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21 June 2019 Esophageal mucosal innervation in functional heartburn: Closer to healthy asymptomatic subjects than to non-erosive reflux disease patients "The mucosal innervation pattern in FH is more alike that of healthy individuals than that of NERD, with afferent nerves lying deep in the mucosa, away from the luminal surface. This supports the theory that heartburn in FH has a distinct nociceptive pathophysiology." (Neurogastroenterology & Motility)

20 June 2019 Roles of esophageal manometry study in children with refractory gastroesophageal reflux symptoms "HRIM [high-resolution esophageal impedance manometry] for the diagnosis of IEM [ineffective esophageal motility] should be considered in pediatric subjects with refractory gastroesophageal reflux symptoms to acid-suppression therapy for 8 weeks to avoid repeat UGI contrast studies, EGD tests, and psychological therapy." (Pediatrics International)

19 June 2019 Using impedance planimetry (EndoFLIP™) in the operating room to assess gastroesophagealjunction distensibility and predict patient outcomes following fundoplication  "EndoFLIP™ measurements correlate well with patient outcomes, with a final DI between 2 and 3.5 mm2/mmHg potentially being ideal. The EndoFLIP™ can be a useful adjunct in the operating room by providing objective measurements of esophageal distensibility after crural closure and fundoplication." (Surgical Endoscopy)

18 June 2019 Long-term (15-year) objective evaluation of 150 patients after laparoscopic Nissen fundoplication "Laparoscopic Nissen fundoplication produces control of symptoms in 80% of patients late (up to 15 years) after surgeries corroborated by endoscopic, histologic examinations, and functional studies. It is essential to perform these objective evaluations to demonstrate the "antireflux effect" after laparoscopic Nissen fundoplication." (Surgery)

18 June 2019 Innovative and Contemporary Interventional Therapies for Esophageal Diseases   "Esophageal surgery has become quite specialized, and both dedicated diagnostic and refined surgical techniques are required to deliver state-of-the-art care" (Journal of Thoracic Imaging)

17 June 2019 Relationship between long-term use of proton pump inhibitors and risk of gastric cancer: A systematic analysis "Long-term use of PPIs can possibly increase the risk of gastric cancer even among patients after H. pylori eradication; in particular, for noncardia gastric cancer, the risk increases with longer durations of PPI use. Due to the limited number of studies, more high-quality studies are required to be designed." (Journal of Gastroenterology & Hepatology)

June 2019 Radiofrequency Ablation in Patients with Barrett's Esophagus- related Neoplasia - Long-Term Outcomes in the Czech National Database "RFA is highly effective in achieving remission in patients with BORN [Barrett's esophagus related neoplasia]. A significant proportion of patients did not achieve CR-IM or had a recurrence of IM despite macroscopically absent BE. Recurrence of neoplasia was infrequent but not negligible, thus, patients after successful RFA still require endoscopic surveillance." (Journal of Gastrointestinal & Liver Disease)

14 June 2019 Modern Esophageal Function Testing and Gastroesophageal Reflux Disease in Morbidly Obese Patients (full text) "The current gold standard of assessment revealed that the prevalence of esophageal motility disorders and (borderline) GERD is high in the morbidly obese population. Further longitudinal data are needed to delineate the natural course of novel motility disorders like JE [jackhammer esophagus] in obesity and to identify risk factors for adverse outcomes following bariatric surgery." (Obesity surgery)

14 June 2019 Esophageal A-ring is associated with the severity of gastroesophageal reflux "There is a significant association between the presence of esophageal A-rings on esophagography and the severity of acid reflux on endoscopy and ambulatory pH testing. The data suggest that the presence of an esophageal A-ring may be either a compensatory mechanism to protect against gastroesophageal reflux and/or an inflammatory consequence of peptic esophagitis." (Laryngoscope)

13 June 2019 Gastroesophageal Reflux Type and Number Correlate with Nutritional Patterns "High energy value, consumption of fat and alcohol showed direct medium-strength correlation with esophageal acid exposure and number of GERs. Dietary fiber consumption correlated inversely with total number, weak acid and high GERs" (Current Developments in Nutrition)

13 June 2019 Risk factors for Barrett's esophagus in young adults who underwent upper gastrointestinal endoscopy in a health examination center (full text) "Significant risk factors of BE in young adults are male sex, the presence of GERD symptoms, and smoking. The risk also increases with an increase in cumulative exposure to smoking." (Therapeutic Advances in Gastroenterology)

13 June 2019 Potential roles of Helicobacter pylori treatment, body mass index and waist circumference in the causation of erosive esophagitis: a randomized clinical trial (HEROES-GERD)  "Excess body weight and concomitant increased waist circumference, but not H. pylori treatment, predicts new-onset esophagitis." (International Journal of Obesity)

