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October - December 2018 Endoscopic management of dysplasia and early oesophageal cancer "A fundamental aspect of endotherapy is removal of the target lesion by endoscopic mucosal resection, or endosopic submucosal dissection. Residual tissue is subsequently ablated to remove the risk of recurrence. The most validated technique for Barrett's oesophagus is radiofrequency ablation, but other techniques such as hybrid-APC and cryotherapy also show good results." (Best Practice & Research - Clinical Gastroenterology)

14 December 2018 Predictor of Slower Gastric Emptying in Gastroesophageal Reflux Disease-Survey of An Asian-Pacific Cohort. "Subgroup analysis discloses that patients with slower gastric emptying and higher depression score tend to present with non-erosive esophagitis whereas higher BMI level and male gender in patients with normal gastric emptying predict the presence of erosive reflux disease." (Journal of Gastroenterology & Hepatology)

14 December 2018 Artificial intelligence and upper gastrointestinal endoscopy: current status and future perspective. "With recent breakthroughs in artificial intelligence, computer-aided diagnosis (CAD) for upper gastrointestinal endoscopy is gaining increasing attention. Main research focuses in this field include automated identification of dysplasia in Barrett's esophagus and detection of early gastric cancers" (Digestive Endoscopy)

12 December 2018 Proton pump inhibitors and risk of hip fracture: a meta-analysis of observational studies. "Our results suggest that PPI use is significantly associated with an increased risk of hip fracture development, which is not observed in H2RA exposure. Physicians should, therefore, exercise caution when considering a long-term PPI treatment to their patients who already have an elevated risk of hip fracture. In addition, patients should be concerned about the inappropriate use of PPIs; if necessary, then, they should continue to receive it with a clear indication." (Osteoporosis International)

12 December 2018 Wide-area transepithelial sampling with computer-assisted 3-dimensional analysis (WATS) markedly improves detection of esophageal dysplasia and Barrett's esophagus: analysis from a prospective multicenter community-based study. (full text) "Thus, adding WATS to the random 4-quadrant FB [Forceps Biopsy] protocol increased the overall detection of dysplasia by 242% (95% confidence interval 191%–315%). Fewer than 61 patients needed to be tested with WATS to identify an additional case of ED missed with FB." (Diseases of the Esophagus)

10 December 2018 Gastroesophageal reflux disease increases the risk of chronic rhinosinusitis: a nested case-control study using a national sample cohort. "The rate of GERD was higher in the CRS group (17.1% [4020 of 23,489]) than in the control group (9.1% [8522 of 93,956]; p < 0.001). The adjusted OR of GERD was 2.04 (95% CI, 1.96-2.13; p < 0.001) in the CRS group. The results of the subgroup analyses were consistent." (International Forum of Allergy & Rhinology)

7 December 2018 Persistent intestinal metaplasia after endoscopic eradication therapy of neoplastic Barrett's esophagus increases the risk of dysplasia recurrence: meta-analysis. "CRIM was associated with lower risk of dysplasia and advanced neoplasia recurrence compared with CR-D only. Achieving CRIM should remain the goal of EET in dysplastic BE." (Gastrointestinal Endoscopy)

6 December 2018 Preoperative High-Resolution Manometry Criteria are Associated with Dysphagia After Nissen Fundoplication. "HRM criteria could not predict the development of postoperative dysphagia. However, in those with preoperative dysphagia and strong manometry criteria, dysphagia is more likely to resolve after Nissen fundoplication. Meanwhile, in those with preoperative dysphagia and weak manometry, dysphagia may persist and these patients may be better served with a partial fundoplication." (World Journal of Surgery)

January-March 2019 Lifestyle Modifications in Adults and Older Adults With Chronic Gastroesophageal RefluxDisease (GERD). "It is likely that the prevalence of GERD will increase as the prevalence of obesity increases. It is here that registered nurses can play an instrumental role in the prevention and management of GERD in older adults by providing education, promoting health behaviors, and serving as patient advocates." (Critical Care Nursing quarterly)

July-September 2018 THE EFFICACY OF THE DIFFERENT ENDOSCOPIC TREATMENTS VERSUS SHAM, PHARMACOLOGIC OR SURGICAL METHODS FOR CHRONIC GASTROESOPHAGEAL REFLUXDISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS. "This systematic review and meta-analysis shows a good short-term efficacy in favor of endoscopic procedures when comparing them to a sham and pharmacological or surgical treatment. Data on long-term follow up is lacking and this should be explored in future studies." (Arquivos de gastroenterologia)

5 December 2018 Changes in the Distal Esophageal Microbiota in Chinese Patients with Reflux Esophagitis. "The structure of distal esophageal microbiota in Chinese RE patients showed moderate changes compared to healthy volunteers. To what extent these changes are associated with the pathogenesis of reflux esophagitis needs further investigation." (Journal of Digestive Diseases)

5 December 2018 Intestinal metaplasia at the gastroesophageal junction is associated with gastroesophageal reflux but not with Helicobacter pylori infection. (full text) "The finding of IM at an endoscopically normal-appearing GEJ is associated with gastroesophageal reflux but not with HP infection." (Scandinavian Journal of Gastroenterology)

4 December 2018 Prevalenceand Clinical Characteristics of Refractoriness to Optimal Proton PumpInhibitor Therapy in Non-erosive Reflux Disease (full text) “True refractoriness in patients with GERD symptoms attending a secondary care setting is lower than previously reported. Following a careful history and optimal PPI dosing, the rate of refractoriness was 20%. True NERD constitutes only a third of the PPI-refractory group. “ (Alimentary Pharmacology & Therapeutics)

