Current Trends in the Management of Gastroesophageal Reflux Disease: A Review

Nwokediuko, Sylvester Chuks

doi:10.5402/2012/391631

Cited by 65 publications

(26 citation statements)

References 108 publications

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“…Among European and American populations, the approximate prevalence rate of GERD has been reported to be between 10%-20%, while in Asia, this number is below 10% [3,4]. Possible risk factors associated with the condition include age, obesity, alcohol consumption, cigarette smoking and presence of hiatus hernia [5]. Mahadeva et al concluded that GERD is more common among persons of British origin compared to people of the South-East Asian dyspeptic population, suggesting that race and/or western lifestyle are crucial contributors to the occurrence of GERD [6].…”

Section: Introductionmentioning

confidence: 99%

Involvement of the TLR4/NF-κB Signaling Pathway in the Repair of Esophageal Mucosa Injury in Rats with Gastroesophageal Reflux Disease

Yu¹,

Wang²,

Zhang³

et al. 2018

Cell Physiol Biochem

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Background/Aims: Numerous studies have highlighted the activation of NF-κB in the esophageal mucosa during the early stages of gastroesophageal reflux disease (GERD). The present study aimed to investigate the role of the TLR4/NF-κB signaling pathway in GERD rat models. Methods: Wistar rats (n = 60) were recruited to establish a GERD animal model. Distal esophageal pH was assessed, followed by determination of the contents of thiobarbituric acid-reactive species (TBARS) and reactive oxygen species (ROS) in esophageal mucosa homogenate. ELISA was employed to detect the levels of inflammatory factors (IL-6, IL-8, IL-10 and TNF-α) in esophageal mucosa. The expression of MMP-3, MPP-9, Cldn1 and Cldn4 was determined by immunohistochemistry. RT-qPCR and western blot analysis were applied to evaluate the protein expressions in TLR4/NF-κB signaling pathway, while TUNEL staining was utilized to examine the apoptosis rate in the esophageal mucosal tissues. Results: Distal esophageal pH of the rats was higher in the GERD + PDTC group than in other groups. Levels of inflammatory factors in esophageal mucosal tissues were downregulated with the inhibition of NF-κB, which was determined to be associated with the decreased contents of TBARS and ROS. Moreover, decreased MMP-3 and MPP-9 in addition to elevated Cldn1 and Cldn4 were detected in the esophageal mucosa as a result of the inactivation of NF-κB. The TLR4/NF-κB signaling pathway-related proteins (TLR4, NF-κB and IκBα); the rate of apoptosis was demonstrated to be suppressed in the GERD + PDTC group, while inactivating NF-κB was found to alleviate the tissue damage observed in the esophageal mucosa. Conclusion: The key findings of the current study demonstrate that the inactivation of the TLR4/NF-κB signaling pathway alleviates oxidative stress injury and promotes the repair of esophageal mucosal injury among rats with GERD, highlighting a potential novel GERD mechanism.

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Section: Introductionmentioning

confidence: 99%

Involvement of the TLR4/NF-κB Signaling Pathway in the Repair of Esophageal Mucosa Injury in Rats with Gastroesophageal Reflux Disease

Yu¹,

Wang²,

Zhang³

et al. 2018

Cell Physiol Biochem

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“…The principles of treatment include lifestyle modifications and control of gastric acid secretion using drugs or surgical treatment with corrective anti-reflux surgery, if required. 24 Multi-drug therapy may be important in bronchial asthma and COPD patients with GERD. The efficacy of proton pump inhibitors may differ between regurgitation-related symptoms and dysmotility related symptoms in asthma patients and COPD patients with GERD.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Gerd in Bronchial Asthma and Copd: Assessment Using FSSG Scale and Gastroesophageal Endoscopy

Gaude¹,

Hattiholi²,

Bhoma³

et al. 2014

jemds

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BACKGROUND: Gastro-esophageal reflux disease (GERD) is a chronic disorder of the upper gastrointestinal tract with global distribution. GERD often coexists with asthma, COPD and is often responsible for their exacerbations. In India, we do not have any clinical data on GERD either in bronchial asthma or COPD. OBJECTIVE: To investigate the prevalence of GERD in adult patients with asthma, COPD and to determine its correlates. MATERIALS AND METHODS: A total of 40 subjects each in bronchial asthma and COPD groups underwent assessment with the frequency scale for the symptoms of GERD (FSSG) Questionnaire for GERD. A score of 8 and above was taken as positive for GERD. The confirmation of GERD was done by Gastroesophageal endoscopy to all GERD positive cases. Grading of GERD was done with endoscopy report according to Los Angeles grading. FSSG score was evaluated in detail and the risk factors were analyzed. RESULTS: The prevalence of GERD in bronchial asthma patients was 40%, while in COPD cases it was 30%. It was observed that by using FSSG questionnaire, the number of patients showing predominance of regurgitation related symptoms were higher in the asthma group (52%) as compared to the COPD group (37%). In COPD group, the number of patients showing predominance of dysmotility-related symptoms was higher (42%) as compared to asthma group (35%). As the severity of both the diseases increased, the severity of GERD also increased as assessed by Los Angeles grading. CONCLUSIONS: According to the current study, more than one-third of adult patients with asthma have GERD and another nearly one third have GERD in COPD cases. Thus high suspicion is required in these cases for the adequate control of either asthma or COPD.

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“…The administration of certain drugs that can relax the LES will also predispose to GER. These drugs include the anticholinergics, calcium-channel blockers, benzodiazepines, and dopamine [5]. Additional risk factors that have been identified in adults are alcohol consumption, smoking, connective tissue diseases (particularly scleroderma) [6], and chronic obstructive pulmonary disease [7].…”

Section: Incidencementioning

confidence: 99%

“…These agents are useful in patients with moderate symptoms [5].

Cisapride is a serotoninergic agent that increases acetylcholine release in the gastrointestinal tract.

…”

Section: Treatment Of Germentioning

confidence: 99%

Gastroesophageal Reflux in Critically Ill Children: A Review

Solana

Cid

Sánchez

2013

ISRN Gastroenterology

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Gastroesophageal reflux (GER) is very common in children due to immaturity of the antireflux barrier. In critically ill patients there is also a high incidence due to a partial or complete loss of pressure of the lower esophageal sphincter though other factors, such as the use of nasogastric tubes, treatment with adrenergic agonists, bronchodilators, or opiates and mechanical ventilation, can further increase the risk of GER. Vomiting and regurgitation are the most common manifestations in infants and are considered pathological when they have repercussions on the nutritional status. In critically ill children, damage to the esophageal mucosa predisposes to digestive tract hemorrhage and nosocomial pneumonia secondary to repeated microaspiration. GER is mainly alkaline in children, as is also the case in critically ill pediatric patients. pH-metry combined with multichannel intraluminal impedance is therefore the technique of choice for diagnosis. The proton pump inhibitors are the drugs of choice for the treatment of GER because they have a greater effect, longer duration of action, and a good safety profile.

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Current Trends in the Management of Gastroesophageal Reflux Disease: A Review

Cited by 65 publications

References 108 publications

Involvement of the TLR4/NF-κB Signaling Pathway in the Repair of Esophageal Mucosa Injury in Rats with Gastroesophageal Reflux Disease

Involvement of the TLR4/NF-κB Signaling Pathway in the Repair of Esophageal Mucosa Injury in Rats with Gastroesophageal Reflux Disease

Prevalence of Gerd in Bronchial Asthma and Copd: Assessment Using FSSG Scale and Gastroesophageal Endoscopy

Gastroesophageal Reflux in Critically Ill Children: A Review

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