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Dao HV, Hoang LB, Nguyen BP, Nguyen HL, Goldberg R, Allison J, Dao TMA, Matsumura T, Dao LV. Esophageal Mucosal Admittance: A New Technique to Diagnose Gastroesophageal Reflux Disease - Is It Feasible? Clin Exp Gastroenterol 2023; 16:45-54. [PMID: 37056486 PMCID: PMC10089276 DOI: 10.2147/ceg.s399764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/28/2023] [Indexed: 04/15/2023] Open
Abstract
Purpose Esophageal mucosal admittance (MA) is a promising diagnostic method for gastroesophageal reflux disease (GERD). We conducted a study to describe the esophageal MA in patients with reflux symptoms and determine its diagnostic accuracy. Patients and Methods We recruited 92 patients with ambulatory pH-impedance monitoring, upper gastrointestinal endoscopy, and MA measured by the tissue conductance meter. MA was measured during endoscopy at 5cm (distal esophagus) and 15cm above the Z line (middle esophagus), repeated at least five times at each position, and median MA was obtained. Afterwards, two biopsies were taken 5cm above the Z line for histopathological evaluation using the Esohisto criteria. Patients were classified as GERD or non-GERD according to the 2018 Lyon consensus. Results The mean age was 43.2 years, and 42 patients were males. The most common symptoms were regurgitation (75.0%), belching (65.2%), and heartburn (46.7%). Twenty-three (32.3%) were diagnosed with GERD using the Lyon consensus, and 24 (26.1%) had esophagitis on histopathology. The median MA at the distal and middle esophagus was moderately correlated. The median MA at both positions was higher in the GERD group but only statistically significant in the middle esophagus. MA was not associated with pH-impedance parameters and esophagitis on histopathology. The diagnostic model developed using the logistic regression did not have good accuracy. Conclusion MA was not different between GERD and non-GERD patients.
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Affiliation(s)
- Hang Viet Dao
- Internal Medicine Faculty, Hanoi Medical University, Hanoi, Vietnam
- Endoscopy Center, Hanoi Medical University Hospital, Hanoi, Vietnam
- Institute of Gastroenterology and Hepatology, Hanoi, Vietnam
- Correspondence: Hang Viet Dao, Institute of Gastroenterology and Hepatology, Floor 10, VCCI Tower, No. 9, Dao Duy Anh Street, Dong Da District, Hanoi City, 10000, Vietnam, Tel +84987988075, Email
| | - Long Bao Hoang
- Institute of Gastroenterology and Hepatology, Hanoi, Vietnam
| | | | - Hoa Lan Nguyen
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Robert Goldberg
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Jeroan Allison
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Thi Minh An Dao
- School of Public Health, University of Queensland, Brisbane, Australia
- Epidemiology Department, Hanoi Medical University, Hanoi, Vietnam
| | - Tomoaki Matsumura
- Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Long Van Dao
- Internal Medicine Faculty, Hanoi Medical University, Hanoi, Vietnam
- Institute of Gastroenterology and Hepatology, Hanoi, Vietnam
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Cho YK, Kim JH, Kim HS, Kim TO, Oh JH, Choi SC, Moon JS, Lee SK, Jung SW, Kim SS, Jung HK, Lee SP, Cheon GJ, Park MI, Jung HY, Ko KH, Sung IK, Lee SH, Lee JY, Lee ST, Rhee PL, Kim N, Hong SJ, Kim HJ, Kim GH, Lee KJ, Kim SK, Shin WG, Lee OY. Randomised clinical trial: comparison of tegoprazan and lansoprazole as maintenance therapy for healed mild erosive oesophagitis. Aliment Pharmacol Ther 2023; 57:72-80. [PMID: 36314172 PMCID: PMC10092320 DOI: 10.1111/apt.17255] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 08/08/2022] [Accepted: 10/06/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Tegoprazan is a novel potassium-competitive acid blocker used to treat acid-related disorders. AIM To compare tegoprazan 25 mg with lansoprazole 15 mg as maintenance therapy in healed erosive oesophagitis (EE) METHODS: In this phase 3, double-blind, multi-centre study, patients with endoscopically confirmed healed EE were randomised 1:1 to receive tegoprazan 25 mg or lansoprazole 15 mg once daily for up to 24 weeks. The primary efficacy endpoint was the endoscopic remission rate after 24 weeks. The secondary efficacy endpoint was the endoscopic remission rate after 12 weeks. Safety endpoints included adverse events, clinical laboratory results and serum gastrin and pepsinogen I/II levels. RESULTS We randomised patients to tegoprazan 25 mg (n = 174) or lansoprazole 15 mg (n = 177). Most had mild EE (Los Angeles (LA) grade A: 57.3%, LA grade B: 37.3%). The endoscopic remission rate after 24 weeks was 90.6% with tegoprazan and 89.5% with lansoprazole. Tegoprazan was not inferior to lansoprazole for maintaining endoscopic remission at 24 weeks and 12 weeks. In subgroup analysis, tegoprazan 25 mg showed no significant difference in maintenance rate according to LA grade (p = 0.47). The maintenance effect of tegoprazan was consistent in CYP2C19 extensive metabolisers (p = 0.76). Increases in serum gastrin were not higher in tegoprazan-treated than lansoprazole-treated patients. CONCLUSIONS Tegoprazan 25 mg was non-inferior to lansoprazole 15 mg in maintenance of healing of mild EE. In this study, tegoprazan had a similar safety profile to lansoprazole.