11 June 2019 Effects of proton pump inhibitor use on risk of Clostridium difficile infection: a hospital cohort study "Our study showed that PPI use was associated with an increased risk of developing CDI and the risk of CDI was dose dependent. Therefore, PPIs should only be used at proper doses and only for the necessary indications to avoid CDI risk." (Journal of Gastroenterology)

11 June 2019 Hiatal hernias in patients with GERD-like symptoms: evaluation of dynamic real-time MRI vs endoscopy "Real-time MRI is a safe and fast imaging modality for examination of the gastroesophageal junction, combining anatomical and functional information for enhanced detection of hiatal hernias. • Real-time MRI and endoscopy yield comparably high diagnostic accuracy: real-time MRI visualizes hiatal hernias that were occult on endoscopy in a relevant number of patients; however, several hiatal hernias detected on endoscopy were occult on real-time MRI. • There is clinical potential of real-time MR imaging in patients with GERD-like symptoms and equivocal findings on endoscopy or pH-metry, for anatomical visualization in patients planned for surgical intervention, or those with suspected fundoplication failures." (European Radiology)

10 June 2019 Proton Pump Inhibitor Therapy and Hepatic Encephalopathy Risk in Cirrhotic Patients: A Systematic Review with Meta-analysis "We found PPI therapy increased the risk of HE in cirrhotic patients, and higher risk was found in post-operative TIPS. Additional studies are warranted to inform clinical decision making." (Clinical Drug Investigation)

7 June 2019 Vonoprazan versus Lansoprazole for the Initial Treatment of Reflux Esophagitis: A Cost-effectiveness Analysis in Japan "The P-CAB strategy was consistently superior to the conventional PPI strategy using the original LPZ in terms of cost-effectiveness and the number of days for which medication was required. Thus, VPZ appears to be the drug of choice for the acute medical treatment of reflux esophagitis." (International Medicine)

7 June 2019 Clinical impact of gastroesophageal reflux disease in patients with subacute/chronic cough (full text) "These results indicate that GERD is associated with the aggravation of other causes including CVA. [cough-variant asthma] Particularly, dysmotility symptoms may be potential therapeutic target for GERD-related cough." (Allergology International)

7 June 2019 The impact of Helicobacter pylori on the presence of Barrett's esophagus in Azerbaijan, a high-prevalence area of infection " In a predominantly Caucasian nation with a high prevalence of H. pylori gastritis, the presence of H. pylori was not inversely associated with the presence of Barrett's esophagus. These data challenge the mechanistic implications of this association." (Diseases of the Esophagus)

7 June 2019 Biliary tumorigenic effect on hypopharyngeal cells is significantly enhanced by pH reduction (full text) "Our findings suggest that biliary tumorigenic effect is strongly pH dependent. Controlling pH during reflux events may be therapeutically effective in reducing the potential risk of bile-induced hypopharyngeal cancer." (Cancer Medicine)

6 June 2019 [Proton pump inhibitors in patients with liver cirrhosis - a survey among hepatologists in Germany] "PPI are frequently prescribed among patients with liver cirrhosis in Germany. Prescribers are aware of an unclear risk-benefit ratio. Further prospective data are urgently needed to increase evidence regarding indication and duration of PPI therapy in patients with cirrhosis." (Zeitschrift für Gastroenterologie)

6 June 2019 Risk of acute kidney injury in patients with HIV receiving proton pump inhibitors "A nationwide cohort study supported the relationship of an increased risk of AKI in patients receiving PPIs." (Journal of Comparative Effectiveness Research)

6 June 2016 What is causing the rising incidence of esophageal adenocarcinoma in the West and will it also happen in the East? (full text) "The incidence of gastric cancer in Japan is still above the level at which a rise in esophageal adenocarcinoma became apparent in the West. Esophageal adenocarcinoma is likely to rise in Japan also as the incidence of gastric cancer falls but the degree of rise will depend on a variety of other environmental and genetic factors." (Journal of Gastroenterology)

5 June 2019 Prescribing of proton-pump inhibitors: auditing the management and reasons for prescribing in Danish general practice "Most patients treated with proton-pump inhibitors are treated daily, on a long-term basis, and due to symptoms. Few consultations led to alterations in treatment, and only 25% of patients had a consultation regarding proton-pump inhibitor treatment with their general practitioner within the last year. Substantial variability between general practitioners with regard to management was detected." (Family Practice)

4 June 2019 Flow based single cell analysis of the immune landscape distinguishes Barrett's esophagus from adjacent normal tissue " Our results suggest that flow based single cell analysis may have the potential for revealing clinically relevant differences between BE and normal adjacent tissue, and that surface immunophenotypes could identify specific subpopulations from dysplastic tissue for further investigation." (Oncotarget)

