Weight Loss Is Truly Effective in Reducing Symptoms and Proton Pump Inhibitor Use in Patients With Gastroesophageal Reflux Disease

Bortoli, Nicola de; Tolone, Salvatore; Savarino, Edoardo

doi:10.1016/j.cgh.2015.05.034

Cited by 5 publications

(2 citation statements)

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“…Patients presenting with symptoms suggestive of reflux disease are often empirically treated with lifestyle advice and acid-suppressive drugs, including PPIs. [102][103][104][105] When patients do not respond to standard therapy, endoscopic and functional testing is performed to challenge the initial diagnosis and to investigate the causes of treatment refractoriness. While the presence of erosive esophagitis confirms the diagnosis, a negative endoscopy cannot be used to rule out reflux disease, as a substantial number of GERD patients do not have any abnormalities seen on endoscopy (NERD).…”

Section: Medical and Surgical Treatment In Nerd He And Fhmentioning

confidence: 99%

“…Patients presenting with symptoms suggestive of reflux disease are often empirically treated with lifestyle advice and acid‐suppressive drugs, including PPIs . When patients do not respond to standard therapy, endoscopic and functional testing is performed to challenge the initial diagnosis and to investigate the causes of treatment refractoriness.…”

Section: Medical and Surgical Treatment In Nerd He And Fhmentioning

confidence: 99%

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Between GERD and NERD: the relevance of weakly acidic reflux

Bortoli

Ottonello

Zerbib³

et al. 2016

Annals of the New York Academy of Sciences

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Nonerosive reflux disease (NERD) is a common condition and the most frequent phenotype of gastroesophageal reflux disease (GERD). NERD is extremely heterogeneous and includes patients with negative endoscopy but abnormal esophageal acid exposure and/or positive reflux-symptom association analysis (hypersensitive esophagus). This segregation is only possible owing to the use of impedance-pH monitoring. Indeed, weakly acidic reflux represents one of the most common causes of refractory symptoms in patients evaluated off antisecretory therapy and, more importantly, during antisecretory drug treatment. Patients with heartburn who do not have any type of reflux underlying their symptoms (functional heartburn) must be excluded from the category of GERD. The drawbacks of impedance-pH are mainly due to the day-to-day variability of the test and the fact that the accuracy of the symptom-reflux correlation scores is often far from perfect. Some histopathological characteristics, such as dilated intercellular spaces, can be helpful in distinguishing patients with NERD through esophageal biopsies. Patients with NERD in whom acid is the main pathogenetic factor respond successfully to proton pump inhibitor therapy, while those with hypersensitive esophagus to weakly acidic reflux could be treated with reflux inhibitors or surgery, although further controlled studies are required.

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Section: Medical and Surgical Treatment In Nerd He And Fhmentioning

confidence: 99%

Section: Medical and Surgical Treatment In Nerd He And Fhmentioning

confidence: 99%