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Affiliation(s)
- Yu Kyung Cho
- Catholic Photomedicine Research Institute, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jae Hak Kim
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, South Korea
| | - Hyun-Soo Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju Christian Hospital, Wonju, South Korea
| | - Tae-Oh Kim
- Department of Internal Medicine, Inje University Haeundae Paik Hospital, Busan, South Korea
| | - Jung-Hwan Oh
- Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Suck Chei Choi
- Department of Internal Medicine, Wonkwang University Hospital, Iksan, South Korea
| | - Jeong Seop Moon
- Department of Internal Medicine, Inje University, Seoul Paik Hospital, Seoul, South Korea
| | - Sang Kil Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea
| | - Sung Woo Jung
- Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Sung Soo Kim
- Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, South Korea
| | - Hye-Kyung Jung
- Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, South Korea
| | - Sang Pyo Lee
- Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, South Korea
| | - Gab-Jin Cheon
- Department of Internal Medicine, GangNeung Asan Hospital, College of Medicine, Ulsan University, Gangneung, South Korea
| | - Moo In Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea
| | - Hwoon-Yong Jung
- Department of Gastroenterology, Asan Medical Center, University of Ulsan, Seoul, South Korea
| | - Kwang Hyun Ko
- Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
| | - In Kyung Sung
- Department of Internal Medicine, Konkuk University Medical Center, Seoul, South Korea
| | - Si Hyung Lee
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, South Korea
| | - Ju Yup Lee
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, South Korea
| | - Soo Teik Lee
- Department of Internal Medicine, Jeonbuk National University Hospital, Jeonju, South Korea
| | - Poong-Lyul Rhee
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea
| | - Nayoung Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam and Seoul National University College of Medicine, Seoul, South Korea
| | - Su Jin Hong
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, South Korea
| | - Hyun Jin Kim
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Gwang Ha Kim
- Department of Internal Medicine, Pusan National University College of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Kwang Jae Lee
- Department of Gastroenterology, Ajou University Hospital, Ajou University School of Medicine, Suwon, South Korea
| | - Sung Kook Kim
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, South Korea
| | - Woon Geon Shin
- Department of Internal Medicine, Hallym University College of Medicine/Institute for Liver and Digestive Diseases, Chuncheon, South Korea
| | - Oh Young Lee
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
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Dao HV, Hoang LB, Luu HTM, Nguyen HL, Goldberg RJ, Allison J, Dao ATM, Van Nguyen HT, Matsumura T, Van Dao L. Clinical symptoms, endoscopic findings, and lower esophageal sphincter characteristics in patients with absent contractility. Medicine (Baltimore) 2022; 101:e31428. [PMID: 36316894 PMCID: PMC9622690 DOI: 10.1097/md.0000000000031428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Absent contractility is a rare esophageal motility disorder defined by high-resolution manometry which remains poorly understood in pathogenesis and management. We investigated the clinical symptoms, upper gastrointestinal endoscopy findings, and lower esophageal sphincter (LES) characteristics in adult patients diagnosed with absent contractility on high resolution manometry and factors associated with erosive esophagitis that were found on endoscopy in these patients. A cross-sectional study was conducted in patients with absent contractility who were examined at the Institute of Gastroenterology and Hepatology, Vietnam between March 2018 and December 2020. Clinical symptoms, endoscopic findings, and LES metrics were collected and compared between individuals with and without erosive esophagitis. Logistic regression analysis was used to examine a variety of factors associated with erosive esophagitis. Among 7519 patients who underwent high resolution manometry, 204 (2.7%) were diagnosed with absent contractility. The mean age of the study sample was 45.9 years, 65.7% were women, and none had systemic sclerosis. The most common symptoms were regurgitation, belching, epigastric pain, and bloating. On endoscopy, 50% had erosive esophagitis, mostly Los Angeles grade A (42.9%). On manometry, 44.6% of the patients had LES hypotension and 68.1% had low integrated relaxation pressure in 4 seconds (IRP4s). Male sex (adjusted odds ratio = 2.01, 95% confidence interval: 1.04-3.89) and an IRP4s < 5 mm Hg (adjusted odds ratio = 2.21, 95% confidence interval: 1.12-4.37) were significantly associated with erosive esophagitis. Absent contractility was present in many patients without known systemic diseases. Erosive esophagitis was common and associated with male sex and low IRP4s.
