Contribution of hiatal hernia to asthma in patients with gastroesophageal reflux disease

Li, Zhi Tong; Ji, Feng; Han, Xiaodan; Gu, Lin Xia; Wang, Li; Yue, Yong; Wang, Zhong Gao

doi:10.1111/crj.12748

Cited by 8 publications

(14 citation statements)

References 36 publications

(68 reference statements)

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“…However, esophagus symptoms improved better with respect to extra-esophageal symptoms after PECC-b treatment (Fig. 3 ), which were the similar as in our study about Stretta procedure [ 14 ] and LARS [ 15 ].…”

Section: Methodssupporting

confidence: 87%

“…The Reflux Diagnostic Questionnaire assessed gastroesophageal reflux-related symptoms scores [ 13 ]. The instrument used a six-point Likert scale system ranging from 0 to 5 to assess both the severity and frequency of heartburn, regurgitation, cough, wheezing, and chest pain as symptoms scores according to the Reflux Diagnostic Questionnaire (with revision) (Table 1 ) [ 14 , 15 ]. More specifically, the frequency was graded as 0 (none), 1 (less than once per week), 2 (once or twice per week), 3 (three or four times per week), 4 (five or six times per week), and 5 (more than six times per week); the severity was graded as 0 (none), 1 (slight), 2 (mild), 3 (moderate), 4 (severe), and 5 (extremely severe).…”

Section: Methodsmentioning

confidence: 99%

“…LARS is an important treatment method for medication-refractory GERD [ 24 ]. Anti-reflux surgery not only controls reflux symptoms, but also improves reflux-related extra-esophageal symptoms [ 15 ]. Previous studies have also reported 65%–75% respiratory symptom improvement in patients who had heartburn or regurgitation after fundoplication [ 25 ].…”

Section: Methodsmentioning

confidence: 99%

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Endoscopic cardial constriction with band ligation in the treatment of refractory gastroesophageal reflux disease: a preliminary feasibility study

Han

et al. 2021

Surg Endosc

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Background Gastroesophageal reflux disease (GERD) is a common digestive disease, could cause extra-esophageal symptoms. Peroral endoscopic cardial constriction with band ligation (PECC-b) is a minimally invasive method for the treatment of GERD in recent years. The goals of this study were to evaluate the clinical efficacy of PECC-b to treat gastroesophageal reflux-related symptoms. Methods A retrospective study of patients undergoing PECC-b between January 2017 and December 2018 at a single institution was conducted. All patients confirmed GERD by endoscopy, esophageal PH-impedance monitoring, esophageal manometry and symptom questionnaires. The outcome measures included reflux-related scores, patients’ satisfaction and drug independence after 12 months following surgery. Results A total of 68 patients, with follow-up of 12 months post surgery, were included in the final analysis. The symptom scores were all significantly decreased as compared with preoperation (P < 0.05). The esophageal symptom scores showed a better improvement than extra-esophageal symptoms (P < 0.001). Fifty-three (77.9%) patients achieved complete drug therapy independence and 52 (76.5%) patients were completely or partially satisfied with the symptom relief following surgery. Conclusions The PECC-b is a safe, effective and recommended approach for the control of GERD-related symptoms. Further multicenter prospective studies are required to confirm these outcomes.

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Section: Methodssupporting

confidence: 87%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Endoscopic cardial constriction with band ligation in the treatment of refractory gastroesophageal reflux disease: a preliminary feasibility study

Han

et al. 2021

Surg Endosc

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“…Conversely, the procedure of only HHR did not produce improvement in mid-term or long-term reflux symptoms. Therefore, HH just is an important factor in aggravating gastroesophageal reflux; Effective control of reflux mechanisms is the key factors for the successful management of GERD-related symptoms 35 . Fundoplication should be routinely performed in HH patients to reduce the risk of postoperative persistence of GERD or of new-onset GERD.…”

