Unmet Needs in the Treatment of Gastroesophageal Reflux Disease

Dickman, Ram; Maradey–Romero, Carla; Gingold‐Belfer, Rachel; Fass, Ronnie

doi:10.5056/jnm15105

Cited by 53 publications

(45 citation statements)

References 120 publications

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“…104,105 PPIs are the most effective medicines for treating GERD. 106 Therefore, patients with GERD are frequently treated with PPIs. 107,108 However, 17-32% of patients with GERD experienced persistent and troublesome heartburn or regurgitation despite standard-dose PPI treatment.…”

Section: Sex/gender and Treatment Responsementioning

confidence: 99%

Sex and Gender Differences in Gastroesophageal Reflux Disease

Kim

2016

J Neurogastroenterol Motil

125

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It is important to understand sex and gender-related differences in gastroesophageal reflux disease (GERD) because gender-related biologic factors might lead to better prevention and therapy. Non-erosive reflux disease (NERD) affects more women than men. GERD symptoms are more frequent in patients with NERD than in those with reflux esophagitis. However, men suffer pathologic diseases such as reflux esophagitis, Barrett's esophagus (BE), and esophageal adenocarcinoma (EAC) more frequently than women. The prevalence of reflux esophagitis is significantly increased with age in women, especially after their 50s. The mean age of EAC incidence in women is higher than in men, suggesting a role of estrogen in delaying the onset of BE and EAC. In a chronic rat reflux esophagitis model, nitric oxide was found to be an aggravating factor of esophageal injury in a male-predominant way. In addition, the expression of esophageal occludin, a tight junction protein that plays an important role in the esophageal defense mechanism, was up-regulated in women. This explains the male predominance of reflux esophagitis and delayed incidence of BE or EAC in women. Moreover, the symptoms such as heartburn, regurgitation, and extra-esophageal symptoms have been more frequently reported by women than by men, suggesting that sex and gender play a role in symptom perception. Differential sensitivity with augmented symptoms in women might have diagnostic and therapeutic influence. Furthermore, recent studies have suggested that hormone replacement therapy has a protective effect against esophageal cancer. However, an anti-inflammatory role of estrogen remains compelling, which means further study is necessary in this area.

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Section: Sex/gender and Treatment Responsementioning

confidence: 99%

Sex and Gender Differences in Gastroesophageal Reflux Disease

Kim

2016

J Neurogastroenterol Motil

125

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“…Der mechanische Funktionsverlust des unteren Ösophagussphinkters (UÖS) ist bei Refluxkranken fast immer nachweisbar, es bleibt im Einzelfall jedoch oft unklar, an welcher Stelle der verschiedenen möglichen pathophysiologischen Sequenzen diese Veränderung eingetreten ist. Vieles deutet darauf hin, dass ernährungsspezifische und mentale Ko-Faktoren häufig nicht erfasst werden, gleichwohl in vielen Fällen eine zentrale Mitursache für das Refluxgeschehen darstellen [23,24].…”

Section: Rationale Für Neue Operative Verfahren Der Gerdunclassified

Hiatushernie und interventionelle bzw. neue operative Therapien der GERD

Freys¹,

Heimbucher²,

Willeke³

2019

Allgemein- und Viszeralchirurgie up2date

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“…Znači da pogoršavanjem simptoma refluksne bolesti, što podrazumeva prisustvo atipičnih simptoma, nije utvrđeno i pogoršanje stepena refluksne bolesti (odnosno nema povezanosti u težini simptoma i proširenosti oštećenja jednjačne sluznice). Ovakav zaključak se može naći i u malom broju raspoložive literature koja se bavila ovom problematikom [15][16][17][18][19][20][21]. Zatim, i kod pacijenata sa vanezofagealnim (atipičnim) simptomima i kod pacijenata sa tipičnim simptomima endoskopski se našao nizak stepen endoskopskih promena (tabela br.…”