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Affiliation(s)
- Hang Viet Dao
- Internal Medicine Faculty, Hanoi Medical University, Hanoi, Vietnam
- The Institute of Gastroenterology and Hepatology, Hanoi, Vietnam
- *Correspondence: Hang Viet Dao, Internal Medicine Faculty, Hanoi Medical University, Hanoi, VietnamThe Institute of Gastroenterology and Hepatology, Hanoi, Vietnam (e-mail: )
| | - Long Bao Hoang
- The Institute of Gastroenterology and Hepatology, Hanoi, Vietnam
| | - Hue Thi Minh Luu
- The Institute of Gastroenterology and Hepatology, Hanoi, Vietnam
| | - Hoa Lan Nguyen
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Robert Joel Goldberg
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Jeroan Allison
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - An Thi Minh Dao
- Internal Medicine Faculty, Hanoi Medical University, Hanoi, Vietnam
| | | | - Tomoaki Matsumura
- Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Long Van Dao
- Internal Medicine Faculty, Hanoi Medical University, Hanoi, Vietnam
- The Institute of Gastroenterology and Hepatology, Hanoi, Vietnam
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Mari A, Abu Baker F, Said Ahmad H, Omari A, Jawabreh Y, Abboud R, Shahin A, Shibli F, Sbeit W, Khoury T. The Yield of Endoscopy and Histology in the Evaluation of Esophageal Dysphagia: Two Referral Centers’ Experiences. Medicina (B Aires) 2021; 57:medicina57121336. [PMID: 34946281 PMCID: PMC8705225 DOI: 10.3390/medicina57121336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/25/2021] [Accepted: 12/02/2021] [Indexed: 11/16/2022] Open
Abstract
Background and Objectives: The initial diagnostic test required to evaluate esophageal dysphagia is upper endoscopy (EGD) to assess the structure of the esophagus and the esophageo-gastric junction (EGJ). Taking biopsies during EGD has become a common practice in patients with dysphagia to rule out eosinophilic esophagitis (EoE). The aims of this study were to evaluate the endoscopic findings of patients who underwent EGD for esophageal dysphagia, to assess the rate of biopsy taking from the esophagus to diagnose/exclude EoE, and to report histology outcomes of these biopsies. Materials and Methods: This was a retrospective multicenter study that included individuals ≥18 years who underwent EGD due to esophageal dysphagia between the years 2015 and2020, (with no other alarm signs, such as weight loss, new iron deficiency anemia, and lymphadenopathy). We obtained data from patients’ electronic files. The endoscopy and histology findings were obtained from endoscopy reports saved in our electronic files. Results: A total of 209 patients were included in the study. The average age was 57.1 ± 17.1 years. The most common endoscopic findings were normal endoscopy in 76 patients (36.4%) and erosive esophagitis in 75 patients (35.9%). Barrett’s esophagus and esophageal malignancy were encountered in 11 patients (5.3%) and 2 patients (0.95%), respectively. Esophageal biopsies were taken in 50.2% of patients, and one patient had histological evidence of EoE (0.5%). On univariate analysis, there was a trend for association between proton pump inhibitors (PPIs) use and a normal EGD, but it was not statistically significant (OR 0.28, 95% CI 0.07–1.11, p = 0.07). Conclusions: Endoscopic findings were prevalent in dysphagia patients even when no other alarm symptoms exist. Neoplastic lesions and EOE were rare in our study.
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Affiliation(s)
- Amir Mari
- Gastroenterology and Endoscopy Units, The Nazareth Hospital, EMMS, Nazareth 16100, Israel;
- Faculty of Medicine in the Galilee, Bar-Ilan University, Safed 1311502, Israel; (A.S.); (W.S.); (T.K.)