3 June 2019 The importance of pH reflux monitoring test for the management of low-grade esophagitis in Chinese patients "The proportion of PAR [pathological acid reflux] in low-grade esophagitis is not high. For patients with low-grade esophagitis in China, especially the patients with grade A esophagitis, regardless of symptom change, reflux monitoring is possibly needed for the patients whose esophageal mucosa break is not improved after 8 weeks of PPI treatment." (Neurogastroenterology & Motility)

2 June 2019 Changing Trends of Color of Different Laryngeal Regions in Laryngopharyngeal Reflux Disease (full text) "Hue values of separate laryngeal regions are different. In negative group, the hue values of interarytenoid region are similar with positive group, and the sensitivity to the acid are different from different regions. The sensitivity in the true vocal folds may be present." (Ear, Nose & Throat journal)

1 June 2019 Mean Nocturnal Baseline Impedance Correlates with Symptom Outcome When Acid Exposure Time is Inconclusive on Esophageal Reflux Monitoring "When low, MNBI identifies patients with pathologic and borderline AET who respond to anti-reflux therapy. MNBI analysis complements AET in defining esophageal reflux burden. MNBI correlates with response of symptoms to anti-reflux therapy." (Clinical Gastroenterology & Hepatology)

June 2019 Association of serum gastric inhibitory polypeptide and pancreatic polypeptide levels with prolonged esophageal acid exposure time in refractory gastroesophageal reflux disease (full text) "The serum levels of GIP and PP in refractory GERD patients with prolongation of AET are significantly elevated, mainly in the upright position." (Medicine - Baltimore)

June 2019 Gender Specific Differences in Prevalence and Risk Factors for Gastro-Esophageal RefluxDisease (full text) "This study showed a predominance of RE in men, but a predominance of symptomatic GERD in women. In women, dynamic increase in the prevalence of GERD is closely related to the menopause conditions and its duration. There are specific risk factors for RE and symptomatic GERD according to gender differences." (Journal of Korean Medical Science)

June 2019 Validity and reliability of the Quality of Life in Reflux and Dyspepsia (QoLRAD) questionnaire in patients with gastroesophageal reflux disease for the Turkish population "The QoLRAD test measuring quality of life, except some subdomains in our study that we performed on patients diagnosed with GERD, was found to be valid and reliable." (Turkish Journal of Gastroenterology)

June 2019 Gastrointestinal Dysmotility and the Implications for Respiratory Disease "Esophageal and gastric dysmotility have a profound effect on development of respiratory symptoms and pulmonary sequalae in aerodigestive patients. However, our understanding of the pathophysiology is in its infancy. Prospective studies in are needed to address key clinical questions such as: What degree of dysmotility initiates respiratory compromise? What diagnostic tests and therapeutic options best predict aerodigestive outcomes?" (Current treatment options in pediatrics)

April 2019 Endoscopic day case antireflux radiofrequency (Stretta) therapy improves quality of life and reduce proton pump inhibitor (PPI) dependency in patients with gastro-oesophageal refluxdisease: a prospective study from a UK tertiary centre "There are currently few effective therapeutic alternatives to antireflux surgery for refractory GORD. This series corroborates the value and safety of Stretta as a viable option for selected patients who are unwilling or unable to undergo an operation. Stretta improves quality of life and decreases PPI dependency in selected patients with GORD." (Frontline Gastroenterology)

April 2019 Dedicated service improves the accuracy of Barrett's oesophagus surveillance: a prospective comparative cohort study "The post-BSG guideline era of BO surveillance remains suboptimal in this UK hospital setting. A dedicated service appears to improve the accuracy and consistency of surveillance care, although the clinical significance of this remains to be determined." (Frontline Gastroenterology)

May 2019 Educational Case: Barrett Esophagus (full text) "The following fictional case is intended as a learning tool within the Pathology Competencies for Medical Education (PCME), a set of national standards for teaching pathology. These are divided into three basic competencies: Disease Mechanisms and Processes, Organ System Pathology, and Diagnostic Medicine and Therapeutic Pathology." (Academic Pathology)

31 May 2019 Proton Pump Inhibitors for the Treatment of Laryngopharyngeal Reflux. A Systematic Review. "Based on the existing data, the use of PPI therapy for the treatment of LPR remains questionable. Six out of the nine systematic reviews/meta-analyses concluded that PPI therapy is not superior to placebo and three concluded that PPI therapy significantly improved LPR symptoms although they did not identify any difference in the post-treatment laryngoscopic findings. There is still a long way to go until we can give a definite answer to this question but in the meantime, the use of PPI therapy for the treatment of LPR will continue even though existing evidence is poor and weak, coming mainly from individual uncontrolled studies." (Journal of Voice)

May 2019 Barrett oesophagus "Developments in endoscopic therapy have resulted in a major shift in the treatment of patients with BE who have dysplasia or early EAC, from surgical resection to endoscopic resection and ablation. In addition to symptom control by optimization of lifestyle and pharmacological therapy with proton pump inhibitors, chemopreventive strategies based on NSAIDs and statins are currently being investigated for BE management." (Nature Reviews)

