جستجوی مقالات مرتبط با کلیدواژه « gastroesophageal reflux » در نشریات گروه « پزشکی »

Surgical treatment of recurrent gastroesophageal reflux disease (GERD) negatively affects patients’ quality of life (QoL). Determination of risk factors is essential when considering a surgical approach. The present study aimed to evaluate short-term and long-term outcomes of primary laparoscopic Nissen fundoplication (LNF) and open Nissen fundoplication (ONF), as well as the risks of laparoscopic redo fundoplication. A retrospective cohort observational study was conducted from 2010 to 2021 at the National Research Center of Surgery (Almaty, Kazakhstan). Depending on the type of primary GERD surgical correction, 475 patients were stratified into two groups, namely LNF (n=117) and ONF (n=358). The outcomes and associated complications of LNF and ONF surgeries were assessed. The odds ratio of recurrent GERD in terms of risk factors was analyzed as well as post-intervention QoL. Postoperative complications in ONF surgery were 2.7-fold higher than in LNF (P=0.0001). Moreover, intra-operative complications were higher with ONF surgery (7.7%) than with LNF (1.4%) (P=0.002). In cases with persistent clinical manifestations, the rate of redo fundoplication was the same after failed primary LNF and ONF. The risk factors associated with recurrent GERD, leading to redo fundoplication, were obesity (OR=2.16, P=0.473) and male sex (OR=3.0, P=0.272). One-year after LNF, 88.7% of the patients were satisfied with the outcome of the surgery. Recurrent symptoms of GERD and the rate of redo fundoplication were associated with obesity and the male sex. Obesity was the main risk factor, necessitating stringent selection of patients for surgical management of the disease.

The effectiveness of eradicating Helicobacter pylori infection in improving the symptoms of chronic gastritis has been examined; however, the results of the studies have been contradictory, especially in childhood. This study aimed to compare the clinical effectiveness of sequential Helicobacter pylori eradication treatment and proton pump inhibitor alone in children with chronic Helicobacter pylori-positive gastritis.

This randomized double-blinded clinical trial was conducted on 84 children aged 5 to 15 years suffering from Helicobacter pylori-associated active chronic gastritis. The patients in the experimental group received sequential therapy including omeprazole, amoxicillin, clarithromycin, and metronidazole; and those in the control group only received omeprazole. Before the intervention, and 2 and 4 months after it, the severity of clinical symptoms was assessed.

After therapeutic regimens, the intervention group was found to have a significantly higher decrease in the severity grades of some symptoms including heartburn, gastroesophageal reflux, and abdominal pain in the epigastric area as compared to the control group (P<0.05). The assessment of the frequency of clinical symptoms in the intervention and control groups also indicated a greater reduction in epigastric pain in the group treated with Helicobacter pylori eradication as compared to the control group (P<0.05).

Prescribing a sequential Helicobacter pylori eradication regimen can lead to reducing the severity of clinical symptoms in children suffering from chronic gastritis.

 Achalasia is a rare esophageal motility disorder that can require surgical intervention in some cases. This retrospective cross-sectional study aims to evaluate the clinical symptoms of patients with advanced achalasia who underwent laparoscopic Heller myotomy (LHM) and Dor fundoplication.

 The study included 86 patients (38 men, 48 women) diagnosed with achalasia between 2010 and 2020, of which 20 patients with advanced achalasia underwent LHM and Dor fundoplication. The median follow-up time was 48 months.

 The study found that LHM and Dor fundoplication surgery improved dysphagia in 12 patients, with four patients showing improvement in solid food dysphagia and two patients showing improvement in semi-solid dysphagia. Nocturnal cough and slow emptying sensation also improved in 16 cases. Additionally, barium stasis decreased significantly in 14 patients. However, two patients who underwent esophagectomy had hospital mortality.

 This study highlights the effectiveness of LHM and Dor fundoplication in reducing dysphagia, nocturnal coughing, regurgitation, and other obstructive symptoms in patients with advanced achalasia. However, the study also underscores the potential risks associated with esophagectomy, suggesting that surgical treatment for achalasia should be carefully considered on a case-by-case basis.