Section: Discussionmentioning

confidence: 99%

Role of fundoplication in treatment of patients with symptoms of hiatal hernia

Han

et al. 2019

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Gastroesophageal reflux disease (GERD) is often associated with hiatal hernia (HH). However, the need for fundoplication during hiatal hernia repair (HHR) remains controversial. The objective of this study was to evaluate the effect of HHR with concomitant laparoscopic Nissen fundoplication (HHR-LNF) in HH patients. A total of 122 patients with symptomatic HH were randomized to receive either HHR (n = 61) or HHR-LNF (n = 61). The measures of evaluating outcomes included DeMeester scores (DMS), complications, Reflux Diagnostic Questionnaire and patients’ satisfaction 24 months following surgery. Despite comparable values in both groups at randomization, the DMS, total numbers of reflux episodes and percentage of time with pH < 4 were significantly higher in HHR group than in HHR-LNF group ( P = 0.017, P = 0.002 and P = 0.019, respectively) at 6 months after surgery. One months postoperatively, complications were higher in the HHR-LNF group than in the HHR group (all P < 0.001), and there was no difference between the two groups at 6 months. By the end of the 2-year follow-up, HHR-LNF group showed a significantly lower reflux syndrome frequency-intensity score and greater percentage of satisfaction compared with HHR group (all P < 0.001). Laparoscopic HHR should be combined with a fundoplication in GERD patients with HH. HHR-LNF is safe and effective, not only improve reflux-related symptom, but also reduce the incidence of complications.

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“…It seems intuitive that patients with chronic cough are more likely to develop a hiatal hernia. Interestingly, an increased prevalence of hiatal hernia with worse disease outcomes has been demonstrated in IPF, bronchiectasis and, more recently, asthma patients [22][23][24]. These conditions have the most end-organ damage of the EOR-related diseases possibly due to greater refluxate associated with a hiatal hernia and, in all, cough is a very dominant symptom.…”

Section: Bronchiolitis Obliteransmentioning

confidence: 99%

Current therapies for gastro-oesophageal reflux in the setting of chronic lung disease: state of the art review

et al. 2020

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The inter-relationship between chronic respiratory disease and reflux disease in the airway reflux paradigm is extremely complex and remains poorly characterised. Reflux disease is reported to cause or contribute to the severity of a number of respiratory tract diseases including laryngeal disorders, sinusitis, chronic cough, asthma, COPD, idiopathic pulmonary fibrosis, cystic fibrosis, bronchiectasis and bronchiolitis obliterans post lung transplant. It is now appreciated that reflux disease is not simply caused by liquid acid reflux but rather by a variety of chemical refluxates originating from the stomach and duodenum due to a number of different mechanisms. Reflux disease can be challenging to diagnose, particularly proving its role in the causation of direct respiratory epithelial damage. Significant advances in oesophageal assessment and gastric biomarkers have emerged in recent years as our understanding increases. There are a number of treatments available for reflux disease, both medical and surgical, but there is a paucity of large randomised trials to evaluate their efficacy in the setting of chronic respiratory disease. Everyday clinical practice, however, informs us that treatment failure in reflux disease is common. This clinical review summarises associations between reflux disease in the setting of chronic respiratory diseases and examines available evidence regarding potential therapeutic strategies.

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Contribution of hiatal hernia to asthma in patients with gastroesophageal reflux disease

Abstract: The patients with GERD with asthma have a high prevalence of HH. The presence of HH maybe correlated with asthma and severe GERD. Actively treating HH not only improved reflux, but also controlled asthma symptoms.

Cited by 8 publications

References 36 publications

Endoscopic cardial constriction with band ligation in the treatment of refractory gastroesophageal reflux disease: a preliminary feasibility study

Endoscopic cardial constriction with band ligation in the treatment of refractory gastroesophageal reflux disease: a preliminary feasibility study

Role of fundoplication in treatment of patients with symptoms of hiatal hernia

Current therapies for gastro-oesophageal reflux in the setting of chronic lung disease: state of the art review

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