November 2018 SHORT-TERM RESULTS OF MINIMALLY INVASIVE TREATMENT OF GASTROESOPHAGEAL REFLUX DISEASE BY RADIOFREQUENCY (STRETTA): FIRST BRAZILIAN SERIES OF CASES. (full text) "Endoscopic treatment for GERD using radiofrequency was effective in the cases presented herein with no technical complications." (Arquivos de gastroenterologia)

30 November 2018 Long-term Results of Robotic Modified Belsey (Gastroesophageal Valvuloplasty) Fundoplication. "Robotic laparoscopic modified Belsey fundoplication (GEV) is associated with excellent long-term durability, reflux control, and low rates of dysphasia and gas bloat. This procedure may represent an alternative to medical antireflux therapy and other surgical antireflux procedures such as Nissen fundoplication." (Surgical Technology International)

29 November 2018 Effects of proton pump inhibitor on the human gut microbiome profile in multi-ethnic groups in Singapore. (full text pdf) "The study demonstrated alterations in the gut microbiome following omeprazole treatment. This may explain the underlying pathology of increased risk of Clostridium difficile infections associated with omeprazole therapy." (Singapore Medical Journal)

29 November 2018 Reintervention After Antireflux Surgery for Gastroesophageal Reflux Disease in England. "At least 3.6% of patients may require surgical reintervention and 59.5% medical therapy following antireflux surgery in England. The influence of patient characteristics and hospital volume highlights the need for patient selection and surgical experience in successful antireflux surgery." (Annals of Surgery)

9 August 2018 The incidence of esophageal cancer and dysplasia in a Chinese population with nondysplastic Barrett's esophagus. (full text) "In a Chinese population with nondysplastic BE, 15.7% of cases developed LGD, with an incidence rate of 2.9% per year, and 2% of cases developed EAC, with an incidence rate of 0.4% per year." (JGH open)

2 April 2018 Risk of small intestinal bacterial overgrowth in patients receiving proton pump inhibitors versus proton pump inhibitors plus prokinetics. (full text) "The use of prokinetics in patients on PPI may reduce the risk of SIBO by enhancing intestinal motility and may reduce SIBO risk associated with long-term PPI use." (JGH open)

28 January 2018 Adiponectin level changes among Egyptians with gastroesophageal reflux disease. (full text) "Low serum adiponectin level appears to be associated with an increased risk of erosive esophagitis, and visceral fat accumulation is related to the impaired secretion of adiponectin, which may have an influence on the pathogenesis of GERD." (JGH open)

11 October 2017 Risk stratifying the screening of Barrett's esophagus: An Asian perspective. (full text) " We demonstrated that no symptoms were indicative of BE in an Asian setting. Age ... and male gender ... proved significant demographic factors for the presence of intestinal metaplasia" (JGH open)

29 November 2018 FindingsChallenge Recommended Time Frame for Barrett’s Eradication (full text) “For patients with Barrett’s esophagus that is indicated for endoscopic eradication, complete eradication of intestinal metaplasia (CEIM) within 18 months has been proposed as a quality indicator. However, a new study evaluating this time frame found no effect on outcome, challenging the clinical utility of the metric.” (Gastroenterology and Endoscopy News)

29 November 2018 ForPPIs, Eat First ... Or Later (full text) “Patients with gastroesophageal reflux disease taking esomeprazole may experience similar reductions in the severity and frequency of their symptoms whether they ingest the medication before or after meals, Israeli researchers have found.” (Gastroenterology and Endoscopy News)

29 November 2018 NewGuidelines Are Not Expected to Recommend Routine Follow-up forGastrointestinal Metaplasia (full text) “Bucking recommendations by European specialists, the American Gastroenterological Association will not consider endoscopic surveillance of gastrointestinal metaplasia standard practice in its new guidelines on the topic, according to a preliminary version that is now open for public comment. Despite the evidence that GI metaplasia is precancerous, a literature search did not yield adequate evidence that surveillance yields an objective net benefit to patients, according to the guidelines panel. ” (Gastroenterology and Endoscopy News)

28 November 2018 Work stress and the risk of cancer: A meta‐analysis of observational studies "a significant association between work stress and esophagus cancer was found in Europe, but not in North America" (International Journal of Cancer)

28 November 2018 A biomarker panel predicts progression of Barrett's esophagus to esophageal adenocarcinoma. "Expert LGD, AOL [Aspergillus oryzae lectin], and p53 independently predict neoplastic progression in BE patients and are applicable to routine practice. These biomarkers can aid in selecting patients for endoscopic ablation or more intensive surveillance." (Diseases of the Esophagus)

27 November 2018 [Esophageal motility and reflux characteristics in gastroesophageal reflux disease patients with or without extra-esophageal symptoms]. "The pathogenesis of GERD with extra-esophageal symptoms may be different from typical GERD. Increase of proximal esophageal reflux and abnormal nonacid reflux may all participate in the mechanisms of GERD with extra-esophageal symptoms." (Zhonghua yi xue za zhi)

27 November 2018 The prevalence of gastroesophageal reflux disease in an adult, South African black population, and the association with obesity.  "GORD is more common in black females than males and in the former group its prevalence rose with increasing BMI and then decreases at BMIs exceeding 33.1. The reason for the gender differences and the inverted 'U' shaped relationship between GORD and BMI are not known and require further investigation." (Minerva Gastroenterologica e dietologica)

27 November 2018 Aseven-Gene Signature assay improves prognostic risk stratification ofperioperative chemotherapy treated gastroesophageal cancer patientsfrom the MAGIC trial (full text) “These results suggest that gene-based risk groups can independently predict prognosis in gastroesophageal cancer patients treated with neoadjuvant chemotherapy. This signature and associated assay may help risk stratify these patients for post-surgery chemotherapy in future perioperative chemotherapy-based clinical trials. “ (Annals of Oncology)