Prevalence of Halitosis includes a variety of 22 up to 50% in different societies. There have been reports of remarkable improvements in Halitosis after Gastroesophageal Reflux Disease (GERD) treatment. The aim of this study was to investigate the relationship between oral factors and halitosis in patients suffering from GERD. 

This cross-sectional analytical study was conducted on 98 patients (45 females and 53 females) with mean age of 19.4 years whose gastroesophageal reflux was diagnosed by gastroenterologist. Halitosis was detected by organoleptic method. Decayed, Missing, and Filled Teeth (DMFT) was utilized to record the dental status. Oral hygiene was evaluated using the Oral Hygiene Index (OHI-S), Debries Index (DI), Calculus Index (CI), and coated tongue. Data were analyzed by Spearman and Pearson correlation tests.

There was not a significant relationship between halitosis and DMFT, OHI-S, and debris index and calculus index, and coated tongue (p>0.01). Also, there was a direct and significant relationship between DI and CI (p<0.01).

Based on the results of the present study, there is no relationship between oral factors (debris index, calculus index, oral hygiene index, and DMFT) and halitosis in patients with GERD. Therefore, the presence of halitosis might be attributed to the presence of GERD in these patients.

Burning mouth syndrome (BMS) is defined as “intra-oral burning or dysestheticsensation, recurring daily for more than 2 hours per day for more than 3 months, without clinically evident causative lesions”. It can be associated with relatedsymptoms, such as dry mouth and dysgeusia. The etiology of BMS remains unknown, although a number of local, systemic and psychological factors have been proposed as being of etiopathogenic importance.

A 55-year-old male patient reported with a complaint of burning sensation in the roof of mouth and tongue for the past 4 months. The patient was under anti-hypertensives and anti-coagulants for the past 4 years and also had moderate reflux esophagitis.Intraoral examination revealed generalized pallor involving the dorsal surface of the tongue and the palatal mucosa, and diminished salivary flow.When tested for unstimulated salivary flow rate, it was < 0.5 mL/min.

All the laboratory results were within normal limits. After careful assessment and counselling, he was referred to a gastroenterologist for further treatment and was reassured that the burning sensation he had felt was associated with his gastric issues

Most information on the association of dietary fat intake and gastro‑esophageal reflux disorder (GERD) came from developed countries, where lifestyle and other dietary components might be different from those in developing countries. This cross‑sectional study was, therefore, conducted to investigate the association between dietary fat intake and odds of having GERD in a large group of Iranian population. Study Design: This cross‑sectional study was done among 3362 adult population in Isfahan, Iran. Dietary intakes were collected by the use of a validated semi‑quantitative food frequency questionnaire.

Assessment of GERD was done using a validated self‑administered questionnaire examining the frequency of heartburn in the last 3 months. Individuals with the presence of heartburn symptoms sometimes, often or always during the last 3 months were defined as having GERD.

Participants in the top category of dietary fat intake had higher daily intakes of energy, macronutrients and micronutrients. Dietary intakes of all food groups were also significantly higher among those in the top quintile as compared with those in the bottom category of dietary fat intake (P < 0.001 for all). There were no significant associations between dietary fat intake and incidence of GERD in general population. Crude and multivariable‑adjusted models revealed no significant associations between dietary fat intake and having GERD in either gender.

We found no significant association between dietary fat intake and odds of having GERD in this population. Further studies, in particular of prospective designs, are warranted to clarify this association.

Due to stressful occupational conditions, irregular dietary and sleep schedules, medical students are at increased risk of developing gastrointestinal disorders, gastroesophageal reflux (GERD) in particular, as well as sleep disturbances. Therefore, for the first time, we aimed to assess the correlation between GERD and sleep disturbances among medical students.

