Gastro-Oesophageal Reflux Symptoms - Clinical Findings and Effect of Ranitidine Treatment

Hallerbäck, B.; Glise, Hans; Johansson, B.; Rosseland, Arne R.; Hultén, S.; Carling, L; Knapstad, L J

doi:10.1080/11024159850191175

Cited by 16 publications

(7 citation statements)

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“…Empirical Treatment for GERD. Allocation concealment in 3 trials 42,43,46 was qualified as possibly adequate. In all other trials, allocation concealment was qualified as adequate.…”

Section: Resultsmentioning

confidence: 99%

“…Most of the studies did not report the number of patients excluded based upon endoscopic findings. In 1 of the studies that did, 46 only 14 out of 441 patients (3%) were excluded on the basis of these endoscopic findings. Thus, we believe that the empirical group represented a good reflection of the adult population presenting with a history of serious and relatively long‐standing but uncomplicated GERD.…”

Section: Discussionmentioning

confidence: 99%

“…The mean number randomized per trial was 490 (range, 208–994); the mean age was 49 years, and 50% of the participants were male. One trial included patients with any combination of 2 of the following complaints: heartburn, epigastric pain, and regurgitation 46 . In all other trials, the primary inclusion criterion was heartburn meeting certain criteria defining severity, frequency, and duration.…”

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confidence: 99%

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Short-term treatment of gastroesophageal reflux disease

et al. 2003

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OBJECTIVE:To investigate the efficacy of acid suppressant drugs in the empirical treatment of gastroesophageal reflux disease (GERD) and in the treatment of endoscopy-negative reflux disease (ENRD).DESIGN: MEDLINE, EMBASE, and the Cochrane Controlled Trials Register were searched. Bibliographies were reviewed.SETTING: Studies were eligible that compared the short-term use of proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H 2 RAs) with each other or with placebo in adults with GERD who were enrolled irrespective of endoscopic findings (empirical cases) or in whom endoscopy showed no signs of esophagitis (endoscopy-negative cases).MEASUREMENTS: Of 1,408 studies, only 13 could be included for meta-analysis. Data on 3,433 patients empirically treated for GERD and 2,520 patients treated for ENRD were extracted. The primary endpoint was relief of heartburn. MAIN RESULTS:In the empirical treatment of GERD, the summary relative risk (sRR) for symptom relief from H 2 RAs versus placebo was 0.77 (95% confidence interval [95% CI], 0.60 to 0.99). RR in the only placebo-controlled PPI trial was 0.35 (95% CI, 0.26 to 0.46). The sRR for standard dose PPIs versus H 2 RAs was 0.55 (95% CI, 0.44 to 0.68). In treatment of ENRD, both PPIs (sRR, 0.64; 95% CI, 0.52 to 0.79) and H 2 RAs (sRR, 0.78; 95% CI, 0.62 to 0.97) were superior to placebo, and PPIs were superior to H 2 RAs (sRR, 0.81; 95% CI, 0.70 to 0.95).CONCLUSIONS: Acid suppressant therapy (with a PPI or an H 2 RA) is more effective than placebo for short-term relief of heartburn in patients with persistent symptoms who are treated empirically for GERD and in those in whom esophagitis was excluded after endoscopy. The benefit of PPIs compared with H 2 RAs is more pronounced in patients treated empirically.

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“…Empirical Treatment for GERD. Allocation concealment in 3 trials 42,43,46 was qualified as possibly adequate. In all other trials, allocation concealment was qualified as adequate.…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Short-term treatment of gastroesophageal reflux disease

et al. 2003

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“…A number of studies have addressed the issue of treatment satisfaction related to anti‐reflux procedures (e.g. Nissen fundoplication) 10–12 and medication response 13–15 in GERD. However, the single questions or few items used in these studies to assess treatment satisfaction have not been well developed or validated; few treatment satisfaction questionnaires have been developed in a rigorous manner 9 .…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a disease‐specific treatment satisfaction questionnaire for gastro‐oesophageal reflux disease

