC Gastroenterol 2020; 20:107. [PMID: 32293291 PMCID: PMC7157995 DOI: 10.1186/s12876-020-01261-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 04/02/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The prevalence of gastroesophageal reflux disease (GERD) in Africa is not known but is believed to be increasing because of demographic and epidemiologic transition. The main objectives of this study were to determine the prevalence and risk factors of GERD, and its degree of overlap with dyspepsia and irritable bowel syndrome (IBS) in Nigeria, a typical African population. METHODS This was an observational, cross-sectional and descriptive study of adult Nigerians. Diagnosis of GERD was by means of the gastroesophageal reflux disease questionnaire (GERDQ) while the diagnosis of dyspepsia and IBS was based on the Rome III criteria for the diagnosis of functional gastrointestinal disorders. The GERDQ and Rome III questionnaires for dyspepsia and IBS were merged into a composite questionnaire and administered to the study participants who were recruited with a multi-stage sampling technique. RESULTS Out of 3520 subjects who participated in the study across the country, 269 (7.6%) satisfied the diagnostic criteria for GERD, while 107 (3.0%) had GERD associated with significant impairment of quality of life. Risk factors of GERD (represented by odds ratios) were age 1.014(95% CI: 1.006-1.022), use of analgesics 1.461 (95% CI: 1.060-2.025), and use of herbs 1.318 (95% CI: 1.020-1.704). Overlap of GERD with dyspepsia and/or IBS was observed in over 50% of cases. CONCLUSIONS The prevalence of GERD in this study is 7.6%. Age, use of analgesics and use of herbs increase the risk, albeit minimally. A high degree of overlap with dyspepsia and IBS exists in Nigerian patients with GERD.
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Affiliation(s)
| | - Olusegun Adekanle
- Department of Medicine, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State, Nigeria
| | - Adegboyega Akere
- Department of Medicine, University College Hospital, Ibadan, Oyo State, Nigeria
| | - Abdulfatai Olokoba
- Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria
| | - Chiedozie Anyanechi
- Department of Medicine, Federal Medical Centre, Umuahia, Abia State, Nigeria
| | - Sabo Mustapha Umar
- Department of Medicine, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Bauchi State, Nigeria
| | - Abubakar Maiyaki
- Department of Medicine, Othman Dan Fodio University Teaching Hospital, Sokoto, Sokoto State, Nigeria
| | - Uchenna Ijoma
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State, Nigeria
| | - Olive Obienu
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State, Nigeria
| | | | - Dennis Ndububa
- Department of Medicine, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State, Nigeria
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14
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Xu SJ, Wang SX, Wang XT, Cai LY, Kong GM. Relationship between gastroesophageal reflux disease and Helicobacter pylori infection. Shijie Huaren Xiaohua Zazhi 2020; 28:65-69. [DOI: 10.11569/wcjd.v28.i2.65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
In recent years, the infection rate of Helicobacter pylori (H. pylori) in China has declined. Due to the relatively large population, the number of H. pylori infection patients in China is still large. For many diseases combined with H. pylori infection, eradication therapy is essential, but the effect of H. pylori on gastroesophageal reflux disease (GERD) is controversial. Therefore, whether to conduct eradication therapy in patients with H. pylori infection remains to be discussed. The pathogenesis of the GERD is related to various factors. This article aims to provide some clues for treating GERD by reviewing the relationship between GERD and H. pylori infection.