The current cross-sectional study was done on 290 medical students at different study periods in Iran during 2018-2019. Age, sex, stage of studying, residence, and body mass index were gathered. The frequency scale for the symptoms of gastroesophageal reflux (FSSG) was utilized to assess gastrointestinal symptoms among them and the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality. Eventually, the association of sleep disturbances with demographic factors and gastrointestinal symptoms was evaluated.

Living in the dormitory (p = 0.048; OR: 1.73; 95%CI: 1.01-2.99) and being overweight (p < 0.001; OR: 3.09; 95%CI: 1.58-6.06) were independently correlated with impaired sleep quality. GERD presented either by heartburn (p < 0.001) or regurgitation (p < 0.001) was associated with a lower quality of life.

GERD was correlated with poor sleep quality among medical students. In addition, residence in dormitory and being overweight were correlated with poor sleep quality

The durability of a fundoplication (FP) in the treatment of gastroesophageal reflux disease (GERD) in children must be confirmed in the long-term. This study aimed to present the long-term outcome after a minimum of five years.

Perioperative data were retrospectively reviewed from clinical records, and the follow-up data were collected through a standardized questionnaire. In total, 21 neurologically impaired (NI) and nine neurologically non-impaired (NNI) children were included in this study. The statistical analysis was performed using SPSS software (version 25) through Fisher’s exact test, t-test, and Kaplan-Meier analysis. A p-value of less than 0.05 was considered statistically significant.

The median follow-up period was 10.8 years (5-19.7), and the refundoplication rates ranged from 11% to 19%. Revisions were usually necessary within the first two postoperative years. Most delayed refundoplications were necessary for the NI children with a laparoscopic Nissen FP. In the long-term, symptoms and medication administration program were favorable in most cases. Most parents were highly satisfied with the postoperative outcome and would approve that FP is conducted on their child again under the same circumstances.

The FP is a safe procedure with consistent benefits in the first 10 postoperative years in NI and NNI children with documented GERD. The NI children treated with a laparoscopic Nissen FP necessitate longer postoperative surveillance since more delayed redofundoplications were required in this group.

Poor sleep quality and daytime fatigue are common features of chronic hepatitis.

To evaluate the association between daytime sleepiness and hepatitis and to identify factors that contribute to daytime sleepiness in patients with hepatitis B and those with hepatitis C.

In this prospective cross-sectional pilot study, outpatients with fatigue who did not receive any treatment for hepatitis were recruited from the Department of Gastroenterology and Hepatology and were classified into 5 groups of hepatitis B, hepatitis C, hepatitis B + C, other hepatitis types, and without hepatitis (controls). Gastroesophageal reflux and daytime sleepiness were determined based on two self-reported questionnaires, and linear and logistic regression analyses were performed.

In total 42 subjects had hepatitis B, 62 had hepatitis C, 9 had hepatitis B + C, 4 had other hepatitis types, and 14 had no hepatitis. Of them, 38 (29.01%) had gastroesophageal reflux (GERDQ score ≥ 12), and 13 (9.92%) had daytime sleepiness (ESS score ≥ 8). Hepatitis B patients with gastroesophageal reflux had significantly higher odds of daytime sleepiness [odds ratio (OR) = 12.44, 95% confidence interval (CI) = 1.59 - 261.02]. In hepatitis C patients, hypertension was significantly associated with daytime sleepiness (OR = 15.6, 95% CI = 2.13 - 143.21), while those with taller body height and elevated serum glutamic-oxaloacetic transaminase (GOT) levels had significantly lower odds of daytime sleepiness (body height: OR = 0.81, 95% CI = 0.65 - 0.93; GOT: OR = 0.76, 95% CI = 0.55 - 0.95).

Gastroesophageal reflux is a risk factor for daytime sleepiness in hepatitis B patients. In hepatitis C patients, hypertension is a risk factor, while taller body height and elevated serum GOT are protective factors for daytime sleepiness.