27 November 2018 The Present Status and Future of Barrett's Esophageal Adenocarcinoma in Japan.  "The future trend in the incidence of Barrett's esophageal adenocarcinoma in Japan will depend on the increase in the incidence of reflux esophagitis, which is essential for the development of Barrett's esophagus and Barrett's esophageal carcinoma. The obesity rate is lower in Japan than that in Europe and the United States, and the incidence and severity of reflux esophagitis are low. We expect that the incidence of Barrett's esophageal adenocarcinoma in Japan will not rise as high as in Europe and the United States, and will remain below 10%." (disgestion)

26 November 2018 Famotidine (full text) "Famotidine decreases the production of stomach acid, and its pharmacologic activity is used in the treatment of acid-related gastrointestinal conditions. Famotidine is available both by prescription and over-the-counter (OTC). It is US Food and Drug Administration (FDA) approved and available through prescription for the treatment of duodenal ulcer, gastric ulcer, and gastroesophageal reflux disease (GERD) in adults and children, with a further indication for treatment of pathological hypersecretory conditions in adults. Famotidine is also FDA approved for over-the-counter treatment and prevention of heartburn due to gastroesophageal reflux in adults and pediatrics. Famotidine is used off-label for reducing gastrointestinal risks of NSAIDs. It is also used off-label for the treatment of refractory urticarial, prevention of stress ulcer in critically-ill patients and symptomatic relief of gastritis." (StatPearls)

26 November 2018 Benefits of the Seattle biopsy protocol in the diagnosis of Barrett's esophagus in a Chinese population. (full text) "The Seattle protocol improved the IM detection in our subjects with higher Prague criteria M levels and disclosed more cases with dysplastic tissues." (World Journal of Clinical Cases)

November 2018 Tethered capsule endomicroscopy for microscopic imaging of the esophagus,stomach, and duodenum without sedation in humans "TCE is a safe and feasible procedure for obtaining high-resolution microscopic images of the upper GI tract without endoscopic assistance or sedation." (Gastrointestinal Endoscopy)

26 November 2018 Investigating rates of reoperation or postsurgical gastroparesis following fundoplication or paraesophageal hernia repair in New York State. The results revealed low reoperation rates following both fundoplication and PEH repairs, with no significant difference between the two groups. Additionally, PEH repair patients tended to be older and were more likely to have a comorbidity compared to fundoplication patients, particularly in the setting of hypertension, obesity, and fluid and electrolyte disorders." (Surgical Endoscopy)

25 November 2018 Long-term efficacy of laparoscopic Nissen versus Toupet fundoplication for the management of types III and IV hiatal hernias.  "Patient-reported symptoms and satisfaction did not vary for patients receiving laparoscopic Nissen versus Toupet fundoplication, which may indicate that patients with large type III and IV hiatal hernia undergoing either procedure have similar long-term postoperative symptom control." (Surgical Endoscopy)

25 November 2018 Effect of proton pump inhibitors on the risk and prognosis of infections in patients with cirrhosis and ascites. "Approximately half of patients with cirrhosis and ascites use PPI. This use increases their risk of bacterial infections, but does not affect their prognosis after an infection occurs." (Liver International)

25 November 2018 The dysphagia stress test for rapid assessment of swallowing difficulties in esophageal conditions. "The DST is the first rapid assessment tool designed for gastroenterology clinics with direct observation of swallowing ability across several conditions to mitigate issues related to patient self-report of esophageal symptoms." (Neurogastoenterology & Motility)

25 November 2018 Advancesin Management of Esophageal Motility Disorders (fulltext) High-resolution manometry and the CC [Chicago Classification] have led to a major restructuring in the classification of esophageal motility disorders. Along with this has come the recognition that a defining feature of the major esophageal motility disorders is obstructive physiology, whether the EGJ, the distal esophagus, or both” (Clinical Gastroenterology and Hepatology)

23 November 2018 Thailand Dyspepsia Guidelines: 2018. (full text pdf downloadable) "This guideline is mainly focused on the following four topics: (1) evaluation of patients with dyspepsia, (2) management, (3) special issues (overlapping gastroesophageal reflux disease/irritable bowel syndrome and non-steroidal anti-inflammatory drug/aspirin use), and (4) long-term follow-up and management to provide guidance for physicians in Thailand and other limited-resource areas managing such patients." (Journal of Neurogastroenterology & Motility)

23 November 2018 Molecularpathways in the development and treatment of oesophageal cancer these findings not only suggest new avenues for treatments in a cancer type with appalling outcomes, but also a new era of molecular rather than purely anatomical classification and staging of oesophageal cancer “ (Best Practice & Research Clinical Gastroenterology)

22 November 2018 [Medium and long-term respiratory outcome in patients operated from congenital diaphragmatic hernia: From a series of 56 patients]. "The long-term respiratory outcome of CDH operated patients is characterized by a moderate prevalence of respiratory symptoms and alterations in PFT [Pulmonary Function Test] that are important to consider in their medical follow-up during adolescence and adulthood. PAH is common in the neonatal period but rarely seems to persist. (Revue de pneumologie clinique)

22 November 2018 Cystic fibrosis is associated with an increased risk of Barrett's esophagus. "Adults with CF have a 3-fold increased risk of BE or related neoplasia and appears to develop at younger ages. Consideration should be given to screening for BE in select CF patients" (Journal of Cystic Fibrosis)

22 November 2018 [Alginate on demand as add-on for patients with gastro-oesophageal reflux disease and insufficient PPI effect]. (full text in German) "In summary, we have shown that a demand-adapted therapy with an alginate with the aim of postprandial and nocturnal symptom control an effective and safe option for GERD patients who have a sole acid control by PPI persistent symptoms." (Deutsche medizinische Wochenschrift) (sponsored by Reckitt Benckiser)