March 2019 Mitochondrial DNA deletions in patients with esophagitis, Barrett's esophagus, esophageal adenocarcinoma and squamous cell carcinoma "We can say that, these deletions are not associated with progression of normal esophagus to BE and EA and they do not have an important role in detecting esophagitis, BE, EA, and ESSC." (African Health Studies)

April 2019 Novel Barrett's esophagus screening assays based on swallowable devices: will they change the game? (full text) "In general, these devices appear to be quite effective at capturing enough cellular material for analysis (there were no reported cases of inadequate sampling in the Wang study), but there is room for improvement in terms of swallowability. In the study by Wang et al., the EsophaCap was successfully swallowed 85% of the time, although Iyer et al. had a 98% success rate using the EsophaCap (11). The Cytosponge was successfully swallowed 91% of the time in prior studies (10), and the first-generation JASSS balloon was swallowed by 82% of the subjects (12). Based on success rates of other screening tests, a non-endoscopic device should be swallowable by at least 90% of the subjects and ideally ≥95% of individuals in a screening population to maximize the impact of the assay on screening." (Translational Gastroenterology & Heptology)

30 May 2019 Estimates of all cause mortality and cause specific mortality associated with proton pump inhibitors among US veterans: cohort study (full text) "Taking PPIs is associated with a small excess of cause specific mortality including death due to cardiovascular disease, chronic kidney disease, and upper gastrointestinal cancer." (BMJ)

29 May 2019 Safety of Proton Pump Inhibitors Based on a Large, Multi-year, Randomized Trial of Patients Receiving Rivaroxaban or Aspirin "In a large placebo-controlled randomized trial, we found that pantoprazole is not associated with any adverse event when used for 3 years, with the possible exception of an increased risk of enteric infections." (Gastroenterology)

29 May 2019 From genetics to signaling pathways: molecular pathogenesis of esophageal adenocarcinoma "This review focuses on the genetic and molecular studies of EAC. The molecular changes that occur during the transformation of normal Barrett's esophagus to esophageal adenocarcinoma are also discussed." (Biochimica et biophysica acta)

29 May 2019 Systematic review and meta-analysis of prevalence and risk factors for Barrett's esophagus "Results of this study provide estimates of BE prevalence based on the presence and the number of risk factors. These results add credence to current guidelines that suggest screening in the presence of multiple risk factors." (Gastrointestinal Endoscopy)

28 May 2019 Gastrointestinal tract 1: the mouth and oesophagus  (full text article) "Our new five-part ‘Systems of life’ series looks at the gastrointestinal tract and starts with the mouth and oesophagus. It comes with a self-assessment so you can test your knowledge after reading it" (Nursing Times)

28 May 2019 Anti-reflux mucosectomy using a cap-assisted endoscopic mucosal resection method for refractory gastroesophageal disease: a prospective feasibility study "Six months after ARMS-C, 63% of patients discontinued the use of pump inhibitors (PPIs), while 30% patients reduced their PPI dose. ... ARMS-C may be an effective and safe treatment method for GERD in terms of short-term outcomes." (Surgical Endoscopy)

28 May 2019 Elevation of Lower Esophageal Sphincter Pressure With Acute Transcutaneous Electrical Acustimulation Synchronized With Inspiration "Gastroesophageal reflux disease (GERD) is a common esophageal disorder. Transcutaneous electrical acustimulation (TEA), as a needleless method of electroacupuncture (EA) has been reported to improve hypotensive lower esophageal sphincters pressure (LESP) in GERD. Synchronized TEA (STEA) with inspiration has been revealed to be more effective than TEA in enhancing vagal tone." (Neuromodulation)

27 May 2019 Clinical characteristics may distinguish patients with esophageal adenocarcinoma arising from long- versus short-segment Barrett's esophagus "Patients who developed EAC on a background of LSBE were more likely to have a hiatus hernia compared to patients with SSBE EAC, who were more likely to have higher smoking pack-years and higher rates of statin use." (Digestive & Liver Disease)

27 May 2019 Editorial: gastric bypass for GERD in class II & III obesity-still the best option? "Although PPIs and weight loss remain the cornerstones of treatment, these clearly have not worked if surgery is being contemplated. Given that fundoplication is off the table because of issues of durability and morbidity, gastric bypass is the main option. However, going into this, all parties involved should be aware gastric bypass is not a perfect anti‐reflux procedure; it likely will reduce volume/regurgitation‐driven symptoms… but many patients will continue to use PPIs afterward." (Alimentary pharmacology & therapeutics)

25 May 2019 Therapeutic options for early cancer of the esophagogastric junction "Accurate staging is necessary in order to provide optimal treatment. The most precise staging technique in these cases is endoscopic ultrasound. The suspicion of deep invasion of the submucosa, presence of unfavorable anatomopathological characteristics or impossibility to perform endoscopic resection make it necessary to consider surgical resection." (Cirugia esponola)