- Correspondence: ; Tel.: +972-0-54214-2070
| | - Fadi Abu Baker
- Department of Gastroenterology, Hillel Yaffe Medical Center, Hadera 38100, Israel;
| | - Helal Said Ahmad
- Gastroenterology and Endoscopy Units, The Nazareth Hospital, EMMS, Nazareth 16100, Israel;
- Faculty of Medicine in the Galilee, Bar-Ilan University, Safed 1311502, Israel; (A.S.); (W.S.); (T.K.)
| | - Ali Omari
- Internal Medicine Department, The Nazareth Hospital, EMMS, Nazareth 16100, Israel; (A.O.); (Y.J.)
| | - Yazed Jawabreh
- Internal Medicine Department, The Nazareth Hospital, EMMS, Nazareth 16100, Israel; (A.O.); (Y.J.)
| | - Rand Abboud
- Surgery Department, The Nazareth Hospital, EMMS, Nazareth 16100, Israel;
| | - Amir Shahin
- Faculty of Medicine in the Galilee, Bar-Ilan University, Safed 1311502, Israel; (A.S.); (W.S.); (T.K.)
- Department of Gastroenterology, Galilee Medical Center, Nahariya 22100, Israel
| | - Fahmi Shibli
- Department of Gastroenterology and Liver Disease, Emek Medical Center, Afula 1855701, Israel;
- Rappaport Faculty of Medicine, Technion—Israel Institute of Technology, Haifa 38100, Israel
| | - Wisam Sbeit
- Faculty of Medicine in the Galilee, Bar-Ilan University, Safed 1311502, Israel; (A.S.); (W.S.); (T.K.)
- Department of Gastroenterology, Galilee Medical Center, Nahariya 22100, Israel
| | - Tawfik Khoury
- Faculty of Medicine in the Galilee, Bar-Ilan University, Safed 1311502, Israel; (A.S.); (W.S.); (T.K.)
- Department of Gastroenterology, Galilee Medical Center, Nahariya 22100, Israel
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5
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Azami M, Salamati M, Ranjbar R, Sahebkar A. The association between metabolic syndrome and erosive esophagitis: A systematic review and meta-analysis. EXCLI JOURNAL 2021; 20:1532-1543. [PMID: 34924903 PMCID: PMC8678055 DOI: 10.17179/excli2021-4282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 10/28/2021] [Indexed: 11/05/2022]
Abstract
Although several studies have shown that each of the metabolic syndrome (MetS) components can be a risk factor for erosive esophagitis (EE), the association between MetS and EE is still a challenging subject, as studies about this association have shown inconsistent results. Therefore, this study was conducted to evaluate the association between MetS and EE. In this study, we followed the MOOSE protocol and the PRISMA guidelines for reporting the results. Web of Science (ISI), Cochrane Library (Cochrane Database of Systematic Reviews - CDSR), EMBASE, Scopus, Science Direct, PubMed/Medline, EBSCO, CINAHL, and Google Scholar search engine were searched for articles published until January 2021. Heterogeneity between studies was estimated by I2 index and Q test. All analyses were performed using Comprehensive Meta-Analysis Software. Finally, 12 studies entered the meta-analysis process after qualitative assessment. MetS was significantly associated with increased risk of EE (OR=1.488 [95 % CI: 1.352-1.638], P<0.001; Heterogeneity: I2= 55.57, P<0.001) in 12 studies with a sample size of 45285 (12825 cases and 29377 controls). In subgroup analysis based on types of studies (P=0.832), MetS diagnostic criteria (P=0.083) and quality of studies (P=0.612), no significant association was found. Sensitivity analysis showed that the overall estimation of effect size is still robust after omission of individual studies from the meta-analysis. Publication bias based on the Begg's test (P=0.945) and Egger's test (P=0.753) were not significant. MetS increases the risk of EE compared to control groups. Future studies should examine if MetS treatment reduces the risk of EE.
