Gastroesophageal reflux disease in the obese: Pathophysiology and treatment

Nadaleto, Barbara Fernandes; Herbella, Fernando A. M.; Patti, Marco G.

doi:10.1016/j.surg.2015.04.034

Cited by 126 publications

(77 citation statements)

References 122 publications

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“…Previous studies have demonstrated that numerous potential mechanisms are involved in the development of GERD, including histologic changes of esophageal inflammation [41], antireflux barrier dysfunction [42], obesity [43], psychological factors [44, 45], hiatal hernia [46], and transient lower esophageal sphincter relaxation (TLESR) [47]. However, our studies, in modern pharmacological field, are consistent with the evidence for the effectiveness of MBXD for GERD.…”

Section: Discussionsupporting

confidence: 89%

Efficacy and Safety of Modified Banxia Xiexin Decoction (Pinellia Decoction for Draining the Heart) for Gastroesophageal Reflux Disease in Adults: A Systematic Review and Meta‐Analysis

Dai

Zhang

et al. 2017

Evidence-Based Complementary and Alternative Medicine

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Modified Banxia Xiexin decoction (MBXD) is a classical Chinese herbal formula in treating gastroesophageal reflux disease (GERD) for long time, but the efficacy of it is still controversial. This study is to evaluate the efficacy and safety of MBXD for the treatment of GERD in adults. The search strategy was carried out for publications in seven electronic databases. RevMan software version 5.3 and the Cochrane Collaboration's risk of bias tool were performed for this review. Twelve RCTs were included for the analysis. The results of overall clinical efficacy and efficacy under gastroscope demonstrated that MBXD was superior to conventional western medicine. Meanwhile, the results of subgroup analysis showed clinical heterogeneity between the two groups. However, there was no statistically significant difference in acid regurgitation between the two groups. But in the improvement of heartburn and sternalgia, the results showed statistically significant differences for the comparison between two groups. In addition, the adverse reactions of the experiment groups were not different from those of the control groups. This systematic review indicates that MBXD may have potential effects on the treatment of patients with GERD. But because the evidence of methodological quality and sample sizes is weak, further standardized researches are required.

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Section: Discussionsupporting

confidence: 89%

Efficacy and Safety of Modified Banxia Xiexin Decoction (Pinellia Decoction for Draining the Heart) for Gastroesophageal Reflux Disease in Adults: A Systematic Review and Meta‐Analysis

Dai

Zhang

et al. 2017

Evidence-Based Complementary and Alternative Medicine

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“…Together with the surrounding crural diaphragm, it forms a valve mechanism at the gastroesophageal junction. The LES prevents reflux by creating a high pressure zone between the stomach and the esophagus . Normal LES function requires both adequate intra‐abdominal sphincter length and adequate resting pressure.…”

Section: Pathogenesismentioning

confidence: 99%

“…In healthy individuals, periodic transient LES relaxation (TLESR) leads to physiological reflux. However, chronic reflux disease can arise when TLESR becomes frequent and prolonged . Defective LES function is one of the main abnormalities in GERD patients .…”

Section: Pathogenesismentioning

confidence: 99%

Insights into the genetics of gastroesophageal reflux disease (GERD) and GERD‐related disorders

Böhmer

Schumacher

2017

Neurogastroenterology Motil

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Gastroesophageal reflux disease (GERD) is associated with obesity and hiatal hernia, and often precedes the development of Barrett's esophagus (BE) and esophageal adenocarcinoma (EA). Epidemiological studies show that the global prevalence of GERD is increasing. GERD is a multifactorial disease with a complex genetic architecture. Genome-wide association studies (GWAS) have provided initial insights into the genetic background of GERD. The present review summarizes current knowledge of the genetics of GERD and a possible genetic overlap between GERD and BE and EA. The review discusses genes and cellular pathways that have been implicated through GWAS, and provides an outlook on how future molecular research will enhance understanding of GERD pathophysiology.

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“…Visceral obesity/increased waist-hip ratio/increased BMI Many studies have demonstrated that obesity is a strong risk factor for the pathogenesis of GERD. [43][44][45][46] However, the association between obesity and BE is less clear. Even though preliminary data from casecontrol studies suggested a significant association between obesity and BE, those results may have been confounded by the presence of GERD.…”

Section: Modifiable Risk Factorsmentioning

confidence: 99%

Risk factors for Barrett's esophagus

Arora

Garber

Thota

2016

J of Digest Diseases

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Barrett's esophagus (BE) is a well-recognized precursor of esophageal adenocarcinoma (EAC) and is defined as ≥1 cm segment of salmon-colored mucosa extending above the gastroesophageal junction into the tubular esophagus with biopsy confirmation of metaplastic replacement of the normal squamous epithelium by intestinal-type columnar epithelium. The incidence of both BE and EAC has been increasing over the past few decades. As a result, preventing the development of BE by identifying and understanding its modifiable and non-modifiable risk factors may help reduce the incidence of EAC. Over the recent past, a tremendous amount of progress has been made towards improving our knowledge of risk factors and pathogenesis of BE. This article reviews the evidence for the various risk factors for developing BE.

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Gastroesophageal reflux disease in the obese: Pathophysiology and treatment

Cited by 126 publications

References 122 publications

Efficacy and Safety of Modified Banxia Xiexin Decoction (Pinellia Decoction for Draining the Heart) for Gastroesophageal Reflux Disease in Adults: A Systematic Review and Meta‐Analysis

Efficacy and Safety of Modified Banxia Xiexin Decoction (Pinellia Decoction for Draining the Heart) for Gastroesophageal Reflux Disease in Adults: A Systematic Review and Meta‐Analysis

Insights into the genetics of gastroesophageal reflux disease (GERD) and GERD‐related disorders

Risk factors for Barrett's esophagus

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