24 May 2018 NRF2 antioxidant response protects against acidic bile salts-induced oxidative stress and DNA damage in esophageal cells "Gastroesophageal reflux disease (GERD) is the main risk factor for esophageal Barrett’s tumorigenesis. Using conditions that mimic GERD, we demonstrate transient induction of NRF2 in response to acidic bile salts (ABS). Acidic bile salts induced oxidation of KEAP1, with release and nuclear accumulation of NRF2. Activation of NRF2 protected esophageal cells by suppressing ABS-induced ROS levels, oxidative DNA damage, DNA double strand breaks, and apoptosis." (Cancer Letters)

23 May 2019 Overlapping of irritable bowel syndrome with erosive esophagitis and the performance of Rome criteria in diagnosing IBS in a clinical setting " IBS is associated with erosive esophagitis. Applying Rome III criteria without red flags and history, was effective in diagnosing IBS. Celiac disease and microscopic colitis should be considered as alternative diagnoses." (Molecular Medicine Reports)

23 May 2019 Clinical Translational Application of Raman Spectroscopy To Advance Benchside Biochemical Characterization to Bedside Diagnosis of Esophageal Diseases "Advanced imaging technologies are being developed to complement current approaches to improve diagnostic, therapeutic and surveillance protocols and advance the field. Raman spectroscopy-based technologies hold promise to increase the sensitivity for detection of diseased and high-risk lesions in vitro and in vivo in real time." (Journal of Gastroenterology & Hepatology)

22 May 2019 Efficacy of long-term maintenance therapy with 10-mg vonoprazan for proton pump inhibitor-resistant reflux esophagitis "Long-term maintenance therapy by 10-mg vonoprazan administration is very effective for proton pump inhibitor-resistant reflux esophagitis patients in whom endoscopic healing was maintained by 8 weeks maintenance therapy with 10-mg vonoprazan administration." (Esophagus)

21 May 2019 Etiology, Cancer Stem cells and Potential Diagnostic Biomarkers for Esophageal Cancer  "ESCC and EAC have distinct cell of origin. Cancer stem cells in ESCC and EAC express different cell surface markers. Non-invasive diagnostic biomarkers for ESCC and EAC seem vastly different." (Cancer Letters)

20 May 2019 CLINICAL AND ENDOSCOPIC EVALUATION IN PATIENTS WITH GASTROESOPHAGEAL SYMPTOMS (full text) "Male gender and hiatal hernia were associated with EE. Aged patients, smoking and hiatal hernia were related to severe EE. It is suggested that the risk factors for EE and non-EE types are different. Cohort studies are necessary to identify the exact mechanisms involved in each disease form." (Arquivos de gastroenerologia)

20 May 2019 Duodenal eosinophilia is associated with functional dyspepsia and new onset gastro-oesophageal reflux disease (full text) "Duodenal eosinophilia is associated with increased risk of GERD at 10-year follow-up in those with functional dyspepsia and post-prandial distress syndrome at baseline. Duodenal eosinophilia may explain the link between GERD and functional dyspepsia, suggesting subsets of functional dyspepsia and GERD may be part of the same disease spectrum." (Alimentary Pharmacology & Therapeutics)

18 May 2018 Advances in the diagnosis and surveillance of Barrett's esophagus "Most patients diagnosed with esophageal adenocarcinoma do not carry a known diagnosis of Barrett's esophagus (BE), suggesting that an improved approach to screening may potentially be of benefit." (Gastrointestial Endoscopy)

17 May 2019 Self-sizing radiofrequency ablation balloon for eradication of Barrett's esophagus: results of an international multicenter randomized trial comparing 3 different treatment regimens "This randomized trial shows that circumferential RFA with the 360 Express using the simple-double ablation regimen results in an unacceptable high risk of stenosis. Furthermore, the results suggest that a single ablation at 10J/cm2 results in inferior BE regression at 3 months. We therefore advise using the standard ablation regimen (1x10J/cm2-clean-1x10J/cm2) for treatment of BE using the 360 Express." (Gastrointestinal Endoscopy)

17 May 2019 Endoscopic GERD therapy: a primer to the transoral incisionless fundoplication procedure "we discuss the landscape of endoscopic GERD therapy, focusing on recent updates in the TIF 2.0 procedure with the EsophyX-Z device. We detail the evolution, differences, and improvements in this technique across different generations of the EsophyX device. We also present a framework for candidates selection, based on medical and anatomical considerations." (Gastrointestinal Endoscopy)

17 May 2018 The Pros and Cons of Partial Versus Total Fundoplication for Gastroesophageal Reflux Disease "it would appear that a full and a partial fundoplication are associated with similar GERD-related outcomes and that a partial fundoplication is associated with fewer side effects such as bloating and dysphagia." (Journal of Laparoscopic & Advanced Surgical techniques)

