Persistent gastro-oesophageal reflux symptoms despite proton pump inhibitor therapy

Ang, Daphne; How, Choon How

doi:10.11622/smedj.2016167

Cited by 11 publications

(11 citation statements)

References 63 publications

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“…1 While classically considered a disease of excess acid, up to 50% of patients with GERD experience little to no relief with pharmacologic acid suppression. 2,3 As more is uncovered regarding the pathophysiology and etiologies underlying GERD, it is evident that the development of reflux disease extends beyond acidity of the refluxate. Variance in symptom presentation and response to treatment can be attributed to the composition of refluxate as well as factors at the level of the esophagus, such as structural, mechanical, biochemical, and physiological aspects (Fig.…”

Section: Introductionmentioning

confidence: 99%

Pathophysiology and treatment options for gastroesophageal reflux disease: looking beyond acid

Sharma

Yadlapati

2020

Annals of the New York Academy of Sciences

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Gastroesophageal reflux disease (GERD) is a disorder due to the retrograde flow of refluxate into the esophagus. Although GERD is a common clinical diagnosis, its pathogenesis is quite complex. As a result of its multifactorial development, many patients continue to experience adverse symptoms due to GERD despite prolonged acid suppression with proton pump inhibitor therapy. The pathogenesis of GERD involves an interplay of chemical, mechanical, psychologic, and neurologic mechanisms, which contribute to symptom presentation, diagnosis, and treatment. As such, GERD should be approached as a disorder beyond acid. This review will investigate the major factors that contribute to the development of GERD, including factors related to the refluxate, esophageal defenses, and factors that promote pathologic reflux into the esophagus. In reviewing GERD pathogenesis, this paper will highlight therapeutic advances, with mention of future opportunities of study when approaching GERD.

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Section: Introductionmentioning

confidence: 99%

Pathophysiology and treatment options for gastroesophageal reflux disease: looking beyond acid

Sharma

Yadlapati

2020

Annals of the New York Academy of Sciences

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“…The drug dispensing regulations of the national health insurance program in Taiwan state that PPI can be used for Los Angeles grade A or B in GERD patients for a maximum of 4 months; thus, we only enrolled participants who took PPI for less than four months. For participants who took PPIs for more than four months, it may result from severe GERD or comorbid with other psychological diseases [45]. Hence, we excluded these participants.…”

Section: Discussionmentioning

confidence: 99%

Profile of the Change in Depression during Proton-Pump Inhibitor Therapy in Patients with Gastroesophageal Reflux Disease: Influence of the Mucosal Break

Chen

Wen

2021

IJERPH

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Given the frequent concomitance between depression and gastroesophageal reflux disease (GERD), it is important to evaluate the change of depression in patients with GERD, especially considering the presence of esophageal mucosal breaks (MB). This study aimed to examine the change in the levels of depression in patients with GERD during proton-pump inhibitors (PPI) therapy. We designed a prospective cohort study to explore the profile of the alteration in depression with respect to the impact of esophageal MB. This study recruited 172 eligible patients with GERD between February 2016 and May 2018. The change in depression was defined as the difference between the respective Taiwanese Depression Questionnaire (TDQ) scores obtained at baseline and after PPI therapy. Multivariate linear regression models were used to estimate the factors associated with the change in depression. The results revealed statistically significant improvements in the TDQ score (mean score: baseline = 13.2, after PPI therapy = 10.9, p < 0.01, Cohen’s d = 0.30) during PPI therapy for GERD. Moreover, the MB was an independent variable associated with changes in the TDQ score [B = 3.31, 95% confidence interval (CI): (1.12, 5.51), p < 0.01] and the improvement in depression [odds ratio = 0.38, 95% CI: (0.17, 0.86), p = 0.02]. Our findings revealed that depressive symptoms improved slightly following PPI therapy. Moreover, MB was an unfavorable prognostic factor for the improvement in depression.

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“…Various agents to treat GERD included proton pump inhibitors (PPIs) and non-steroidal anti-in ammatory drug (NSAID) [9,10]. Among these agents, PPIs has an excellent effect on esophageal mucosal healing by blocking HCl secretion and inhibiting H+/K + ATPase [11,12]. However, long-term use of PPI has a high relapse rate of 11-35%, with complications and side effects.…”

Section: Introductionmentioning

confidence: 99%

The Study of Anti-inflammatory Effect of Curcumae Longae Rhizoma 30% EtOH Extract on Chronic Acid Reflux Esophagitis Rats

Lee

Kim

Shin

et al. 2021

Preprint

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Background: Gastroesophageal reflux disease (GERD) is associated with hypotensive lower esophageal sphincter, frequent transient lower esophageal sphincter relaxation and esophageal hypersensitivity, and often precedes the development of Barrett's esophagus and esophageal adenocarcinoma. GERD is a very common diseased, and is on the rise worldwide. The purpose of this study is to investigate the pharmacological efficacy of Curcumae Longae Rhizoma 30% EtOH extract (CLR) on the chronic acid reflux esophagitis (CARE) rats. Methods: CLR was measured antioxidant activity, such as total polyphenol and total flavonoid contents, 1, 1-diphenyl-2-picrylhydrazyl (DPPH), and 2, 2’-azinobis-3-ethyl-enzothiazoline-6-sulfonic acid (ABTS) radical scavenging activity. And, to confirm the effect of CLR on esophageal in CARE-model, gross esophageal tissue was observed, and esophageal mucosal infiltration and inflammatory cell changes were observed under a microscope. We measured the level of reactive oxygen species (ROS) and peroxynitrite (ONOO-) in serum. Also, we measured the level of 2-thiobarbituric acid-reactive substance (TBARS) in serum and esophageal tissue. In addition, the antioxidant and inflammatory protein levels were investigated western blot analysis. Results: Administration of CLR to rats of induction of CARE was found to reduce esophagus tissue injury. ROS, ONOO-, and TBARS levels were significantly decreased in CLR compared with Veh rats. In addition, CLR was effectively reduced inflammatory protein, and increase antioxidant-related factors.Conclusions: Overall, CLR treatment suggested that markedly ameliorated the inactivation of NF-κB by blocking the phosphorylation of IκBα led to the inhibition of the expressions of proinflammatory proteins.

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Persistent gastro-oesophageal reflux symptoms despite proton pump inhibitor therapy

Cited by 11 publications

References 63 publications

Pathophysiology and treatment options for gastroesophageal reflux disease: looking beyond acid

Pathophysiology and treatment options for gastroesophageal reflux disease: looking beyond acid

Profile of the Change in Depression during Proton-Pump Inhibitor Therapy in Patients with Gastroesophageal Reflux Disease: Influence of the Mucosal Break

The Study of Anti-inflammatory Effect of Curcumae Longae Rhizoma 30% EtOH Extract on Chronic Acid Reflux Esophagitis Rats

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