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Affiliation(s)
- Si-Jia Xu
- Institute of Translational Medicine, Medical College of Yangzhou University, Yangzhou 225009, Jiangsu Province, China
| | - Shu-Xian Wang
- Institute of Translational Medicine, Medical College of Yangzhou University, Yangzhou 225009, Jiangsu Province, China
| | - Xiao-Tong Wang
- Institute of Translational Medicine, Medical College of Yangzhou University, Yangzhou 225009, Jiangsu Province, China
| | - Ling-Yu Cai
- Institute of Translational Medicine, Medical College of Yangzhou University, Yangzhou 225009, Jiangsu Province, China
| | - Gui-Mei Kong
- Institute of Translational Medicine, Medical College of Yangzhou University, Yangzhou 225009, Jiangsu Province, China
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15
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Sfara A, Dumitrascu DL. The management of hiatal hernia: an update on diagnosis and treatment. Med Pharm Rep 2019; 92:321-325. [PMID: 31750430 PMCID: PMC6853045 DOI: 10.15386/mpr-1323] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 06/13/2019] [Indexed: 12/15/2022] Open
Abstract
Background and aim Hiatal hernia (HH) occurs quite frequently in the general population and is characterized by a wide range of non-specific symptoms, most of them related to gastroesophageal reflux disease. Treatment can be challenging at times, depending on the existence of complications. The most recent guideline regarding the management of hiatal hernia was released by the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) in the year 2013. This review aims to present the most recent updates on the diagnosis and management of hiatal hernia for clinical practitioners. Methods The PubMed database was screened for publications using the terms: “hiatal hernia”, “paraesophageal hernia”, “management”, “treatment”, “hiatal repair”. A literature review of contemporary and latest studies was completed. The studies that we looked into include prospective, randomized trials, systematic reviews, clinical reviews and original articles. The information was compiled in narrative review format. Results This narrative review presents new data on the diagnosis and management of hiatal hernia. While the diagnostic pathway has remained virtually unchanged, new data have come to light regarding the surgical treatment of hiatal hernia. We present the imaging methods used for its diagnosis, as well as the medical and surgical treatment currently available. Conclusion In the last five years, there has been vast research in the field of hiatal hernia management, especially regarding the surgical treatment. However, unanswered questions still remain and solid updates on the guidelines have yet to be formulated. To address this, more randomized studies need to be done on subsets of patients, stratified by age, gender, symptoms and comorbidities.
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Affiliation(s)
- Alice Sfara
- Gastroenterology Department, "Prof. Dr. Octavian Fodor" Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania
| | - Dan L Dumitrascu
- 2 Medical Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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16
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Niu CY, Zhou YS, Wu FX. Individualized medicine of gastroesophageal reflux disease. Shijie Huaren Xiaohua Zazhi 2018; 26:2046-2056. [DOI: 10.11569/wcjd.v26.i35.2046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Gastroesophageal reflux disease (GERD) is a common disease worldwide, and its prevalence is increasing in both developed and developing countries. GERD is divided into three subtypes, namely, erosive esophagitis, nonerosive reflux disease (NERD), and Barrett's esophagus. The etiology, pathogenesis, clinical manifestations, and response to treatment of GERD invariably show high heterogeneity or significant individual difference, especially NERD and refractory GERD. On the other hand, advanced technology has currently provided a wide range of methods for the diagnosis and treatment of GERD patients; however, the long-term efficacy and quality of life of some patients are unsatisfactory. Therefore, each GERD patient needs a specialized management strategy aiming at his/her own condition, which is known as individualized medicine or personalized medicine. The goal of GERD treatment is to relieve the symptoms, while symptomatic remission is directly related to the quality of life. In other words, health-related quality of life and patient satisfaction may be reasonable criteria for GERD. In this paper, we will discuss the individualized medicine of GERD.
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Affiliation(s)
- Chun-Yan Niu
- Department of Gastroenterology, Xiang'an Hospital, Xiamen University, Xiamen 361101, Fujian Province, China
| | - Yong-Shun Zhou
- Department of Gastroenterology, Xiamen University Hospital, Xiamen 361005, Fujian Province, China
| | - Fang-Xiong Wu
- Department of Gastroenterology, the First Affiliated Hospital of Xi'an Medical College, Xi'an 710077, Shaanxi Province, China
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17
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Kim SY, Kim HJ, Lim H, Lim MS, Kim M, Choi HG. Increased risk of appendectomy in patients with gastroesophageal reflux disease: A nested case-control study using a national sample cohort. Medicine (Baltimore) 2018; 97:e13700. [PMID: 30593140 PMCID: PMC6314750 DOI: 10.1097/md.0000000000013700] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 11/22/2018] [Indexed: 01/10/2023] Open
Abstract
The purpose of this study is to confirm and complement previous data regarding an association between gastroesophageal reflux disease and appendectomy.The Korean National Health Insurance Service-National Sample Cohort includes data from people ≥ 20 years old collected from 2002 to 2013. A total of 13,484 participants who received an appendectomy were matched with 53,936 controls at a 1:4 ratio. We analyzed the previous histories of gastroesophageal reflux disease (GERD) in the appendectomy and control groups. Appendectomies were identified using operation codes (Q2860-Q2863) exclusive for appendicitis (International Classification of Disease-10 (ICD-10): K35). GERD was defined using the ICD-10 (K21), and patients who were treated ≥ 2 times and were prescribed a proton pump inhibitor (PPI) for ≥ 2 weeks were included. Crude (simple) and adjusted odds ratios (ORs) for GERD and appendectomy were analyzed using conditional logistic regression analyses.A higher GERD rate was detected in the appendectomy group (11.4% [1,713/15,062]) than in the control group (8.2% [4,947/60,248], P < .001). Adjusted ORs for GERD were 1.37 (95% confidence interval [CI] = 1.30-1.45) (P < .001). Subgroup analyses stratified according to age and sex revealed consistent findings. The adjusted OR for GERD in participants prescribed PPIs for ≥ 30 days was 1.31 (95% CI = 1.20-1.43), and the adjusted OR for GERD in participants prescribed PPIs for ≥ 60 days was 1.30 (95% CI = 1.15-1.48).The Odds for GERD were higher in the appendectomy group than in the control group.