21 November 2018 Cryotherapy in the management of premalignant and malignant conditions of the esophagus. (full text) "In conclusion, cryotherapy is an effective and a safe method for the ablation of wide range of esophageal lesions from LGD to advanced cancers. Even though the efficacy is slightly inferior to RFA, it can be used in situations when RFA is ineffective or not feasible. Large randomized controlled trials are needed before cryotherapy has an established role in the management of neoplastic processes in the esophagus." (World Journal of Gastroenterology)

20 November 2018 Role of Acid Suppression in Acid-related Diseases: Proton Pump Inhibitor and Potassium-competitive Acid Blocker. (full text pdf downloadable) "Vonoprazan is a first-in-class potassium-competitive acid blocker, which has distinct advantages compared to other conventional proton pump inhibitors in terms of the rate and effectiveness at which gastric acid suppression occurs. Due to its strong gastric acid suppression capabilities, vonoprazan serves as an effective drug for the treatment of gastroesophageal reflux disease and H. pylori infection." (Journal of Neurogastroenterology & Motility)

20 November 2018 Gastroesophageal Reflux in Asymptomatic Patients with Diabetes: An Impedance Study Diabetes, Obesity and Gastroesophageal Reflux. "Acid reflux is common in patients with diabetes.GER is associated with the existence of obesity rather than hyperglycemia." (Experimental and Clinical Endocrinology & Diabetes)

16 November 2018 Omeprazole protects against cisplatin-induced nephrotoxicity by alleviating oxidative stress, inflammation, and transporter-mediated cisplatin accumulation in rats and HK-2 cells. (full text) "OME showed renoprotective effect against CP-induced toxicity in HK-2 cells and rat kidneys, by suppressing oxidative stress and mediating NF-κB-dependent inflammation, apoptosis, and transporter function." (Chemico-biological interactions)

15 November 2018 Relative potency of proton-pump inhibitors, Helicobacter pylori therapy cure rates, and meaning of double-dose PPI. (full text) "Simply doubling the dose of any PPI achieves markedly different effects on pH4-time. However, PPIs can be used interchangeably and cost effectively based on their omeprazole equivalency." (Helicobacter)

14 November 2018 Barrett's oesophagus: A qualitative study of patient burden, care delivery experience and follow-up needs. (full text) "Ten subthemes and three main themes emerged from the analysis: (a) burden of disease-symptom control, worry of oesophageal cancer and surveillance endoscopy; (b) follow-up experiences-follow-up care, at this NHS hospital, was found to be inconsistent and often inadequate to meet patients' needs, in particular a lack of disease-specific information; and (c) follow-up needs-participants sought enhanced communication, organization and structure of care. They highly valued face-to-face interaction with a specialist, and the concept of direct secondary care access in-between endoscopies was reassuring to participants." (Health Expectations)

November 2018 The use of proton pump inhibitors among older adults with intellectual disability: A cross sectional observational study. (full text) "PPI use among older people with intellectual disability is prevalent and frequently long term, often without a clear indication. PPI use especially among those with severe/profound ID and those who live in residential care homes, could predispose these individuals to additional comorbidities and in order to avoid inappropriate long term of use regular review is required." (Saudi Pharmaceutical Journal)

13 November 2018 Dexlansoprazole and Esomeprazole Do Not Affect Bone Homeostasis in Healthy Postmenopausal Women. "Our findings indicate that 26 weeks of treatment with a PPI has no clinically meaningful effects on bone homeostasis." (Gastroenterology)

13 November 2018 Associations between Community-Acquired Pneumonia and Proton Pump Inhibitors in the Laryngeal/Voice-Disordered Population. "Patients without and with pre-index date PPI use experienced a roughly 30% to 50% increased likelihood of CAP, respectively, as compared with patients who had not had PPI prescriptions." (Otolaryngology - head and neck surgery)

12 November 2018 Swallowing MRI-a reliable method for the evaluation of the postoperative gastroesophageal situs after Nissen fundoplication. "MR swallowing readily depicts the major failure mechanisms of LARS and has good reliability even in non-experienced readers." (European Radiology)

10 November 2018 Short-Term Symptomatic Relief in Gastroesophageal Reflux Disease: A Comparative Study of Esomeprazole and Vonoprazan. (full text) "At 4 weeks, the treatment response rates for symptom relief according to the GerdQ were 88.0% in the esomeprazole group and 81.8% in the vonoprazan group. The GOS  [Global Overall Symptom] scales, which reflect the impact of GERD symptoms, were similar for both groups. The FSSG [Frequency Scale for the Symptoms of GERD] scores decreased from the 1st to the 14th day in both groups.


There were no substantial differences in the symptom relief between the two groups at any time point in this short-term study.(Digestive Diseases & Sciences)

7 November 2018 The Relationship Between Hiatal Hernia and Cricopharyngeus Muscle Dysfunction. "many have hypothesized that a hypertrophied CPM may develop as a protective compensation against gastroesophageal reflux disease ... The frequency of CPMD in the HH group was 78% versus 58% in the non-HH group (p < 0.05). Individuals with a HH were 2.57 times more likely to have evidence of CPMD (95% CI 1.07- 6.15). Although these data suggest an association between GERD and CPMD, further research is required before a causal relationship can be presumed." (Dysphagia)

5 November 2018 Dietaryvitamin B intake and the risk of esophageal cancer: a meta-analysis These findings support that vitamin B may have an influence on carcinogenesis of the esophagus. Vitamin B1, B3, B6, B9 showed a decreased risk of EC, and vitamin B12 showed an increased risk of EC.” (Dove Press)

2 November 2018 Dual Delayed-Release Dexlansoprazole for Healing and Maintenance of Healed Erosive Esophagitis: A Safety Study in Adolescents. (full text) "Dexlansoprazole is safe and efficacious for healing EE and maintenance of healed EE in adolescents." (Digestive Diseases & Sciences)