Section: Wwwtmgorgrsunclassified

Gastroesophageal reflux disease (GERD): Many faces of one disease

Zec¹

2016

Tim Med Glas

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Sažetak:Gastroezofagealna refluksna bolest jednjaka (GERB, engl. GERD), je patološko stanje ili oboljenje pruzrokovano vraćanjem želudačnog i duodenalnog sadržaja kroz nekompetentni gastroezofagealni spoj u jednjak. Gorušica i regurgitacija su najčešći i najkarakterističniji tipični simptomi GERB-a. Međutim, postoji i čitav niz atipičnih simptoma GERB-a na koje moramo misliti jer u prvom momentu ne izgledaju da su posledica refluksa. Cilj rada je da se istakne značaj atipičnih (ekstraezofagealnih) simptoma GERB-a i utvrđivanje korelacije između atipičnih simptoma kod pacijenata sa refluksnom bolesti jednjaka i njihovog endoskopskog nalaza. Ispitanici su izabrani po metodi slučajnog uzorka i po redosledu javljanja na endoskopski pregled. Osnovni kriterijum je bio da imaju kardinalne simptome GERB-a: gorušicu i regurgitaciju. Endoskopska klasifikacija zatečenih promena u jednjaku je vršena na osnovu Los Angeles endoskopske klasifikacije GERB-a. U toku endoskopskog pregleda uzimane su najmanje po dve biopsije za utvrđivanje helicobacter pylori statusa. Analiziran je uzorak od 88 ispitanika, podeljenih u 3 poduzorka prema stepenu refluksne bolesti. U statističkoj obradi su se koristili multivarijantni postupci, MANOVA i diskriminativna analiza. Od univarijantnih postupaka primenjivao se Royev test. Utvrđeno je da ima statistički značajne povezanosti između težine stepena refluksne bolesti i simptoma: regurgitacija, suv kašalj, globus sindrom, nekardiogeni bol u grudima. Nema povezanosti u težini simptoma i proširenosti oštećenja jednjačne sluznice. Kod pacijenata sa atipičnim simptomima, endoskopski se našao nizak stepen oštećenja sluznice. Gorušica kao kardinalni simptom refluksne bolesti je ispoljena kod najvećeg broja ispitanika, ali nije uočena povezanost između stepena težine refluksne bolesti i učestalosti simptoma gorušice. Zaključeno je da pacijenti sa atipičnim simptomima GERB-a ne moraju imati ili se ne moraju žaliti na gorušicu. Pacijenti se međusobno najviše razlikuju po ORL atipičnim manifestacijama refluksne bolesti, što znači da je ova simptomatologija i najkarakterističnija za atipične manifestacije GERB-a. Strpljivo i iscrpno uzeta anamneza je ključna u prvom koraku dijagnostike pacijenata sa atipičnim manifestacijama GERB-a. U cilju kompletiranja dijagnostike i adekvatnog lečenja, kod pacijenata sa atipičnim manifestacijama GERB-a, potrebno je uraditi i pH metriju i manometriju jednjaka. Ključne reči: GERB, simptomi, endoskopski nalaz, lečenje. Summary:Gastroesophageal reflux disease (GERD) is a pathological condition or disease, caused by returning the gastric and duodenal content through incompetent gastroesophageal junction into the esophagus. Heartburn and regurgitation are the most common and most characteristic typical symptoms of GERD. But there is a whole range of atypical symptoms of GERD that we have to think of, because at first glance they do not seem to be the result of reflux. The aim of this study is to highlight the importance of atypical (extraesophageal) symptoms of GERD and deter...

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Unmet Needs in the Treatment of Gastroesophageal Reflux Disease

Cited by 53 publications

References 120 publications

Sex and Gender Differences in Gastroesophageal Reflux Disease

Sex and Gender Differences in Gastroesophageal Reflux Disease

Hiatushernie und interventionelle bzw. neue operative Therapien der GERD

Gastroesophageal reflux disease (GERD): Many faces of one disease

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