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Affiliation(s)
- Milad Azami
- Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Majid Salamati
- Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Reza Ranjbar
- Molecular Biology Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran,*To whom correspondence should be addressed: Reza Ranjbar, Molecular Biology Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran, E-mail:
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran,Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran,School of Medicine, The University of Western Australia, Perth, Australia,School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
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Jung HK, Tae CH, Song KH, Kang SJ, Park JK, Gong EJ, Shin JE, Lim HC, Lee SK, Jung DH, Choi YJ, Seo SI, Kim JS, Lee JM, Kim BJ, Kang SH, Park CH, Choi SC, Kwon JG, Park KS, Park MI, Lee TH, Kim SY, Cho YS, Lee HH, Jung KW, Kim DH, Moon HS, Miwa H, Chen CL, Gonlachanvit S, Ghoshal UC, Wu JCY, Siah KTH, Hou X, Oshima T, Choi MY, Lee KJ. 2020 Seoul Consensus on the Diagnosis and Management of Gastroesophageal Reflux Disease. J Neurogastroenterol Motil 2021; 27:453-481. [PMID: 34642267 PMCID: PMC8521465 DOI: 10.5056/jnm21077] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 07/02/2021] [Indexed: 02/06/2023] Open
Abstract
Gastroesophageal reflux disease (GERD) is a condition in which gastric contents regurgitate into the esophagus or beyond, resulting in either troublesome symptoms or complications. GERD is heterogeneous in terms of varied manifestations, test findings, and treatment responsiveness. GERD diagnosis can be established with symptomatology, pathology, or physiology. Recently the Lyon consensus defined the “proven GERD” with concrete evidence for reflux, including advanced grade erosive esophagitis (Los Angeles classification grades C and or D esophagitis), long-segment Barrett’s mucosa or peptic strictures on endoscopy or distal esophageal acid exposure time > 6% on 24-hour ambulatory pH-impedance monitoring. However, some Asian researchers have different opinions on whether the same standards should be applied to the Asian population. The prevalence of GERD is increasing in Asia. The present evidence-based guidelines were developed using a systematic review and meta-analysis approach. In GERD with typical symptoms, a proton pump inhibitor test can be recommended as a sensitive, cost-effective, and practical test for GERD diagnosis. Based on a meta-analysis of 19 estimated acid-exposure time values in Asians, the reference range upper limit for esophageal acid exposure time was 3.2% (95% confidence interval, 2.7-3.9%) in the Asian countries. Esophageal manometry and novel impedance measurements, including mucosal impedance and a post-reflux swallow-induced peristaltic wave, are promising in discrimination of GERD among different reflux phenotypes, thus increasing its diagnostic yield. We also propose a long-term strategy of evidence-based GERD treatment with proton pump inhibitors and other drugs.
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Affiliation(s)
- Hye-Kyung Jung
- Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Chung Hyun Tae
- Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Kyung Ho Song
- Division of Gastroenterology, Department of Internal Medicine, CHA Ilsan Medical Center, CHA University School of Medicine, Ilsan, Jeollabuk-do, Korea
| | - Seung Joo Kang
- Department of Internal Medicine, Seoul National University Hospital Gangnam Center, Seoul, Korea
| | - Jong Kyu Park
- Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Gangwon-do, Korea
| | - Eun Jeong Gong
- Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Gangwon-do, Korea
| | - Jeong Eun Shin
- Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Chungcheongnam-do, Korea
| | - Hyun Chul Lim
- Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Gyeonggi-do, Korea
| | - Sang Kil Lee
- Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Da Hyun Jung
- Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Yoon Jin Choi
- Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Seung In Seo
- Division of Gastroenterology, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Joon Sung Kim
- Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Jung Min Lee
- Digestive Disease Center, CHA Gangnam Medical Center, CHA University, Seoul, Korea
| | - Beom Jin Kim
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Sun Hyung Kang
- Department of Gastroenterology, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea
| | - Chan Hyuk Park
- Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Gyeonggi-do, Korea
| | - Suck Chei Choi
- Department of Internal Medicine and Digestive Disease Research Institute, Wonkwang University School of Medicine, Iksan, Jeollabuk-do, Korea
| | - Joong Goo Kwon
- Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Kyung Sik Park
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Moo In Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Tae Hee Lee
- Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Seung Young Kim
- Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Young Sin Cho
- Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Cheonan, Hospital, Cheonan, Chungcheongnamdo, Korea
| | - Han Hong Lee
- Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kee Wook Jung
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Do Hoon Kim
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hee Seok Moon
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Hirota Miwa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Chien-Lin Chen
- Institute of Medical Sciences, Tzu Chi University, and Department of Public Health, College of Medicine, Tzu Chi University, Hualien City, Taiwan
| | - Sutep Gonlachanvit
- Center of Excellence on Neurogastroenterology and Motility, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Uday C Ghoshal
- Departments of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Science, Lucknow, India
| | - Justin C Y Wu
- Institute of Digestive Disease, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, China