1 November 2018 Risk of Esophageal Adenocarcinoma After Antireflux Surgery in Patients With Gastroesophageal Reflux Disease in the Nordic Countries. "Medical and surgical treatment of GERD were associated with a similar reduced esophageal adenocarcinoma risk, with the risk decreasing to the same level as that in the background population over time, supporting the hypothesis that effective treatment of GERD might prevent esophageal adenocarcinoma." (JAMA oncology)

1 November 2018 [Gastroesophageal reflux disease is associated with high risk of obstructive sleep apnea syndrome]. " More GERD patients are combined with high risk OSAS than controls, especially subjects with reflux esophagitis. Male and aging GERD patients with acid regurgitation and reflux esophagitis need further evaluation on OSAS screening." (Zhongua nei ke za zhi)

1 November 2018 Removing the magnetic sphincter augmentation device: operative management and outcomes. "Recurrent or persistent symptoms of reflux, dysphagia, or device erosion can lead to removal of the magnetic sphincter augmentation (MSA aka Linx) device. ... MSA removal when necessary can be accomplished through minimally invasive means. Repeat Linx or fundoplication can be performed after removal, however may not be necessary in patients with removal for dysphagia." (Surgical Endoscopy)

November 2018 Diagnostic yield of ambulatory oesophageal studies on versus off proton pump inhibitors: a systematic review and meta-analysis. (full text) " Oesophageal studies after proton pump inhibitor cessation improve the positive yield for acid reflux-related events but reduce the detection of symptomatic non-acid reflux events." (United European Gastroenterology Journal)

November - December 2018 Gastroesophageal reflux disease, functional dyspepsia and irritable bowel syndrome: common overlapping gastrointestinal disorders. (full text pdf) "The aim of the present review article was to appraise and discuss the current evidence supporting the possible concomitance of GERD with IBS and FD in the same patients and to evaluate how various GERD treatments could impact on the quality of life of these patients." (Annals of Gastroenterology)

October 2018 Comparative Study of Alginate and Omeprazole in Symptomatic Treatment of Non-erosive Gastroesophageal Reflux Disease. "achieving complete symptom relief (heart burn) was 56.7% in alginate group & 60% in omeprazole group. ... Therapeutic efficacy and safety profiles of alginate were comparable to omeprazole after two weeks treatment in NERD subjects. So alginate may be considered as a relevant and effective alternative medication in non-erosive reflux." (Mymensingh Medical journal)

October 2018 On-demand versus half-dose continuous therapy with esomeprazole for maintenance treatment of gastroesophageal reflux disease: A randomized comparative study. (full text) "Intensities and frequencies of heartburn and regurgitation responded well to maintenance treatment in patients in the on-demand and continuous groups. On-demand therapy with esomeprazole 40 mg appears to be sufficient for maintenance treatment in GERD patients." (Medicine - Baltimore)

September - December 2018 [Pharmaceutical prescription of proton pump inhibitors and ranitidine in the general population living in the area of the Healthcare Authority and University of Udine (Friuli Venezia Giulia, Northeastern Italy)] "in 2016, 162 persons per 1,000 used those medications; in particular, 158/1,000 used PPIs. Prevalence of use increased with age, as did the median treatment duration with PPIs. Co-prescription of two medications of the same class were observed in 0.43% of antacid users. The likelihood of receiving co-prescriptions was higher among non-elderly subjects, long-term PPI users, and those with chronical diseases, such asthma." (Epidemiologia e prevenzione)

30 October 2018 Pneumatic dilation versus laparoscopic Heller's myotomy in the treatment of achalasia: systematic review and meta-analysis based on randomized controlled trials. "There was no significant difference in terms of LESP or GER. For the treatment of esophageal achalasia, LHM and PD were found to be similar in terms of their long-term efficacy, as well as in terms of the posttreatment GER rates. However, the perforation rate appears to be lower when LHM is employed." (Diseases of the Esophagus)

30 October 2018 Impact of Barrett's esophagus surveillance on the prognosis of esophageal adenocarcinoma: A meta-analysis. "Our meta-analysis supported the concept that endoscopic surveillance for patients with Barrett's esophagus could improve the prognosis of esophageal adenocarcinoma" (Journal of Digestive Diseases)

29 October 2018 Endoscopic therapy for confirmed low-grade dysplasia in Barrett's esophagus. (full text) "To date, the management in case of confirmed low-grade dysplasia (LGD) remains controversial. In this article we summarize the available endoscopic options and their results in terms of efficacy and safety in the treatment of confirmed LGD in BE." (Translational Gastroenterology & Hepatology)

29 October 2018 Endosheath ultrathin transnasal endoscopy is a cost-effective method for screening for Barrett's esophagus in patients with GERD symptoms.  "Both uTNE and standard endoscopy seem cost effective screening methods in a screening cohort of 50-year-old white men with GERD at a willingness to pay cut-off of $50,000." (Gastrointestinal Endoscopy)

28 October 2018 Missed Opportunities for Screening and Surveillance of Barrett's Esophagus in Veterans with Esophageal Adenocarcinoma. "Despite having established risk factors for BE, the majority of EAC patients had no prior EGD to screen for BE. BE screening may represent the largest missed opportunity to reduce EAC mortality" (Digestive Diseases & Sciences)

26 October 2018 AdverseEffects of Proton Pump Inhibitors: Fact or Fake News? (full text) When PPIs are prescribed appropriately, the benefits greatly outweigh potential adverse effects. The absolute risk to an individual is extremely low (less than 1 in 500) and fear of these risks should not dictate prescribing habits.Not only has the information derived from these observational studies been unhelpful, but also the unattended consequence is that patients who require PPIs to prevent UGI bleeding are not receiving these medications, mainly due to fear on the part of the patient and provider.” (Current opinion in Gastroenterology) 