Coyne¹,

Wiklund

Schmier³

et al. 2003

Aliment Pharmacol Ther

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Summary Background : Currently, no disease‐specific, patient‐based, treatment satisfaction instruments related to gastro‐oesophageal reflux disease exist. Aim: To develop and validate a treatment satisfaction questionnaire for gastro‐oesophageal reflux disease (TSQ‐G). Methods : A new questionnaire was developed from patient focus groups, clinician input and literature review. A validation study was conducted in treated gastro‐oesophageal reflux disease patients. Ancillary measures included the Medical Outcomes Study Short Form‐36, Quality of Life in Reflux and Dyspepsia, Gastrointestinal Symptom Rating Scale, Socially Desirable Response Scale, Patient Satisfaction Questionnaire‐18 and physician and patient measures of symptoms and satisfaction. Statistical analyses included exploratory factor analysis, Cronbach's alpha, intra‐class correlations, analyses of variance and t‐tests. Results : A total of 198 gastro‐oesophageal reflux disease patients participated in the study, with a mean age of 50.7 years, 68% female and 84% Caucasian. The physician‐rated severity of gastro‐oesophageal reflux disease was mild (32%), moderate (50%) and severe (18%); 83% were on proton pump inhibitors. The final TSQ‐G consisted of 28 items with seven sub‐scales; Cronbach's alpha ranged from 0.58 to 0.94. Correlations with the expected sub‐scales of the ancillary measures were moderate to strong. The TSQ‐G sub‐scales discriminated significantly between levels of physician‐rated disease severity, symptom days and patient and physician ratings of satisfaction. Conclusions : The TSQ‐G has excellent reliability and construct validity and appears to be a useful tool for the evaluation of treatment satisfaction in gastro‐oesophageal reflux disease patients.

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“…GER has long been thought to be a cause of apnea. However, a recent study in preterm infants showed that GER and apnea, while both common, are not temporally related to one another; only 3.5% of apneic events are associated with a significant reflux episode 19 . GER has also been implicated in the development of BPD.…”

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confidence: 97%

Non-pulmonary therapy in the NICU

Aschner

2004

Pediatr. Pulmonol.

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Abbreviations:RCT -randomized, controlled trial VLBW -very low birth weight BPD -bronchopulmonary dysplasia NICU -neonatal intensive care unit ELBW -extremely low birth weight BW -birth weight NEC -necrotizing enterocolitis GBS -Group B Streptococcus GER -gastroesophageal reflux PDA -patent ductus arteriosusThe pediatric community can take pride in accomplishments of the past two decades that have contributed to improved respiratory outcomes for infants requiring neonatal intensive care. The development, investigation and implementation of surfactant therapy for respiratory distress syndrome and inhaled nitric oxide for persistent pulmonary hypertension of the newborn are excellent examples of translational research that have resulted in a fundamental change in clinical practice. On the other hand, the field of neonatology is infamous for the adoption of new therapies into wide-spread practice before efficacy and safety have been rigorously evaluated and validated. Our history of therapeutic misadventures demands that we adopt a more scientific approach to the implementation of new therapies and practices.Randomized, controlled trials (RCT) provide the bestavailable, unbiased estimates of the risks and benefits of an intervention 1 . Establishment of research networks capable of conducting large RCTs and dissemination of trial results and meta-analyses on web sites such as the NICHD Cochrane Collaboration Neonatal Review Group (www.nichd.nih.gov/cochraneneonatal/) have contributed to an important change in the culture of neonatology to one that strives for an evidence-based approach to practice. Despite this laudable change in practice goals and attitudes, the reality is that many currently accepted neonatal practices have not been validated in RCT; rather they represent accumulated, often anecdotal experience, and extrapolation from practices tested and untested in adults. The first step toward a more evidence-based approach is acknowledgement of the experimental nature of many current treatments for preterm infants. This review on ''non-pulmonary therapy'' will focus on the medical rather than ventilator management of neonates, with emphasis on practices likely to impact pulmonary outcomes. Optimal management and improved outcomes for extremely low birth weight (ELBW; birth weight 1000 g) infants will require a comprehensive approach that incorporates evidence-based management of all aspects of their care.Optimizing the growth and nutrition of ELBW infants has been an elusive goal. Growth failure occurs in 89% by 36 weeks adjusted age; by 18-22 months, 40% of ELBW infants still are below the 10th percentile for weight, length and head circumference 2 . Infants with BPD, necrotizing enterocolitis (NEC) and nosocomial sepsis grow more slowly than those that avoid these complications.More concerning are the correlations between inhospital growth rates and neurodevelopmental outcomes and failure-to-thrive at 18-22 months adjusted age 2 . Inadequate nutrition per se may have a detrimental impact on brain maturation,...

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Gastro-Oesophageal Reflux Symptoms - Clinical Findings and Effect of Ranitidine Treatment

Cited by 16 publications

References 0 publications

Short-term treatment of gastroesophageal reflux disease

Short-term treatment of gastroesophageal reflux disease

Development and validation of a disease‐specific treatment satisfaction questionnaire for gastro‐oesophageal reflux disease

Non-pulmonary therapy in the NICU

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