GERD: Diagnosing and treating the burn

Alzubaidi, Mohammed; Gabbard, Scott

doi:10.3949/ccjm.82a.14138

Cited by 19 publications

(8 citation statements)

References 53 publications

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“…GERD is defined as a group symptoms or a presence of mucosal damage caused by abnormal reflux of highly-acidic gastric content into the esophagus or beyond, including into the oral cavity or respiratory pathways[8]. The symptoms of GERD are classified as typical symptoms that include heartburn, sensation of regurgitation and atypical symptoms which are associated with chronic cough, asthma, hoarseness caused by laryngitis, dyspepsia and nausea[9]. Another group of symptoms are defined as alarm symptoms since they can be potentially associated with life-threatening conditions (chest pain/myocardial infarction, dysphagia/esophageal stricture or malignancy)[9,10].…”

Section: Definitionmentioning

confidence: 99%

“…The symptoms of GERD are classified as typical symptoms that include heartburn, sensation of regurgitation and atypical symptoms which are associated with chronic cough, asthma, hoarseness caused by laryngitis, dyspepsia and nausea[9]. Another group of symptoms are defined as alarm symptoms since they can be potentially associated with life-threatening conditions (chest pain/myocardial infarction, dysphagia/esophageal stricture or malignancy)[9,10]. About 70% of GERD patients have non-erosive reflux disease (NERD).…”

Section: Definitionmentioning

confidence: 99%

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Management of gastroesophageal reflux disease: Patient and physician communication challenges and shared decision making

Klenzak

Danelisen

Brannan

et al. 2018

WJCC

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Gastroesophageal reflux disease (GERD) is a common upper esophageal condition and typical symptoms can include heartburn and sensation of regurgitation while atypical symptoms include chronic cough, asthma, hoarseness, dyspepsia and nausea. Typically, diagnosis is presumptive given the presence of typical and atypical symptoms and is an indication for empiric therapy. Treatment management can include lifestyle modifications and/or medication therapy with proton pump inhibitor (PPI) class being the preferred and most effective. Complete symptom resolution is not always achieved and long-term PPI therapy can put patients at risk for serious side effects and needless expense. The brain-gut connection and hypervigilance plays an important role in symptom resolution and treatment success, especially in the case of non-PPI responders. Hypervigilance is a combination of increased esophageal sensory sensitivity in combination with exaggerated threat perception surrounding esophageal symptoms. Hypervigilance requires a different approach to GERD managements, where continued PPI therapy and surgery are usually not recommended. Rather, helping physicians and patients understand the brain-gut connection can guide and improve care. Education and reassurance should be the main pillars or treatment. However, it is important not to suggest the symptoms are due to anxiety alone, this often leads to patient dissatisfaction. Patient dissatisfaction with treatment reveals the need for a more patient-centered approach to GERD management and better communication between patients and providers. Shared decision making (SDM) with the incorporation of patient-reported outcomes (PRO) promotes patient adherence and satisfaction. SDM is a joint discussion between clinician and patient in which a mutually shared solution is explored for GERD symptoms. For SDM to work the physician needs to capture patients’ perceptions which may not be obtained in the standard interview. This can be done through the use of PROs which promote a dialogue with patients about their symptoms and treatment priorities in the context of the SDM patient encounter. SDM could potentially help in the management of patient expectations for GERD treatment, ultimately positively impacting their health-related quality of life.

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Section: Definitionmentioning

confidence: 99%

Section: Definitionmentioning

confidence: 99%

Management of gastroesophageal reflux disease: Patient and physician communication challenges and shared decision making

Klenzak

Danelisen

Brannan

et al. 2018

WJCC

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“…A 6- to 8-week course of empiric proton-pump inhibitor (PPI) therapy, known as the PPI trial, may confirm the presence of GERD when patients have the typical symptoms. [ 13 ] However, this approach has some limitations: negative findings cannot rule out GERD, and PPI trial has a sensitivity of 78% and specificity of 54%. [ 14 ]…”