16 May 2019 Intragastric pH effect of 20mg of levo-pantoprazole versus 40mg of racemic pantoprazole the first seven days of treatment in patients with gastroesophageal reflux disease (full text Spanish) "The S enantiomer of pantoprazole (levo-pantoprazole) had a faster and stronger effect with respect to acid suppression, compared with its racemic formulation. Although the effect on symptoms was faster with levo-pantoprazole, occurring within the first days of treatment, it was equivalent to that of the racemate at one week of treatment." (Revista de gastroenterolia de Mexico)

16 May 2019 Proton pump inhibitor-induced hypomagnesemia complicated with serious cardiac arrhythmias "The review of these papers suggests that PPIs cause hypomagnesemia, which could be associated with serious cardiac arrhythmias including TdP [torsades de pointes]. However, its incidence is not very common considering the millions of people taking PPIs, but the FDA has advised the physicians to be watchful about this serious adverse effect of PPIs and check the magnesium levels before initiation of PPI treatment." (Expert Review Cardiovascular Therapy)

15 May 2019 Combined EsophaCap cytology and MUC2 immunohistochemistry for screening of intestinal metaplasia, dysplasia and carcinoma (full text) "Using the biopsy as our gold standard to screen IM, dysplasia and EAC by combined cytology and MUC2 IHC, the sensitivity and specificity were 68% and 91%, respectively, which is in the range of clinically useful cytological screening tests such as the cervical Pap smear. Conclusions: Combined EsophaCap cytology and MUC2 IHC could be a good screening test for IM and Beyond." (Clinical & Experimental Gastroenterology)

15 May 2019 Modified inspiratory muscle training (m-IMT) as promising treatment for gastro-oesophageal reflux disease (GERD) "m-IMT is a low cost therapy without side effects. It could be useful in association with PPI or alone for selected GERD cases and for mild NERD forms, in association with diet. Further studies are required to prove the effects of m-IMT on GERD symptoms and decide the best treatment schedule." (Acta otorrinolaringologica espanola)

15 May 2019 Understanding the current evidence on proton pump inhibitor use and bone health (pdf) "Although the treatment with dexlansoprazole or esomeprazole caused small increases in circulating markers of bone turnover, the authors found no clinically meaningful impact on areal bone mineral density (aBMD) in the lumbar spine, total hip or femoral neck." (Gastroenterology)

14 May 2019 Alteration of the esophageal microbiota in Barrett's esophagus and esophageal adenocarcinoma "The activation of the LPS-TLR4-NF-κB pathway may contribute to inflammation and malignant transformation. This exciting field of gastrointestinal microbiota allows us to unravel the mystery of carcinogenesis from another perspective. Further studies are needed to explore whether the microbiota changes before or after disease onset, to improve our understanding of the pathogenesis, and to find novel targets for prevention, diagnosis and therapy, which could offer more cost-effective and relatively safe choices." (World Journal of Gastroenterology)

14 May 2019 The validation in china of a Non-Invasive salivary pepsin biomarker containing two unique human pepsin monoclonal antibodies to diagnose gastroesophageal reflux disease "Peptest enabled the rapid diagnosis of reflux demonstrating high pepsin sensitivity between 83% and 100% resulting in an overall sensitivity across all 9 centers of 85%, specificity 60% and positive predictive value 82%." (Journal of Digestive Diseases)

13 May 2019 Gastroesophageal reflux disease and Barrett's oesophagus: an overview of evidence-based guidelines (full text pdf) "Evidence supports the safety of proton pump inhibitors for symptom control medium term (i.e. 9 years) and reducing the risk of progression of BE whilst surgical options are cost effective treatments for certain patients. BE surveillance should be directed towards high risk groups while those at lower risk may benefit for chemoprevention strategies." (Polish Archives of Internal Medicine)

May 2019 Evaluation of symptomatic reflux esophagitis in proton pump inhibitor users (full text) " In conclusion, a younger age and HH were associated with symptomatic RE in patients with RE who were administered PPIs." Biomedical Reports)

May 2019 Relationship between esophageal motility and severity of gastroesophageal reflux disease according to the Los Angeles classification (full text) "Patients with severe esophagitis may have motor dysfunction not only in the LES but also in the esophageal body, with resulting increased esophageal acid exposure, which causes esophagitis. Low LES pressure might be the main reason that patients with HH develop esophagitis. GERD without HH may be due to a variety of motor dysfunctions." (Medicine - Baltimore)

11 May 2019 Endoscopists systematically undersample patients with long-segment Barrett's esophagus: an analysis of biopsy practices from a quality improvement registry "Nearly 20% of endoscopies performed in BE patients were not adherent to Seattle protocol. As BE length increases, endoscopists become less compliant with odds of nonadherence increasing by 31% with every 1 cm increase in length." (Gastroenterointestinal endoscopy)

