scholarly journals Clinical Characteristics of Patients with Gastroesophageal Reflux Disease Refractory to Proton Pump Inhibitors and the Effects of Switching to 20 mg Esomeprazole on Reflux Symptoms and Quality of Life

2015 ◽  
Vol 21 ◽  
pp. 4111-4121 ◽  
Author(s):  
Fuminao Takeshima ◽  
Keiichi Hashiguchi ◽  
Yasunori Onitsuka ◽  
Ken Tanigawa ◽  
Hitomi Minami ◽  
...  
2016 ◽  
Vol 25 (4) ◽  
pp. 537-546 ◽  
Author(s):  
Teodora Surdea-Blaga ◽  
Ion Băncilă ◽  
Daniela Dobru ◽  
Vasile Drug ◽  
Ovidiu Frățilă ◽  
...  

Background & Aims: Gastroesophageal reflux disease (GERD) therapy is challenging and suppression of acid secretion or prokinetics do not cure all cases. Some drugs with protective action on the esophageal mucosa have been used alternatively or in association with proton pump inhibitors (PPIs) and/or prokinetics. The Romanian Society of Neurogastroenterology undertook an Evidence-Based analysis, from which this position paper evolved. Methods: We performed a systematic literature search in PubMed until October 2015, using the terms: sucralfate, guaiazulene, gaiazulene, dimethicone, alginate, antacids and gastroesophageal reflux. Forty-seven papers were included and analyzed. Several statements were elaborated regarding the use of these drugs in GERD. The evidence and recommendations were discussed between the authors. Results: There is evidence in the medical literature suggesting the benefit of these drugs in GERD. In patients with persistent or mild reflux symptoms antacids rapidly relieve heartburn. Alginate-antacid combination is superior both over placebo and antacids to treat mild reflux symptoms, and can be used to treat persistent reflux symptoms despite acid suppressant therapy. Sucralfate is superior over placebo in alleviating GERD symptoms and can be used as maintenance therapy. Guaiazulene-dimethicone improves the quality of life in patients with GERD. Conclusions: Drugs used to protect the esophageal mucosa against acid are useful in alleviating chronic heartburn, especially in patients with mild reflux symptoms. Abbreviations: CS: Chondroitin sulfate; DA: Double Action; EE : Erosive esophagitis ; GERD: Gastroesophageal reflux disease; HA: Hyaluronic acid; H2RA: Histamine 2 receptor antagonist; ITT: Intention to treat; IM: Irsogladine maleate; NERD: Non-erosive reflux disease; PPIs: Proton pump inhibitors; RCT: Randomized controlled trial; RDQ: Reflux disease questionnaire; QoL: Quality of life.


2021 ◽  
Vol 36 (2) ◽  
pp. 63-70
Author(s):  
Pramita G.D. Poerwantoro ◽  
Yuni Astria

Abstrak Penyakit refluks gastroesofageal berat (PRGE)adalah gerakan retrograd isi lambung ke kerongkongan. Pada prematuritas, kelemahan peristaltik esofagus terjadi akibat kurangnya relaksasi reseptif bersihan material refluks ke esofagus. Penyakit ini menyebabkan penurunan kualitas hidup dan komplikasi. Laporan ini bertujuan menggambarkan kasus PRGE parah pada anak marasmik dengan kelahiran prematur. Kasus berasal dari seorang anak perempuan berusia tiga tahun dirawat di Rumah Sakit Umum Cipto Mangunkusumo karena menderita muntah terus-menerus setiap kali setelah menyusu. Pasien lahir prematur pada usia kehamilan 31 minggu dengan berat lahir 900 gram, mengalami malnutrisi berat dan keterlambatan perkembangan. Pasien menjalani prosedur endoskopi, pemeriksaan histopatologi dan didapatkan esofagitis berat, gastritis erosif, striktur pilorik, dan refluks laringofaringeal (LPR).Pasien diberikan proton pump inhibitors (PPIs), menjalani dilatasi pilorik satu kali dan pemasangan nasogastricjejunal feeding tube (NJFT), serta susu formula khusus medium chain tryglyceride (MCT) enam kali sehari. Dalam 18 bulan masa tindak lanjut, pasien menunjukkan peningkatan skor Z berat-berdasarkan-panjang badan, panjang berdasarkan usia dan lingkar kepala berdasarkan usia.Dalam menangani bayi prematur, harus mempertimbangkan PRGE sebagai salah satu etiologi pertumbuhan yang terganggu. Prosedur endoskopi dan pemasangan NJFT untuk terapi nutrisi jangka panjang mengurangi komplikasi dan meningkatkan kualitas hidup.Follow up intensif diperlukan agar mencapai pertumbuhan dan perkembangan optimal.   Kata kunci: anak, komplikasi, GERD, lahir prematur, proton pump inhibitors Severe Gastroesophageal Reflux Disease in Malnourished Children with History of Prematurity Abstract Gastroesophageal reflux disease (GERD) is an involuntary retrograde propulsion of gastric contents to esophagus. In prematurity, esophagus peristaltic weakness due to lack of receptive relaxation contribute to inadequate cleaning of material reflux to esophagus which become GERD predisposition. Furthermore, GERD can cause a decline of quality of life and various complications. This report aimed to describe severe GERD case in a marasmic child with premature birth. A 36-month-old girl was hospitalized at dr. Cipto Mangunkusumo General Hospital because of persistent vomitus after every milk feeding. She was prematurely born at 31 weeks of gestation with birthweight of 900 grams, and become severely malnourished with developmental delayed. She then underwent gastrointestinal endoscopic procedure and histopathology examination that revealed a severe esophagitis, erosive gastritis, pyloric stricture, and laryngopharyngeal reflux (LPR).She was treated with proton pump inhibitors (PPI) and underwent one-time pyloric dilatation with nasogastricjejunal feeding tube (NJFT) insertion and continued with medium chain triglycerides formula six times a day. At 18-month follow-up, weight-for-length Z score, length-for-age and head circumference Z score are increased.In dealing with premature baby, we should consider GERD as one of growth faltering etiologies. Endoscopy procedure followed by NJFT insertion for long-term nutrition therapy in severe GERD are the cornerstones to reduce complications and to improve quality of life. Moreover, close follow up for optimal growth and development should be done in such case. Keywords: children, complications, GERD, premature birth, proton pump inhibitors


2015 ◽  
Vol 143 (11-12) ◽  
pp. 676-680
Author(s):  
Milos Bjelovic ◽  
Tamara Babic ◽  
Igor Dragicevic ◽  
Aleksandar Corac ◽  
Goran Trajkovic

Introduction. Recent data from the studies conducted in the Western countries have proved that patients with gastroesophageal reflux disease have significantly impaired health-related quality of life compared to general population. Objective. The study is aimed at evaluating the burden of reflux symptoms on patients? health-related quality of life. Methods. The study involved 1,593 patients with diagnosed gastroesophageal reflux disease. The Serbian version of a generic self-administered Centers for Disease Control and Prevention questionnaire was used. Statistical analyses included descriptive statistics, Pearson chi-square test and a multiple regression model. Results. Among all participants, 43.9% reported fair or poor health. Mean value of unhealthy days during the past 30 days was 10.4 days, physically unhealthy days 6.4 days, mentally unhealthy days 5.3 days and activity limitation days 4.3 days. Furthermore, 24.8% participants reported having ?14 unhealthy days, 14.9% had ?14 physically unhealthy days, 11.8% reported ?14 mentally unhealthy days, and 9.4% had ?14 activity limitation days. Conclusion. This study addressed complex relationships between reflux symptoms and patients? impaired everyday lives.


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