| | - Kewin T H Siah
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Division of Gastroenterology and Hepatology, University Medicine Cluster, National University Hospital, Singapore
| | - Xiaohua Hou
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Tadayuki Oshima
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Mi-Young Choi
- Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - Kwang Jae Lee
- Department of Gastroenterology, Ajou University School of Medicine, Suwon, Gyeonggi-do, Korea
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Prevalence of reflux esophagitis among patients undergoing endoscopy in a secondary referral hospital in Giza, Egypt. ALEXANDRIA JOURNAL OF MEDICINE 2019. [DOI: 10.1016/j.ajme.2013.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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8
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Lee KJ, Son BK, Kim GH, Jung H, Jung H, Chung I, Sung I, Kim JI, Kim JH, Lee JS, Kwon JG, Park JH, Huh KC, Park KS, Park M, Kim N, Lee OY, Jee SR, Lee SK, Youn SJ, Kim SK, Lee ST, Hong SJ, Choi SC, Kim TN, Youn YH, Park HJ, Kang MJ, Park CH, Kim BT, Youn S, Song GS, Rhee P. Randomised phase 3 trial: tegoprazan, a novel potassium-competitive acid blocker, vs. esomeprazole in patients with erosive oesophagitis. Aliment Pharmacol Ther 2019; 49:864-872. [PMID: 30843245 PMCID: PMC6594096 DOI: 10.1111/apt.15185] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 06/25/2018] [Accepted: 01/18/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Tegoprazan is a novel potassium-competitive acid blocker that has a fast onset of action and can control gastric pH for a prolonged period, which could offer clinical benefit in acid-related disorders. AIM To confirm the non-inferiority of tegoprazan to esomeprazole in patients with erosive oesophagitis (EE). METHODS In this multicentre, randomised, double-blind, parallel-group comparison study, 302 Korean patients with endoscopically confirmed EE (Los Angeles Classification Grades A-D) were randomly allocated to either tegoprazan (50 or 100 mg) or esomeprazole (40 mg) treatment groups for 4 or 8 weeks. The primary endpoint was the cumulative proportion of patients with healed EE confirmed by endoscopy up to 8 weeks from treatment initiation. Symptoms, safety and tolerability were also assessed. RESULTS The cumulative healing rates at week 8 were 98.9% (91/92), 98.9% (90/91) and 98.9% (87/88) for tegoprazan 50 mg, tegoprazan 100 mg and esomeprazole 40 mg, respectively. Both doses of tegoprazan were non-inferior to esomeprazole 40 mg. The incidence of adverse events was comparable among the groups, and tegoprazan was well-tolerated. CONCLUSION Once daily administration of tegoprazan 50 or 100 mg showed non-inferior efficacy in healing EE and tolerability to that of esomeprazole 40 mg.
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9
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Richter JE, Rubenstein JH. Presentation and Epidemiology of Gastroesophageal Reflux Disease. Gastroenterology 2018; 154:267-276. [PMID: 28780072 PMCID: PMC5797499 DOI: 10.1053/j.gastro.2017.07.045] [Citation(s) in RCA: 272] [Impact Index Per Article: 45.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 07/18/2017] [Accepted: 07/18/2017] [Indexed: 12/11/2022]
Abstract
Gastroesophageal reflux disease (GERD) is the most prevalent gastrointestinal disorder in the United States, and leads to substantial morbidity, though associated mortality is rare. The prevalence of GERD symptoms appeared to increase until 1999. Risk factors for complications of GERD include advanced age, male sex, white race, abdominal obesity, and tobacco use. Most patients with GERD present with heartburn and effortless regurgitation. Coexistent dysphagia is considered an alarm symptom, prompting evaluation. There is substantial overlap between symptoms of GERD and those of eosinophilic esophagitis, functional dyspepsia, and gastroparesis, posing a challenge for patient management.
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Affiliation(s)
- Joel E. Richter
- Joy McCann Culverhouse Center for Swallowing Disorders, Division of Digestive Diseases & Nutrition, University of South Florida College of Medicine, Tampa FL
| | - Joel H. Rubenstein
- Veterans Affairs Center for Clinical Management Research, Ann Arbor, MI,Barrett’s Esophagus Program, Division of Gastroenterology & Hepatology, University of Michigan Medical School, Ann Arbor, MI
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10
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Chung TH, Lee J, Kim MC. Impact of night-shift work on the prevalence of erosive esophagitis in shipyard male workers. Int Arch Occup Environ Health 2016; 89:961-6. [PMID: 27129469 PMCID: PMC4927591 DOI: 10.1007/s00420-016-1130-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 04/11/2016] [Indexed: 02/07/2023]
Abstract
Purpose Whether night-shift work is a risk factor for gastroesophageal reflux disease is controversial. The aim of this study was to investigate the association between night-shift work and other factors, and erosive esophagitis. Methods A cross-sectional study with 6040 male shipyard workers was performed. Esophagogastroduodenoscopic examination and a survey about night-shift work status, lifestyle, medical history, educational status, and marital status were conducted in all workers. The odds ratios of erosive esophagitis according to night-shift work status were calculated by using the logistic regression model. Results The prevalence of erosive esophagitis increased in the night-shift workers [odds ratio, 95 % confidence interval: 1.41 (1.03–1.94)]. According to multiple logistic regression models, night-shift work, obesity, smoking, and alcohol consumption of ≥140 g/week were significant risk factors for erosive esophagitis. By contrast, Helicobacter pylori infection was negatively associated with erosive esophagitis. Conclusion Night-shift work is suggested to be a risk factor for erosive esophagitis. Avoidance of night-shift work and lifestyle modification should be considered for prevention and management of gastroesophageal reflux disease.