 According to the instructions of Iranian traditional medicine (ITM), modification of breast milk through nursing mothers, is the first step in the treatment of infant disorders. In fact, maternal lifestyle, especially diet and eating habits, can change the quality and quantity of breast milk. The modern medical literature emphasizes that exclusive breastfeeding is the optimal nutrition for infants with gastroesophageal reflux disease (GERD).

 The present study was conducted to evaluate the effect of maternal eating principles and diet based on ITM on infantile GERD symptoms.

 Exclusive-breastfeeding, under 5 - month infants with clinical diagnosis of GERD and their nursing mothers, were selected for this 6-weeks parallel randomized, controlled trial. All participants were randomly assigned to the intervention and the control group. The mothers of infants in the intervention group received ITM-based dietary principles, and feeding-positioning modifications were trained to the mothers of all infants of both groups, because of observation of ethical issues (not deprived of standard treatment). Age-Specific Questionnaire for Infants (GSQ-I) was used to assess the frequency and intensity of the GERD symptoms. Measuring the difference between the mean Composite Symptom Score (CSS) in week 0, 4, and 6, between the intervention group and the control group, was the main outcome of this study.

 Both the intervention and control groups had statistically significant differences in the mean CSS of week 4 and 6 compared with baseline (P < 0.05). Also, there was a significant reduction of the mean CSS values in the intervention group compared to the control group (P < 0.05).

 Maternal eating principles and diet based on Iranian Traditional Medicine appears to affect the reduction of infantile GERD signs and symptoms.

Gastroesophageal Reflux Disease (GERD) characterized by a backward movement of gastric contents from the lower esophageal sphincter (1). GERD is the exacerbated and pathologic form of Gastroesophageal Reflux (GER) accompanied by symptoms and complications of damage to the esophagus (2). Vomiting is the most common symptom of this disease, which occurs in 50% of children; it will peak in 4 months and decrease over a year (3). An infant's reflux often brings about regurgitation and symptoms of esophagitis (e.g. irritability, arching, choking, gagging and food refusal) and therefore causes delayed growth (4). Due to high prevalence of this disease and side effects of drugs in infants, it is necessary to find simple remedies for prevention and reduce the complications of GERD. Persian Medicine (PM) as a branch of complementary medicine has some recommendations to prevent infant's gastrointestinal disease. Although these recommendations are recorded hundred years ago, many of them has been approved in conventional medicine. In Persian literature, clinical symptoms such as (Joshā-e Hāmiz) regurgitation of sour material and (Horqat laz’) heartburn are similar to GERD (5). Iranian physicians have proposed the following recommendation:

To probe into the possible connection between gastroesophageal reflux disorders (GERDs) and functionally occurring dyspepsia as a factor raising the risk of chronic periodontitis.

A cross‑sectional study was carried out on 40 patients with chronic periodontitis with age group between 40–60 years. The test group included 20 people diagnosed with gastroesophageal reflux disease (GERD), according to the Montreal Definition and Classification agreement, and chronic periodontitis. Symptomatic diagnoses were done to confirm functional dyspepsia. The control group comprised 20 systematically healthy people suffering from chronic periodontitis. Indices measured included flow‑rate of saliva, repetitive saliva swallowing test for swallowing function, papillary marginal attachment index of gingiva, oral hygiene index‑simplified and decayed, missing, filled teeth index. Data was analyzed using SPSS version 22 (IBM Inc. Chicago, USA). Descriptive statistics, such as mean and standard deviation (SD) for continuous variables and frequency and percentage for categorical variables were determined. T test was performed for intergroup comparison and Pearson correlation test was done for evaluating correlation between various parameters. P ≤ 0.05 considered as significant.

Statistically significant differences were observed between the test and control groups with regard to all the clinical parameters of interest. Pearson’s correlation test revealed a strong negative correlation between salivary flow rate and OHI‑S and DMFT scores. The RSST swallow function values demonstrated a moderate negative correlation with OHI‑S scores, while OHI‑I scores and DMFT scores were observed to be strongly correlated in a positive direction. A statistically significant difference was present in the probing depth and CAL levels between both the groups with higher levels in test group.