26 October 2018 ProtonPump Inhibitor Doesn't Reduce ICU Mortality 

(full textGiving intensive care unit (ICU) patients a proton-pump inhibitor (PPI) to prevent gastrointestinal bleeding does not seem to affect mortality, according to a European trial of nearly 3,300 adults.” (New England Journal of Medicine)

25 October 2018 Potent Acid Suppression with PPIs and P-CABs: What's New? "Vonoprazan, the first P-CAB, has so far been introduced only into a small number of Asian countries. Safety issues have been extensively addressed in numerous publications. This review sets the needs, individual new drug classes and key individual new treatments into clinical context." (Current Treatment Options in Gastroenterology)

25 October 2018 Gastroesophageal and Laryngopharyngeal Reflux Associated with Laryngeal Malignancy: A Systematic Review and Meta-Analysis. "In a systematic review and meta-analysis, we found a significant association between reflux disease and the presence of laryngeal malignancy. " (Clinical Gastroenterology & Hepatology)

25 October 2018 Laryngopharyngeal Reflux and Functional Laryngeal Disorder: Perspective and Common Practice of the General Gastroenterologist. "In this article, which focuses on the perspective and common practice of the general gastroenterologist, we review our understanding of the pathophysiology, diagnosis, and treatment of LPR" (Gastroenterology & Hepatology)

23 October 2018 Protective Propensity of Race or Environmental Features in the Development of Barrett's Esophagus in African Americans - A Single Center Pilot Study. "Salmon colored esophageal mucosa was observed in 1105 of 15,564 patients (7.1%) with BE histologically confirmed in 249 of 1105 patients (23%). Ethnic distribution of histologic BE patients: 83% non-Hispanic white (nHw), 13% African American (AA) and 4% other. No difference was seen between groups with regard to BMI, GERD symptom/complications, BE length, and cigarette, alcohol or medication use." (Journal of the National Medical Association)

22 October 2018 Independent factors associated with the impact of gastroesophageal reflux disease on health-related quality of life. (full text pdf) "the principal factors independently associated with a deterioration in health-related quality of life in patients with gastroesophageal reflux disease included the severity of typical symptoms and the presence of dyspepsia. There is also an additional impact of body mass index and the psychological component." (Revista Espanola de enfermadades digestives)

21 October 2018 Cardiovascular and non-cardiovascular concerns with proton pump inhibitors: Are they safe?  "Clinical epidemiology evidence coming from well-designed analyses of observational data consistently reported that long-term use of PPIs may increase the risk of cardiovascular events among patients treated with thienopyridines, tubular-interstitial nephritis and chronic kidney disease, hypomagnesemia, and fractures. Conversely, currently available evidence about the impact of PPIs on cardiovascular risk among patients not treated with thienopyridines, infections, nutritional disorders, cognitive impairment and dementia is limited by confounding." (Trends in Cardiovascular Medicine)

19 October 2018 A phase I pilot study evaluating the beneficial effects of black raspberries in patients with Barrett's esophagus. (full text) "LBR significantly decreased urinary lipid peroxidation levels and significantly increased GST-pi, a marker of detoxification, in BE epithelium. Still, LBR [lyophilized black raspberries] may need to be formulated differently, administered at higher concentrations or multiple times a day to increase efficacy." (Oncotarget)

18 October 2018 New Approaches to Diagnosis and Treatment of Functional Dyspepsia. "Regarding non-pharmacological treatment, recent topics include acupuncture, electrical stimulation, gastric peroral endoscopic myotomy, and meal and lifestyle modification. These treatments have provided significant efficacy, which provides some insights into the main pathophysiology of this disease. Although FD is common among functional gastrointestinal disorders, it is not easy to relieve the dyspeptic symptoms of FD patients. Combinations of pharmacological and non-pharmacological treatment options are expected" (Current Gastroenterology Reports)

17 October 2018 Clinical Characteristics and Outcomes of Patients With Post-Fundoplication Dysphagia. "Early and late post-fundoplication dysphagia can be successfully managed conservatively or with endoscopic dilation, respectively. Lack of contraction reserve on multiple rapid swallows is independently associated with late post-fundoplication dysphagia." (Clinical Gastroenterology & Hepatology)

17 October 2018 Negative Association of Proton Pump Inhibitors With Subsequent Development of Breast Cancer: A Nationwide Population-Based Study. "Our findings may suggest that women at a higher-than-average risk of breast cancer may benefit from PPI prescriptions if they have medical conditions that could benefit from PPIs." (Journal of Clinical Pharmacology)

17 October 2018 Duration and dosing of Proton Pump Inhibitors associated with high incidence of chronic kidney disease in population-based cohort. (full text) "In this study, we found that use of Proton Pump Inhibitors is associated with an increased risk in the development of CKD, especially after a total exposure time of more than three months and if high doses are used.

"Although cause and effect cannot be determined with an observational study, providers should consider whether PPI therapy is indicated for the individuals. Careful monitoring of kidney function while on PPI use and cessation of PPIs when there is no clear indication for use might reduce the population burden of CKD." (PLoS One)

17 October 2018 RecentAdvances In Surveillance of Patients With Barrett’s Esophagus (full text) “Multiple challenges remain for the accurate risk stratification and detection of dysplasia in patients with BE undergoing surveillance, given the overall low rate of BE progression to neoplasia and the patchy distribution of the disease. Recently published data using the PIB score will aid in risk-stratifying patients with BE at high versus low risk for progression to HGD/cancer. Furthermore, careful inspection of the BE mucosa and the concept of Barrett’s inspection time will improve the recognition of HGD/cancer lesions within the BE mucosa. Finally, the use of advanced techniques, such as acetic acid CE, virtual CE, and WATS, can improve the effectiveness of surveillance programs.” (Gastroenterology & Endoscopy News)