11 May 2019 Endoscopic resection for early esophageal carcinoma (full text) "Endoscopic radiofrequency ablation is the most widely used ablation technique for Barrett's epithelium and highly effective to achieve full remission of dysplasia and intestinal metaplasia. The role of radiofrequency ablation in the treatment armamentarium in squamous cell carcinoma of the esophagus has still to be determined." (Journal of Thoracic Disease)

March 2019 Esophageal adenocarcinoma in a first-degree relative increases risk for esophageal adenocarcinoma in patients with Barrett's esophagus (full text) "Our study indicates that Barrett's esophagus patients with a first-degree family member with esophageal adenocarcinoma are at 5.5-fold higher risk for disease progression to esophageal adenocarcinoma. Family history of esophageal adenocarcinoma in Barrett's esophagus patients should be considered in patient surveillance and radiofrequency ablation treatment, beyond recommended guidelines." (United European Gastroenterology Journal)

10 May 2019 Pathogenesis and Cells of Origin of Barrett's Esophagus "We review mechanisms of BE pathogenesis, including transdifferentiation and transcommitment, and discuss potential cells of origin including basal cells of the squamous epithelium, cells of esophageal submucosal glands and their ducts, cells of the proximal stomach, and specialized populations of cells at the esophago-gastric junction (residual embryonic cells and transitional basal cells). We discuss the concept of metaplasia as a wound-healing response, and how cardiac mucosa might be the precursor of the intestinal metaplasia of BE." (Gastroenterology)

10 May 2019 Late esophagogastric anatomic and functional changes after sleeve gastrectomy and its clinical consequences with regards to gastroesophageal reflux disease "Positive duodenogastric reflux was found in 31.8% of patients and 57.7% of our patients received proton pump inhibitor treatment after SG. Sleeve gastrectomy presents anatomic and functional changes that are associated with increased GERD" (Diseases of the Esophagus)

10 May 2019 Efficacy of cryotherapy as first line therapy in patients with Barrett's neoplasia: a systematic review and pooled analysis "The published data demonstrate efficacy rates of 69% and 98% for complete eradication of metaplasia and neoplasia, respectively. These results need to be assessed in prospective, comparative trials with other forms of therapy." (Diseases of the Esophagus)

10 May 2019 Durability of Endoscopic Treatment for Dysplastic Barrett's Esophagus "Dysplastic Barrett's esophagus and adenocarcinoma following ablation are rare. New data emphasize that most recurrent disease occurs in the initial year following treatment. Additionally, recent publications suggest that a much-attenuated surveillance interval may provide adequate detection of neoplasia with many fewer surveillance endoscopies." (Current treatment options in Gastroenterology)

9 May 2019 Laparoscopic magnetic sphincter augmentation versus fundoplication for gastroesophageal reflux disease: systematic review and pooled analysis "In conclusion, magnetic sphincter augmentation achieves good GERD symptomatic control similar to that of fundoplication, with the benefit of less gas bloating. The safety of MSA also appears acceptable with only 3.3% of patients requiring device removal. There is an urgent need for randomized data directly comparing fundoplication with MSA for the treatment of GERD to truly evaluate the efficacy of this treatment approach." (Diseases of the Esophagus)

9 May 2019 Interpretation of volumetric laser endomicroscopy in Barrett's esophagus using image enhancement software "Nondysplastic BE targets (N = 39) showed surface hyper-reflectivity (64%), epithelial glands (51%), and lack of layering (74%). Targets of BE with early neoplasia (N = 24), showed surface hyper-reflectivity (96%), epithelial glands (67%), and lack of layering (96%). IRIS [intelligent real-time image segmentation] features that characterize each tissue type appear to mirror the nonenhanced VLE counterparts that define them." (Diseases of the Esophagus)

8 May 2019 Prevalence and Incidence of Intestinal Metaplasia and Dysplasia of Gastric Cardia in Patients With Barrett's Esophagus after Endoscopic Therapy "In a prospective study, we found that cardia dysplasia becomes less, not more, common, after successful EET; recurrence of IM or dysplasia was more frequent in the cardia than the esophagus. Patients with BE undergoing EET should have careful examination of the cardia, with a single set of surveillance biopsies at the top of the gastric folds." (Clinical Gastroenterology & Hepatology)

7 May 2019 Evolving screening and surveillance techniques for Barrett's esophagus (full text) "Despite an understanding of its association with BE for many years and the falling incidence rates of squamous cell carcinoma of the esophagus, the incidence for EAC continues to rise exponentially. In association with this rising incidence, if the delay in diagnosis of EAC occurs after the onset of symptoms, then the mortality at 5 years is greater than 80%. Appropriate diagnosis and surveillance strategies are therefore vital for BE." (World Journal of Gastroenterology)