GERD was linked to incremental incidences of chronic periodontitis and was established as an independent risk‑raising factor.

Background Gastroesophageal Reflux is a physiological phenomenon, which occurs in infants, children, and normal adults. Various studies have shown that Baclofen is a potent inhibitor of lower esophageal sphincter and has beneficial effects in adult reflux disease. We aimed to evaluate the Baclofen effect in pediatric Gastroesophageal disease.

Children 6 months to 12 years old, with Gastroesophageal reflux disease were enrolled in this Clinical trial study. Patients referred to Taleghani Children’s Center in Gorgan, Golestan province, Iran from May to August 2019.  Patients were randomly divided into two intervention group and control group. The controls received only proton pump inhibitor 1 mg per kg treatment, and intervention group received proton pump inhibitor (PPI) plus baclofen 0.25 mg per kg two times per day. Patient data including age, gender, family history, growth status, reflux symptoms, previous drug treatment history, and symptoms in two groups, were compared.

Fifty-four patients in the baclofen treatment group and 58 patients in the non-baclofen treatment group were included. The mean age of the patients was 6.61+ 3.55 years. The most common symptoms of all patients were abdominal pain (73.2%), nausea (73.2%), regurgitation (64.3%), and dental erosion (55.4%). The rate of recovery was significantly related to gender, with 69.9% of patients having moderate to full recovery (p = 0.017). Weight gain in baclofen treated group was significantly higher.

The results suggest that baclofen along with routine Gastroesophageal reflux treatments in children can help reduce or improve symptoms of the disease. Due to limited studies, further studies are needed to confirm the positive effect of this drug with higher sample size.

This research aimed to evaluate the effect of gastroesophageal reflux disease (GERD) on pulmonary volumes, airflows, and airway resistance in the patients without respiratory symptoms and compare them with the healthy subjects.

GERD is the return of gastric content into the esophagus and beyond. GERD may play an essential role in the extraesophageal diseases, including chest pain, asthma, laryngitis, chronic cough, and sinusitis. The relation between GERD and airway involvement in asthma and also bronchoconstrictor effects of GERD are well recognized, but its impact on lung parameters in the patients with GERD without respiratory symptoms is unclear.

In a case-control study, 78 GERD patients without pulmonary symptoms and 93 healthy subjects as control group were enrolled. The impulse oscillometry examined airway resistance. The body plethysmograph measured the pulmonary volumes and airflows.

The mean age of GERD patients and the healthy subjects were 37.30±9.76 and 34.74±11.10, respectively. A total of 53.8% of patients and 67.7% of healthy subjects were male. The lung volumes measured by the body plethysmography were normal in both patients and healthy subjects. However, there was a significant difference between the groups in forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) (P=0.01) and maximal mid expiratory flow (MMEF) (P=0.008). Airway resistance at R5Hz was significantly higher in the case group than the control group (P=0.001).

The results of the current study demonstrated that GERD patients have small airway disease even in the absence of respiratory symptoms.Keywords: Gastroesophageal reflux, Lung function, Plethysmography, Airway resistance, Oscillometry.(Please cite as Nazemiyeh M, Nouri-Vaskeh M, Somi MH, Saeedi E, Sharifi A. Lung function parameters in patients with gastroesophageal reflux without respiratory symptoms: a case-control study. Gastroenterol Hepatol Bed Bench 2019;12(4):287-291).

Chest pain is one of the most frequent causes of a child’s referral to a cardiologist.

The present study aimed at determining whether treatment of constipation in 4 - 17-year-old children with idiopathic chest pain stops their chest pain.

The current descriptive study was conducted on all patients aged 4 - 17 years old with idiopathic chest pain referring to the Pediatric Cardiology Clinic of Hejazi Hospital, Shiraz, Iran in 2016. A diagnosis of idiopathic chest pain is established after a thorough history taking, physical examination, and appropriate laboratory investigations in patients with no abnormality in the heart, lung, musculoskeletal system, psychological condition, and upper gastrointestinal tract. The study patients were divided into two groups: 36 patients with constipation as cases and 27 patients without constipation as controls. Patients with constipation were supported with toilet training programs and pharmacological treatment. Relief of chest pain was evaluated in the two groups after four months.