17 October 2018 SignificantAssociation Between the Use of Different Proton Pump Inhibitors andMicroscopic Colitis (full textWe found a strong association between microscopic colitis and ongoing use of proton pump inhibitors, especially lansoprazole.” (Alimentary Pharmacology & Therapeutics)

March 2018 Effect of long-term proton pump inhibitors on bone mineral density. "Long-term PPI use is associated with risk of bone complications, especiallyamong patients at risk for osteoporosis. It seems reasonable to be more vigilant in prescribing PPIs and to use the lowest effective dose for patients with appropriate indications." (La Tunisie Medicale)

15 October 2018 Revisiting Montreal: New Insights into Symptoms and Their Causes, and Implications for the Future of GERD. (full text) "the concept of GERD as a composite, symptom-based entity needs re-evaluation, so that new understandings of upper GI symptoms can direct more precise management." (American Journal of Gastroenterology)

15 October 2018 Some of the effective factors in the pathogenesis of gastro-oesophageal reflux disease. (full text) "The aetiology of oesophageal mucosal damage is complicated. Many inflammatory mediators are produced within the gastrointestinal (GI) tract, but their contributions in pathophysiology and disease pathogenesis have not been well investigated. Despite the protective barrier provided by the oesophageal mucosa, refluxed materials can cause oxidative injury and inflammatory responses that involve the epithelium and immune cells. ... we want to discuss some of the important and key factors of GERD disease in this article." (Journal of Cellular and Molecular Medicine)

November 2018 KAAACI Evidence-Based Clinical Practice Guidelines for Chronic Cough in Adults and Children in Korea. (full text) "a considerable proportion of adult patients with chronic cough are unexplained or refractory to conventional treatment. The present clinical practice guidelines aim to address major clinical questions regarding empirical treatment, practical diagnostic tools for non-specific chronic cough, and available therapeutic options" (Allergy, asthma & immunology research)

October  2018 The relationship between adenoid hypertrophy and gastroesophageal reflux disease: A meta-analysis. (full text) "This meta-analysis provided a strong correlation between adenoid hypertrophy and GERD, the children with adenoid hypertrophy had a higher incidence of GERD than healthy children, but the pathogenesis of GERD in adenoid hypertrophy awaits more investigations and suggests that we should not overlook GERD in clinical practice and an appropriate evaluation for GERD may be needed." (Medicine- Baltimore)

11 October 2018 Prevalence of esophageal inlet patch and clinical characteristics of the patients. (full text in Spanish) "The prevalence of IP was high. The primary referral diagnosis was gastroesophageal reflux disease. No differences were found in relation to symptoms or the presence of Barrett's esophagus between the patients with and without IP." (Revista de Gastroenterologia de Mexico)

11 October 2018 Gastroesophageal Reflux Disease in Idiopathic Pulmonary Fibrosis: Uncertainties and Controversies.  "On the basis of the possible beneficial effects of antireflux or antacid therapy on lung function, acute exacerbation, and survival, the recent international IPF guideline recommends antacid therapies for patients with IPF, regardless of symptomatic GERD. However, due to newer conflicting data, several national guidelines do not support this recommendation." (Respiration)

10 October 2018 Surgical outcomes and over one year follow-up results of laparoscopic Nissen fundoplication for gastroesophageal reflux disease: Single-center experiences. (full text) "LNF is a feasible, safe, and effective treatment option for controlling GERD symptoms as well as improving the quality of life. Presence of reflux esophagitis was a predictor of successful outcomes." (Asian Journal of Surgery)

10 October 2018 Minimally Invasive Intragastric Approach to Gastroesophageal Junction Pathology. "Resection of selected intramural GEJ pathology using a minimally invasive trans-gastric approach can be performed safely with acceptable morbidity and good long-term results. The approach allows preservation of the LES and vagi, a potential advantage compared to other surgical alternatives to resection in this region." (Annals of Thoracic Surgery)

9 October 2018 Benchmarking of a Simple Scintigraphic Test for Gastro-oesophageal Reflux Disease That Assesses Oesophageal Disease and Its Pulmonary Complications (full text) "Scintigraphic reflux studies offer a viable alternative test for GORD and extra-oesophageal manifestations of reflux disease. Strong correlations were found between measurable scintigraphic parameters and oesophageal motility and lung aspiration of refluxate. This may provide a more confident decision analysis in patients being considered for fundoplication for troubling extra-oesophageal symptoms." (Molecular imaging and radionuclide therapy)

October 2018 [The acid pocket - a novel target for the treatment of gastro-esophageal reflux disease]. "Recently, the acid pocket has been proposed as a target for pharmacological and surgical therapies of GERD. Proton pump inhibitors and related medications reduce its acidity; whereas, alginate preparations, prokinetics, and fundoplication displace it away from the gastro-esophageal junction." (Zeitschrift fur Gastroenterologie)

8 October 2018 An Ethanolic Extract of Allium hookeri Root Alleviates Reflux Esophagitis and Modulates NF-κB Signaling. (full text) "AHE suppressed LPS-induced inflammatory responses in RAW264.7 cells and may help reduce the development of esophagitis through the modulation of inflammation by regulating NF-κB activation." (Evidence-based complementary & alternative medicine)

8 October 2018 Proton Pump Inhibitors, Histamine-2 Receptor Antagonists, and Hip Fracture Risk among Patients on Hemodialysis. "Among patients with ESKD on hemodialysis, PPIs and not histamine-2 receptor antagonists were associated with hip fracture events." (Clinical Journal of the American Society of Nephrology)

7 October 2018 Prevalence and clinical characteristics of refractoriness to optimal proton pump inhibitor therapy in non-erosive reflux disease. "True refractoriness in patients with GERD symptoms attending a secondary care setting is lower than previously reported. Following a careful history and optimal PPI dosing, the rate of refractoriness was 20%. True NERD constitutes only a third of the PPI-refractory group." (Alimentary Pharmacology & Theraputics)