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Affiliation(s)
- Tae Heum Chung
- Department of Family Medicine, University of Ulsan College of Medicine, Ulsan University Hospital, 877 Bangeojinsunwhando-Ro, Dong-Gu, Ulsan, 44033, Korea
| | - Jiho Lee
- Department of Occupational and Environmental Medicine, University of Ulsan College of Medicine, Ulsan University Hospital, 877 Bangeojinsunwhando-Ro, Dong-Gu, Ulsan, 44033, Korea.
| | - Moon Chan Kim
- Department of Family Medicine, University of Ulsan College of Medicine, Ulsan University Hospital, 877 Bangeojinsunwhando-Ro, Dong-Gu, Ulsan, 44033, Korea
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11
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Jung JG, Kang HW, Hahn SJ, Kim JH, Lee JK, Lim YJ, Koh MS, Lee JH. Vegetarianism as a protective factor for reflux esophagitis: a retrospective, cross-sectional study between Buddhist priests and general population. Dig Dis Sci 2013; 58:2244-52. [PMID: 23508985 DOI: 10.1007/s10620-013-2639-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Accepted: 03/07/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND/AIMS Several risk factors for reflux esophagitis, such as smoking, alcohol consumption, obesity, and metabolic syndrome, are recognized. But vegetarianism as a protective factor for reflux esophagitis has not been reported. The aim of this study is to elucidate the protective effect of vegetarianism for reflux esophagitis. METHODS This is a cross-sectional study that compared the prevalence of reflux esophagitis of 148 Buddhist priests, who are obligatory vegetarians with that of age- and sex-matched controls who underwent health checkups in a health promotion center. RESULTS The prevalence of reflux esophagitis was higher in the control group than in the Buddhist priest group (21.6 vs 12.2 %). Weight, body mass index, waist circumference, waist-to-hip ratio, and abdominal adipose tissue area were higher and high density lipoprotein (HDL) cholesterol and total cholesterol were lower in the Buddhist priest group. The prevalence of metabolic syndrome was higher in the Buddhist priest group than the control group (30.4 vs 17.6 %). In univariate analysis, male sex (odds ratio [OR] = 3.325; 95 % confidence interval [CI], 1.659-6.666), current smoking (OR = 3.37; 95 % CI, 1.439-7.881), alcohol consumption (OR = 2.75; 95 % CI, 1.375-5.481), waist circumference (OR = 1.99; 95 % CI, 1.062-3.739), negative for Helicobacter pylori IgG antibody (OR = 1.89; 95 % CI, 1.018-3.491) and non-vegetarianism (OR = 1.99; 95 % CI, 1.062-3.739) were associated with reflux esophagitis. According to multivariate analysis, male sex (OR = 3.44; 95 % CI, 1.698-6.970), non-vegetarianism (OR = 2.08; 95 % CI, 1.086-3.974) and negative H. pylori IgG antibody (OR = 1.96; 95 % CI, 1.039-3.712) were significantly associated with reflux esophagitis. CONCLUSIONS A non-vegetarian diet is associated with reflux esophagitis.
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Affiliation(s)
- Jae Gu Jung
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Seoul, 410-773, Republic of Korea
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12
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Park CH, Kim KO, Baek IH, Choi MH, Jang HJ, Kae SH, Kim JB, Baik GH, Shin WG, Kim KH, Kim HY. Differences in the risk factors of reflux esophagitis according to age in Korea. Dis Esophagus 2012; 27:116-21. [PMID: 23009198 DOI: 10.1111/j.1442-2050.2012.01417.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The prevalence of gastroesophageal reflux disease in Korea has been believed to be low, but the incidence of gastroesophageal reflux disease in Korea is expected to increase because of the longer life expectancy and more ingestion of westernized food. The aim of this study was to report differences in the risk factors of reflux esophagitis (RE) according to age in Korea. We prospectively recruited the subjects who had RE among those who visited a health promotion center for upper gastrointestinal cancer surveillance at Hallym Medical Center (five institutions) between January 2008 and February 2009. The enrolled study participants comprised 742 subjects with RE and 1484 healthy controls. The independent risk factors of RE in young and adult group were male sex, smoking, coffee, body mass index ≥ 25, hiatal hernia, and Helicobacter pylori negativity. The risk factors of RE in elderly group were smoking, coffee, and hiatal hernia. The risk factors for RE according to age group were found to differ. In elderly group, Helicobacter pylori infection was not a significant protective factor contrary to young and adult groups.