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Affiliation(s)
- So Young Kim
- Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam
| | - Hyung-Jong Kim
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine
| | - Hyun Lim
- Department of Internal Medicine, Hallym University College of Medicine, Anyang
| | - Man Sup Lim
- Department of General Surgery, Hallym University College of Medicine, Chuncheon
| | - Miyoung Kim
- Department of Laboratory Medicine, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Hyo Geun Choi
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine
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18
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Kim GH. It Is Time to Meet the Challenges of the Changing Epidemiology of Gastroesophageal Reflux Disease. J Neurogastroenterol Motil 2018; 24:507-509. [PMID: 30347932 PMCID: PMC6175555 DOI: 10.5056/jnm18152] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 09/13/2018] [Indexed: 12/13/2022] Open
Affiliation(s)
- Gwang Ha Kim
- Department of Internal Medicine, Pusan National University School of Medicine, and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
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19
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MacFarlane B. Management of gastroesophageal reflux disease in adults: a pharmacist's perspective. INTEGRATED PHARMACY RESEARCH AND PRACTICE 2018; 7:41-52. [PMID: 29892570 PMCID: PMC5993040 DOI: 10.2147/iprp.s142932] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Gastroesophageal reflux disease (GERD) is a common gastrointestinal diagnosis, a leading reason for endoscopy and cause of potentially serious complications, resulting in significant individual and system-wide health burden. Approximately one quarter of people living in western countries have experienced GERD, and the prevalence appears to be on the rise. Risk factors for GERD include hiatus hernia, obesity, high-fat diet, tobacco smoking, alcohol consumption, pregnancy, genetics, and some medications. The cardinal symptoms of GERD are troublesome heartburn and regurgitation. GERD is identified by taking a patient-centered history and if necessary can be classified by endoscopic investigation. The role of the pharmacist in the management of GERD is to confirm the diagnosis by history taking, confirm there are no alarming signs or symptoms that require referral to a doctor, and recommendation of short-term therapy to control symptoms. Effective pharmacological treatments for GERD include antacids, alginate, histamine H2 receptor antagonists, and proton pump inhibitors. This narrative review includes a comparison of the efficacy and safety of these treatments and pertinent information to help pharmacists advise patients with GERD on their appropriate use.
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Affiliation(s)
- Brett MacFarlane
- Australian College of Pharmacy, Canberra, ACT, Australia.,Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
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20
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Abstract
OPINION STATEMENT Despite the political and social controversy affiliated with it, the medical community must come to the realization that cannabinoids exist as a ubiquitous signaling system in many organ systems. Our understanding of cannabinoids and how they relate not only to homeostasis but also in disease states must be furthered through research, both clinically and in the laboratory. The identification of the cannabinoid receptors in the early 1990s have provided us with the perfect target of translational research. Already, much has been done with cannabinoids and the nervous system. Here, we explore the implications it has for the gastrointestinal tract. Most therapeutics currently on the market presently target only one aspect of the cannabinoid system. Our main purpose here is to highlight areas of research and potential avenues of discovery that the cannabinoid system has yet to reveal.
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Affiliation(s)
- Zachary Wilmer Reichenbach
- Center for Substance Abuse Research (CSAR), Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA.,Section of Gastroenterology, Department of Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Ron Schey
- Section of Gastroenterology, Department of Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA.
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