5 October 2018 Buried Barrett's Esophagus with High-Grade Dysplasia after Radiofrequency Ablation.  "Here, we describe a new case of subsquamous neoplasia (high-grade dysplasia) following radiofrequency ablation that was managed with endoscopic resection. Our experience suggests that a meticulous endoscopic inspection prior to and after radiofrequency ablation is fundamental to reduce the risk of buried neoplasia development." (Cinical Endoscopy)

4 October 2018 ARE THE PERSISTENT SYMPTOMS TO PROTON PUMP INHIBITOR THERAPY DUE TO REFRACTORY GASTROESOPHAGEAL REFLUX DISEASE OR TO OTHER DISORDERS? (full text) "the problem is not the treatment but the diagnosis. Causes of misdiagnosis of GERD are functional heartburn, achalasia, megaesophagus, eosinophilic esophagitis, other types of esophagitis, and other causes. The diagnosis and treatment are specific to each of these causes of refractoriness to clinical therapy with PPI." (Arquivos de Gastroenterologia)

4 October 2018 PROLONGED GASTROESOPHAGEAL REFLUX MONITORING BY IMPEDANCE-PHMETRY: A REVIEW OF THE SUBJECT PONDERED WITH OUR EXPERIENCE WITH 1,200 CASES. (full text) "Impedance-pHmetry is a promising method, with great advantages over conventional pHmetry. The choice between these two types of monitoring should be very judicious. The authors suggest the importance of careful evaluation of each reflux episode by the physician responsible for the examination, necessary for the correct interpretation of the tracings." (Arquivos de Gastroenterologia)

4 October 2018 Does proton pump inhibition change the on-treatment anti-Xa activity in xabans-treated patients with atrial fibrillation? A pilot study. "This pilot study did not reveal significant changes in xabans on-treatment anti-Xa activity according the PPI status." (Journal of Thrombosis & Thrombolysis)

4 October 2018 Surgical Management of Gastroesophageal Reflux Disease in Patients with Severe Esophageal Dysmotility.  "A tailored partial fundoplication may be effective in symptom relief for non-achalasia patients with esophageal motility disorders and GERD. Significant symptom improvement, low HHR, and PPI use clearly indicate this approach to be effective for this population." (Journal of gastrointestinal surgery)

2 October 2018 Negative payoffs of upper gastrointestinal endoscopy in patients admitted under observation status. "Upper gastrointestinal endoscopy in patients with atypical chest pain of GI origin as an initial step is a significant healthcare burden and contradicts the currently recommended High Value Care recommendations. Our study delineates this large negative financial impact when performing upper endoscopies under observation status. Such patients should be started on an empirical trial of PPI, and endoscopy should be reserved for patients whose symptoms are unresponsive to PPIs or have alarm features." (Minerva gastroenterologica e dietologica)

1 October 2018 It Is Time to Meet the Challenges of the Changing Epidemiology of Gastroesophageal Reflux Disease. (full text) "It is true that, currently, the proportion of young GERD patients is continuously increasing. It means that we must prepare to manage the complications of GERD and the adverse effects of PPIs that these patients may encounter in the future. For this, clinicians need to have a comprehensive knowledge regarding the systematic surveillance needed to manage the complications of GERD, as well as knowledge regarding the proper use of PPIs."  (Journal of neurogastroenterology & motility)

1 October 2018 The Changing Epidemiology of Gastroesophageal Reflux Disease: Are Patients Getting Younger? (full text) "Over the last decade, there has been a significant increase in the proportion of younger patients with GERD, especially those within the age range of 30-39 years." (Journal of neurogastroenterology & motility)

1 October 2018 Pathophysiology of Potassium-competitive Acid Blocker-refractory Gastroesophageal Reflux and the Potential of Potassium-competitive Acid Blocker Test. (full text) "Intra-gastric pH and acid reflux were strongly suppressed by 20-mg vonoprazan. When patients with gastroesophageal reflux disease present symptoms after administration of 20-mg vonoprazan, the possibility of pathophysiologies other than acid reflux should be considered." (Journal of neurogastroenterology & motility)

1 October 2018 Development and Psychometric Assessment of a Self-evaluation Questionnaire for Gastroesophageal Reflux Disease. (full text) "This study supports that SEQ-GERD is reliable and valid, and can be used to evaluate the treatment response in patients with GERD" (Journal of neurogastroenterology & motility)

1 October 2018 Association Between Anxiety and Depression and Gastroesophageal Reflux Disease: Results From a Large Cross-sectional Study. (full text) "Subjects who underwent esophagogastroduodenoscopy and completed a symptom questionnaire between January 2008 and December 2011 were analyzed. ... This cross-sectional study revealed that anxiety and depression levels were significantly higher in subjects with GERD (notably in the NERD) than in controls." (Journal of neurogastroenterology & motility)

1 October 2018 Proton Pump Inhibitor Use is Associated With Risk of Pancreatic Cancer: A Nested Case-Control Study. (full text) "Risk of pancreas cancer was associated with PPI use in patients with peptic ulcer diseases or gastroesophageal reflux disease." (Dose Response)

October 2018 Surgical results of laparoscopic Toupet fundoplication for gastroesophageal reflux disease with special reference to recurrence. "Laparoscopic Toupet fundoplication for GERD could be performed safely, with a response rate as good as 85%. Compared with non-recurrent cases, preoperative clinical conditions such as esophageal hiatal hernia, reflux esophagitis, and acid reflux time were all advanced in recurrent cases" (Esophagus)

October 2018 Impact of reflux esophagitis on the esophageal function before and after laparoscopic fundoplication. "Regardless of the presence of RE, cardiac function and LES function were improved following laparoscopic Toupet fundoplication, but no changes were observed in esophageal body motor function." (Esophagus)