7 May 2019 Eosinophilic Esophagitis Is Rarely Continually Symptomatic 10 Years After an Initial Treatment Course in Adults "Ten years after diagnosis, treated EoE is rarely continually symptomatic, requires mainly PPI-based therapies and is associated with a minimal decrease in QoL scores." (Digestive Diseases & Sciences)

6 May 2019 The role of body mass index in determining clinical and quality of life outcomes after laparoscopic anti-reflux surgery "These findings suggest LARS in the overweight, obese, and morbidly obese populations-when compared to normal-weight cohorts in short-term follow-up-may have similar value in addressing pathological reflux manifestations and conveying quality of life benefits without added morbidity or mortality." (Surgical Endoscopy)

5 May 2019 The impact of proton pump inhibitors on bone regeneration and implant osseointegration  "Results from the studies suggest a link between PPIs intake and bone regeneration, but several concerns are raised regarding inadequate recipient bone, surgical trauma, limitations on the titanium surface, comorbidities or interference with other pharmacological agents." (Drug metabolism reviews)

5 May 2019 Proton Pump Inhibitors and Fracture Risk: A Review of Current Evidence and Mechanisms Involved "Overall, PPIs were positively associated with elevated fracture risk in multiple studies (n = 14), although some studies reported no significant relationship (n = 4). Increased gastrin production and hypochlorhydria are the two main mechanisms that affect bone remodeling, mineral absorption, and muscle strength, contributing to increased fracture risk among PPI users." (Internationnal Journal of Environmental Research & Public Health)

May 2019 Transoral incisionless fundoplication with EsophyX for gastroesophageal reflux disease: clinical efficacy is maintained up to 10 years. (full text) "Transoral incisionless fundoplication with EsophyX is an effective therapeutic option for symptomatic gastroesophageal reflux disease patients, with Hill grades I - II or hiatal hernia < 2 cm, who refuse life-long medical therapy or surgery." (Endoscopy International Open)

2019 Prevalence of acidic and non-acidic refluxes in patients with functional dyspepsia and its risk factors investigated by means of multichannel intraluminal pH-monitoring "In functional dyspepsia abnormal acidic reflux are common and affect 22.8% of patients. It is independently associated with hiatal hernia (OR=4.17), previously healed a peptic ulcer (OR=3.90), occasional heartburn (OR=1.25), body mass index (OR=1.11), younger age (OR=0.97)." (Wiadomosci Lerkaski)

3 May 2019 Gastroesophageal reflux and antacid therapy in IPF: analysis from the Australia IPF Registry (full text) "Neither the use of antacid therapy nor the presence of GORD symptoms affects longer term outcomes in IPF patients. This contributes to the increasing evidence that antacid therapy may not be beneficial in IPF patients and that GORD directed therapy should be considered on an individual basis to treat the symptoms of reflux." (BMC Pulmonary Medicine)

3 May 2019 Achalasia and associated esophageal cancer risk: What lessons can we learn from the molecular analysis of Barrett's-associated adenocarcinoma? "The present review will discuss possible lessons that we can learn from the molecular analysis of BE for the study of achalasia-associated cancer and contrast findings in BE with those in achalasia. First, we will describe cellular fate during development of BE, EAC, and ESCC, and consider the inflammatory status of the epithelial barrier in BE and achalasia in terms of its contribution to carcinogenesis." (Biochimica et biophysica acta)

3 May 2019 Polymorphisms of the BARX1 and ADAMTS17 locus genes in individuals with gastroesophageal reflux disease "This is a study investigating the potential correlation between 2 BARX1 and ADAMTS17 polymorphisms and the development of GERD, showing a considerable association between both polymorphisms and the disease. This finding suggests that esophageal differentiation or altered regulation on microfibrils in the cell environment could be implicated as possible mechanisms in the pathogenesis of GERD." (Journal of Nerogastroenterology & Motility)

2 May 2019 Esophageal pepsin and proton pump synthesis in barrett's esophagus and esophageal adenocarcinoma "Local synthesis of pepsin and proton pumps in BE and EAC is not uncommon. Absence of these molecules in normal (noncancer) esophagi, SCC, and in vitro data support a role for pepsin in reflux-attributed carcinogenic changes in the esophagus." (Laryngoscope)

2 May 2019 Surgical Treatment for Laryngopharyngeal Reflux Disease: A Systematic Review "The reported studies of fundoplication in LPR disease have important heterogeneity in method of diagnosis, exclusion criteria, symptoms, and signs assessed as therapeutic outcomes; therefore, this systematic review was nonconclusive regarding whether surgery for LPR disease is associated with effective control of sight and symptoms." (JAMA otolaryngology)

1 May 2019 Effects of Chronic Proton-Pump Inhibitor Use on Kidney Function in Older Adults "Chronic PPI use was associated with a significant reduction in eGFR in ambulatory older adults at two years, beyond that expected based on increased age alone." (Senior care pharmacist)