There were no significant differences in terms of age, gender, weight, and height between the patients with idiopathic chest pain with and without constipation. The number and length of chest pain were significantly different between the case and control groups (P < 0.001 and 0.047, respectively). After medical treatment of constipation, chest pain was significantly stopped in patients with constipation compared with the ones without constipation (P < 0.001).

The current study showed that resolution of constipation stopped chest pain in the patients with idiopathic chest pain and constipation. Physicians should consider treatment of constipation as a first modality in each patient with idiopathic chest pain and constipation due to its easy assessment.

Gastroesophageal reflux disease is one of the most common diseases in adults. Ultrasonography (US) is a noninvasive and reliable diagnostic tool for the disease at least in infants but the diagnostic value in adults has not been evaluated well. A total of 72 patients complaining form gastroesophageal reflux disease symptoms who have undergone upper endoscopy were recruited for this study. In abdominal sonography, the following variables were measured or observed: esophageal wall thickness at gastroesophageal junction, AP diameter of esophagus at hiatus and gastroesophageal junction, abdominal esophagus length, funnel shape esophagus and presence of reflux after drinking a glass of water. Among all variables, only the presence of reflux in sonography was significantly related to the positive endoscopic findings with a sensitivity of 45% and specificity of 86%. Sonography can predict induced esophagitis by gastroesophageal reflux disease induced.

GastroEsophageal Reflux Disease (GERD) is the most common gastrointestinal disorders, which may be caused or aggravated by occupational stress. In this study we aimed to investigate the prevalence of GERD in nurses working in hospitals of a province in Iran and assessing its relationship with their occupational stress.
The study was a cross-sectional and correlational one. The study population included all nurses working in public hospitals of a province in Iran in 2016. The stratified random sampling was used. The data were collected using Nursing Stress Scale (NSS) and Gastroesophageal Reflux Disease Questionnaire. The SPSS software version 22 and independent t, Chi-square, and Mann-Whitney tests were used for data analysis.
The prevalence of GERD and severe levels of occupational stress among nurses were 26.8%, and 25.9%, respectively. Statistical analyses showed no significant correlation between occupational stress and the risk of GERD, but a significant relation was found between the sex of the nurses and their occupational stress and between their type of employment and the risks of GERD.
The prevalence of GERD among nurses had no significant difference with that in the general community. Although nursing is considered as a stressful job, it seems that nurses adapt themselves with the working conditions after a while and experience stress levels similar to other people in the community.

BACKGROUNDDespite progress in the health indexes in recent years, health inequalities remain as a global challenge within and between regions and countries. This study is the first to quantify the socioeconomic inequity in gastroesophageal reflux disease (GERD) using the concentration index.
METHODSIn this cross-sectional study, we used baseline data (7012 subjects) from the Fasa Cohort Study (the Southern Iran). The principal component analysis was used to construct socioeconomic status of the participants. The concentration index and concentration curve were used to measure socioeconomic-related inequality in GERD. Decomposition of concentration index was also done to identify the contribution of each explanatory variable to the wealth-related inequality in GERD prevalence.
RESULTSThe prevalence of GERD was 16.9% (95% CI: 15.9-17.7%). The overall concentration index for GERD was 0.093 (95% CI: 0.062-0.166]. Correspondingly, this figure for men and women were 0.116 (95% CI: 0.062-0.171%) and 0.091 (95% CI: 0.044-0.137%), respectively. The main contributors of socioeconomic-related inequality in GERD prevalence were socioeconomic status (64.4%), alcohol drinking (29%), and age (8.4%).
CONCLUSIONGERD is significantly more concentrated among richest people. There was significant socioeconomic inequality in GERD according to some individual factors. These inequalities need to be addressed by policy makers to identify the vulnerable subgroups and to reduce the disease burden in the community.