Gastroesophageal Reflux Disease

Chen, Jingtao; Brady, Patrick

doi:10.1097/sga.0000000000000359

Cited by 79 publications

(34 citation statements)

References 44 publications

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“…4 Heartburn and regurgitation are the most frequent symptoms of reflux, and also, dysphagia, chest pain, chronic cough, laryngitis, and asthma may be present. 5 The main underlying causal mechanism of GERD constitutes a failure in the valvular mechanism of the lower esophageal sphincter (LES), which normally prevents the return of stomach contents to the esophagus. The diaphragm muscle, the abdominal part of the esophagus, and the acute angle of His are the main structures of the antireflux barrier.…”

Section: Introductionmentioning

confidence: 99%

Different Effects of Aerobic Exercise and Diaphragmatic Breathing on Lower Esophageal Sphincter Pressure and Quality of Life in Patients with Reflux: A Comparative Study

Ahmadi

Amiri

Rezaeian

et al. 2021

Middle East J Dig Dis

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BACKGROUND Gastroesophageal reflux disease (GERD) is a worldwide disorder with an increasing prevalence. The quality of life (QOL) of the patients may be influenced by reflux disease. Diaphragmatic breathing (DB), as well as aerobic exercise (AE), may improve the symptoms of reflux disease, although it remains a controversial issue. The aim of this study was to compare the effects of AE and DB on QOL and lower esophageal sphincter (LES) pressure of patients with moderate to severe reflux. METHODS This was a case-control study that was conducted for 8 weeks among patients with moderate to severe GERD. The block randomization method was designed to randomize patients into three groups (AE, DB, and control) to achieve equal sample sizes. The control group received omeprazole 20 mg once daily. The other groups, in addition to omeprazole, received AE and DB. QOL and LES pressure were measured before and after the study by Questionary and Manometry method, respectively. RESULTS 75 patients were enrolled in this study. Positive effects of DB on LES pressure was approved (p = 0.001). DB had significantly more effects on QOL than aerobic exercise (p = 0.003). AE can significantly improve QOL in patients (p = 0.02) but no significant change in LES pressure (p = 0.38). There was no change in the control group for both variables. CONCLUSION AE had no effects on LES pressure but can improve QOL of the patients. DB had more effects on QOL than AE, so injured or disable patients with reflux who cannot do AE, can benefit from DB to improve their reflux symptoms.

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Section: Introductionmentioning

confidence: 99%

Different Effects of Aerobic Exercise and Diaphragmatic Breathing on Lower Esophageal Sphincter Pressure and Quality of Life in Patients with Reflux: A Comparative Study

Ahmadi

Amiri

Rezaeian

et al. 2021

Middle East J Dig Dis

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“…1 Gastric acid suppression, especially maintaining gastric acidity at a pH ≥ 4.0, is important for controlling GERD, and proton-pump inhibitors (PPIs) have been widely used as the most successful agents. 2,3 Nonetheless, PPIs, the mainstay therapies for GERD, have some unmet needs such as nocturnal acid breakthrough and CYP2C19 phenotype-related variability in efficacy.…”

mentioning

confidence: 99%

Night‐time gastric acid suppression by tegoprazan compared to vonoprazan or esomeprazole

Yang

Kim

et al. 2022

Brit J Clinical Pharma

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Aims Nocturnal acid breakthrough has been considered an unmet need of proton‐pump inhibitors. Tegoprazan, a novel potassium‐competitive acid blocker, is expected to show improved properties for this unmet need. This study was aimed to compare night‐time acid suppression by tegoprazan with that by vonoprazan or esomeprazole, and to explore the effect of CYP2C19 phenotypes on acid‐suppressive effects. Methods A randomized, open‐label, 3‐period, 6‐sequence crossover study was conducted. A single oral dose of tegoprazan 50 mg, vonoprazan 20 mg or esomeprazole 40 mg was administered at night in each period. Continuous intragastric pH was monitored at baseline and after each dosing. Results Sixteen healthy subjects (6 CYP2C19 extensive metabolizers, 5 intermediate metabolizers, 5 poor metabolizers) completed the study. After a single dose of tegoprazan, intragastric pH increased more rapidly to over 4 at approximately 1 hour compared to the other treatments, and elevated intragastric pH was maintained stably at night. Tegoprazan exhibited night‐time acid suppression for slightly but not significantly longer than vonoprazan, and greater than esomeprazole; % time at pH ≥ 4 at night was 66.0%, 60.5% and 36.1% for tegoprazan, vonoprazan and esomeprazole, respectively. Night‐time acid suppression by tegoprazan and vonoprazan was not dependent on CYP2C19 phenotypes, while that by esomeprazole tended to be influenced by CYP2C19 phenotypes. Conclusion Tegoprazan produced more rapid, potent and well sustained night‐time acid suppression vs. vonoprazan or esomeprazole when administered at night. Furthermore, tegoprazan showed no CYP2C19 phenotype dependency in acid suppression. It suggests the potential of tegoprazan, especially in preventing nocturnal acid breakthrough.

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“…signs of gastro-intestinal bleeding, weight loss, and dysphagia, an empiric PPI-trial is currently considered not only to be a cost-effective diagnostic tool, but also an efficient initial intervention for GERD. 13 In both erosive GERD (ERD) and non-erosive reflux disease (NERD), complete symptom relief is reported in 72% of patients, whereas this number decreases to more or less 50% if there is no objective evidence of abnormal oesophageal acid exposure. 14 In the event where patients experience extra-oesophageal manifestations of GERD (hoarseness, non-cardiac chest pain, coughing and asthma) as well as nocturnal GERD, symptoms may require twice daily PPI treatment 4 as superior intragastric pH control is achieved with a twice daily omeprazole 20 mg regimen compared to a once daily 40 mg omeprazole dose.…”

Section: Pharmacotherapymentioning

confidence: 99%

Taking the ‘sauer’ out of sauerkraut: a rapid update on the pathophysiology and treatment of gastro-oesophageal reflux disease

Brand

Steyn

Wolmarans

2020

SAGP

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Gastro-oesophageal reflux disease (GERD), in layman’s terms known as heartburn, is a condition characterised by frequent oesophageal contact with gastric acid. Contrary to what is generally accepted, GERD is not caused by excessive quantities of gastric acid. Rather, symptoms result from any combination of a number of contributing factors, including decreased lower oesophageal sphincter pressure, hiatus hernia (where the stomach protrudes through the diaphragm), reduced oesophageal and gastric clearance and compromised oesophageal mucosa barrier integrity. Although most patients are able to manage GERD symptoms by means of lifestyle changes, chronic and recurrent episodes of reflux may result in erosive oesophagitis, nasal inflammation, dysphagia, i.e. difficulty in swallowing, and even pulmonary complications, e.g. asthma.

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Gastroesophageal Reflux Disease

Cited by 79 publications

References 44 publications

Different Effects of Aerobic Exercise and Diaphragmatic Breathing on Lower Esophageal Sphincter Pressure and Quality of Life in Patients with Reflux: A Comparative Study

Different Effects of Aerobic Exercise and Diaphragmatic Breathing on Lower Esophageal Sphincter Pressure and Quality of Life in Patients with Reflux: A Comparative Study

Night‐time gastric acid suppression by tegoprazan compared to vonoprazan or esomeprazole

Taking the ‘sauer’ out of sauerkraut: a rapid update on the pathophysiology and treatment of gastro-oesophageal reflux disease

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