Section: Introductionmentioning

confidence: 99%

Tongue diagnosis indices for gastroesophageal reflux disease

et al. 2020

Medicine

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Traditional Chinese medicine tongue diagnosis can mirror the status of the internal organ, but evidence is lacking regarding the accuracy of tongue diagnosis to gastroesophageal reflux disease (GERD). This study was to investigate the association between GERD and tongue manifestation, and whether tongue imaging could be initial diagnosis of GERD noninvasively. We conducted a cross-sectional, case-controlled observational study at Kaohsiung Chang Gung Memorial Hospital in Taiwan from January 2016 to September 2017. Participants aged over 20 years old with GERD were enrolled and control group without GERD were matched by sex. Tongue imaging were acquired with automatic tongue diagnosis system, then followed by endoscope examination. Nine tongue features were extracted, and a receiver operating characteristic (ROC) curve, analysis of variance, and logistic regression were used. Each group enrolled 67 participants. We found that the saliva amount ( P = .009) and thickness of the tongue's fur ( P = .036), especially that in the spleen–stomach area (%) ( P = .029), were significantly greater in patients with GERD than in those without. The areas under the ROC curve of the amount of saliva and tongue fur in the spleen–stomach area (%) were 0.606 ± 0.049 and 0.615 ± 0.050, respectively. Additionally, as the value of the amount of saliva and tongue fur in the spleen–stomach area (%) increased, the risk of GERD rose by 3.621 and 1.019 times, respectively. The tongue fur in the spleen–stomach area (%) related to severity of GERD from grade 0 to greater than grade B were 51.67 ± 18.72, 58.10 ± 24.60, and 67.29 ± 24.84, respectively. The amount of saliva and tongue fur in the spleen–stomach area (%) might predict the risk and severity of GERD and might be noninvasive indicators of GERD. Further large-scale, multi-center, randomized investigations are needed to confirm the results. Trial registration: NCT03258216, registered August 23, 2017.

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“…Gastroesophageal reflux diseases (GERDs) are the symptoms or complications resulting from the reflux of gastric contents into the esophagus, oral cavity (including larynx), or lung [1]. GERDs are common clinical chronic diseases that up to 40% of the world's population suffer from at least once a month [2]. e prevalence of gastroesophageal reflux in Asia is lower than that in Europe and America, whereas there is an increasing trend in Asia in recent years [3].…”

Section: Introductionmentioning

confidence: 99%

“…Proton pump inhibitors, antireflux drugs, gastric motility drugs, and antidepressants are usually used in clinics to treat GERDs. Proton pump inhibitor is the preferred drug of choice [2,5]. It is the most potent in inhibiting gastric acid secretion and relieving the pain in patients with GERDs, but 20 to 30 percent of patients reported no significant results [6].…”

Section: Introductionmentioning

confidence: 99%

Zhujie Hewei Granules Ameliorated Reflux Esophagitis in Rats

Qiu

Zhao

et al. 2019

Evidence-Based Complementary and Alternative Medicine

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Background. Gastroesophageal reflux disease (GERDs) is a common chronic digestive system disease, in which the symptoms of reflux esophagitis (RE) seriously affect the quality of life. Aims. We aimed to study the therapeutic effect of Zhujie Hewei granules (ZHG) on reflux esophagitis in model rats. Materials and Methods. A rat model of RE was established with the steps of half pylorus ligation, cardiotomy, and hydrochloric acid perfusion. The rats in treatment groups were orally administered with 1.30, 2.60, or 5.20 g/kg ZHG once daily for 28 days. Histopathological changes of the esophagus were observed with hematoxylin-eosin staining. The content of total bilirubin and pH in gastric juice was determined. Esophageal mucosal injury was assessed by macroscopic observation scores, mucosal injury index scores, and esophageal inflammation scores. The levels of gastrin (GAS), motilin (MTL), and vasoactive intestinal peptide (VIP) in serum were evaluated by using ELISA kits. Results. After treatment with ZHG, the body weight of RE rats tended to increase drastically, the macroscopic observation scores of the esophagus mucous membrane decreased (P<0.05), the mucosal injury index scores decreased (P<0.05), the gastric pH values increased (P<0.05), and the levels of serum MTL and VIP decreased (P<0.05). In addition, the high dose of the ZHG-treated group showed lower serum GAS (P<0.05), while the high and middle doses of the ZHG-treated groups showed lower esophageal inflammation scores (P<0.05). Conclusions. ZHG was effective in treating RE in rats due using mechanisms including improving the pH value of gastric contents, decreasing the gastrointestinal hormones (including GAS, MTL, and VIP), and improving the inflammatory damage.

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GERD: Diagnosing and treating the burn

Cited by 19 publications

References 53 publications

Management of gastroesophageal reflux disease: Patient and physician communication challenges and shared decision making

Management of gastroesophageal reflux disease: Patient and physician communication challenges and shared decision making

Tongue diagnosis indices for gastroesophageal reflux disease

Zhujie Hewei Granules Ameliorated Reflux Esophagitis in Rats

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