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Affiliation(s)
- C H Park
- Department of Gastroenterology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
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13
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Silverman JL, Smith DG, Sukoff Rizzo SJ, Karras MN, Turner SM, Tolu SS, Bryce DK, Smith DL, Fonseca K, Ring RH, Crawley JN. Negative allosteric modulation of the mGluR5 receptor reduces repetitive behaviors and rescues social deficits in mouse models of autism. Sci Transl Med 2012; 4:131ra51. [PMID: 22539775 PMCID: PMC4904784 DOI: 10.1126/scitranslmed.3003501] [Citation(s) in RCA: 200] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Neurodevelopmental disorders such as autism and fragile X syndrome were long thought to be medically untreatable, on the assumption that brain dysfunctions were immutably hardwired before diagnosis. Recent revelations that many cases of autism are caused by mutations in genes that control the ongoing formation and maturation of synapses have challenged this dogma. Antagonists of metabotropic glutamate receptor subtype 5 (mGluR5), which modulate excitatory neurotransmission, are in clinical trials for fragile X syndrome, a major genetic cause of intellectual disabilities. About 30% of patients with fragile X syndrome meet the diagnostic criteria for autism. Reasoning by analogy, we considered the mGluR5 receptor as a potential target for intervention in autism. We used BTBR T+tf/J (BTBR) mice, an established model with robust behavioral phenotypes relevant to the three diagnostic behavioral symptoms of autism--unusual social interactions, impaired communication, and repetitive behaviors--to probe the efficacy of a selective negative allosteric modulator of the mGluR5 receptor, GRN-529. GRN-529 reduced repetitive behaviors in three cohorts of BTBR mice at doses that did not induce sedation in control assays of open field locomotion. In addition, the same nonsedating doses reduced the spontaneous stereotyped jumping that characterizes a second inbred strain of mice, C58/J. Further, GRN-529 partially reversed the striking lack of sociability in BTBR mice on some parameters of social approach and reciprocal social interactions. These findings raise the possibility that a single targeted pharmacological intervention may alleviate multiple diagnostic behavioral symptoms of autism.
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MESH Headings
- Animals
- Behavior, Animal/drug effects
- Blood-Brain Barrier/metabolism
- Brain/drug effects
- Brain/metabolism
- Brain/physiopathology
- Capillary Permeability
- Child Development Disorders, Pervasive/drug therapy
- Child Development Disorders, Pervasive/metabolism
- Child Development Disorders, Pervasive/physiopathology
- Child Development Disorders, Pervasive/psychology
- Child, Preschool
- Disease Models, Animal
- Excitatory Amino Acid Antagonists/blood
- Excitatory Amino Acid Antagonists/pharmacology
- Female
- Humans
- Male
- Mice
- Mice, Inbred C57BL
- Motor Activity/drug effects
- Receptor, Metabotropic Glutamate 5
- Receptors, Metabotropic Glutamate/antagonists & inhibitors
- Receptors, Metabotropic Glutamate/metabolism
- Sleep/drug effects
- Social Behavior
- Stereotyped Behavior
- Time Factors
- Video Recording
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Affiliation(s)
- Jill L. Silverman
- Laboratory of Behavioral Neuroscience, National Institute of Mental Health, Bethesda, MD 20892–3730, USA
| | - Daniel G. Smith
- Pfizer Worldwide Research and Development, Groton, CT 06340, USA
| | | | - Michael N. Karras
- Laboratory of Behavioral Neuroscience, National Institute of Mental Health, Bethesda, MD 20892–3730, USA
| | - Sarah M. Turner
- Laboratory of Behavioral Neuroscience, National Institute of Mental Health, Bethesda, MD 20892–3730, USA
| | - Seda S. Tolu
- Laboratory of Behavioral Neuroscience, National Institute of Mental Health, Bethesda, MD 20892–3730, USA
| | - Dianne K. Bryce
- Pfizer Worldwide Research and Development, Groton, CT 06340, USA
| | - Deborah L. Smith
- Pfizer Worldwide Research and Development, Groton, CT 06340, USA
| | - Kari Fonseca
- Pfizer Worldwide Research and Development, Groton, CT 06340, USA
| | - Robert H. Ring
- Pfizer Worldwide Research and Development, Groton, CT 06340, USA
| | - Jacqueline N. Crawley
- Laboratory of Behavioral Neuroscience, National Institute of Mental Health, Bethesda, MD 20892–3730, USA
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