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23 November 2017 Economic evaluation of endoscopic radiofrequency ablation for the treatment of dysplastic Barrett's esophagus in Spain. "Endoscopic treatment based on radiofrequency ablation plus endoscopic mucosal resection is the intervention of choice for dysplastic Barrett's esophagus patients for health care professionals in Spain." (Revista espanola de enfermedades digestivas)

22 November 2017 Gastroesophageal flap valve reflected EGJ morphology and correlated to acid reflux. "The GEFV grades were associated with acid reflux positively and could be a good reflection of EGJ morphology in HRM. But it had no impact on the four HRM metrics. Our research revealed that GEFV may play an assistant role in the anti-reflux barrier." (BMC Gastroenterology)

21 November 2017 Lansoprazole use and tuberculosis incidence in the United Kingdom Clinical Practice Research Datalink: A population based cohort. "In this study, use of the commonly prescribed and cheaply available PPI lansoprazole was associated with reduced incidence of TB disease. Given the serious problem of drug resistance and the adverse side effect profiles of many TB drugs, further investigation of lansoprazole as a potential antituberculosis agent is warranted." (PLoS one)

21 November 2017 Proton pump inhibitors for functional dyspepsia. "There is evidence that PPIs are effective for the treatment of FD, independent of the dose and duration of treatment compared with placebo. PPIs may be slightly more effective than prokinetics for the treatment of FD; however, the evidence is scarce. The trials evaluating PPIs versus prokinetics are difficult to interpret as they are at risk of bias. Although the effect of these drugs seems to be small, the drugs are well tolerated." (Cochrane Database of systematic reviews)

21 November 2017 Esophageal Baseline Impedance Reflects Mucosal Integrity and Predicts Symptomatic Outcome With Proton Pump Inhibitor Treatment. "The dilated intercellular space and decreased baseline impedance was observed in patients with mucosa erosion or pathological acid reflux. The baseline impedance reflected the mucosal integrity, it was more sensitive to esophageal acid exposure. Patients with high impedance might not benefit from the PPI treatment." (Journal of neurogastroenterology & motility)

21 November 2017 Long-term outcomes of the randomized controlled trial comparing 5-aminolaevulinic acid and Photofrin photodynamic therapy for Barrett's oesophagus related neoplasia. "Initial response to PDT plays key role in long term outcome. RFA ± EMR have, however, become preferred minimally invasive ablative therapy for BE-related neoplasia due to poor efficacy of PDT." (Scandinavian journal of gastroenterology)

October 2017 Oral manifestations of gastrointestinal disorders "Although the frequency of oral manifestations is variable across GIDs and in most cases is non-specific, these alterations may precede the underlying disease and therefore can facilitate an opportune diagnosis" (Journal of clinical and experimental dentistry)

October 2017 Long-Term (over 10 Years) Retrospective Follow-up of Laparoscopic Adjustable Gastric Banding. "LAGB required removal in the majority of our patients and showed poor resolution of comorbidities with worsening of GERD-related symptoms. Patients who go on to have another bariatric procedure have more durable weight loss outcomes." (Obesity Surgery)

20 November 2017 Iron Deficiency Anemia Due to the Long-term Use of a Proton Pump Inhibitor. "This case demonstrates that long-term PPI use for as long as 25 years may cause iron deficiency anemia and should be considered in the differential diagnosis of iron deficiency anemia in long-term PPI users." (Internal Medicine)

17 November 2017 The association between gastro-oesophageal reflux disease and subsequent rheumatoid arthritis occurrence: a nested case-control study from Taiwan. "We observed that GORD might associate with subsequent RA occurrence. Because current treatment guidelines for RA emphasise early diagnosis and prompt treatment, the observed association between GORD and RA may help acquaint clinicians to patients with GORD with higher RA risk and facilitate early diagnosis and treatment." (BMJ Open)

August 2017 Identification and validation of FGFR2 peptide for detection of early Barrett's neoplasia. "These results demonstrate potential for this FGFR2 peptide to be used as a clinical imaging agent to guide tissue biopsy and improve methods for early detection of EAC and potentially other epithelial-derived cancers." (Oncotarget)

17 November 2017 Genetic risk factors for perception of symptoms in GERD: an observational cohort study. "Genetic polymorphisms in G-protein beta-3 subunit (GNβ3) and beta-2 adrenergic receptor (ADRB2) are associated with pain and gut hypersensitivity, which can overlap with gastroesophageal reflux disease (GERD) ... Genetic variation within GNβ3 predicts oesophageal symptom burden and affect, but not oesophageal acid burden or symptom association with reflux episodes." (Alimentary Pharmacology & Therapeutics)

17 November 2017 Increased Risk for Colon Polyps in Patients with Reflux Disease. "All types of GERD represent a risk factor for the occurrence of different colon polyps" (Digestive Diseases & Sciences)

2017 Treatment Strategy for Standard-Dose Proton Pump Inhibitor-Resistant Reflux Esophagitis. "PPI-resistant reflux esophagitis has been increasing. When the standard dose of PPI is not effective, modification of the lifestyle with PPI therapy, switching to another PPI, or a change in the administration method (before meals), as well as double-dose PPI (in divided doses), may be effective" (Journal of Nippon Medical School)

14 November 2017 [Relationship between the severity of reflux esophagitis and the esophageal motility features on high resolution manometry]. "Hypo-dynamic state of esophageal and HH are the main motility characteristics of erosive gastroesophageal reflux disease, Esophageal motility abnormalities increase in parallel with the severity of GERD from NERD to severe esophagitis, these motility disorders may also play important roles in causing esophagitis." (Zhonghua yi xue za zh)

14 November 2017 Proton Pump Inhibitor Use and Dementia Risk: Prospective Population-Based Study. "Proton pump inhibitor use was not associated with dementia risk, even for people with high cumulative exposure. Although there are other safety concerns with long-term PPI use, results from our study do not support that these medications should be avoided out of concern about dementia risk." (Journal of American Geriatrics Society)

December 2017 Vonoprazan treatment improves gastrointestinal symptoms in patients with gastroesophageal reflux disease. "Advanced age, obesity, erosive esophagitis, alcohol use and history of H. pylori eradication influence the resolution of GERD symptoms. Treatment with vonoprazan favorably affects gastrointestinal symptoms in patients with GERD." (Kaohsiung journal of medical sciences)

December 2017 Gastroesophageal Reflux Disease. "The typical symptoms of GERD are heartburn and regurgitation of gastric contents into the oropharynx. GERD affects quality of life and may cause erosive esophagitis, esophageal strictures, and Barrett esophagus, a precursor to esophageal adenocarcinoma. GERD is a clinical diagnosis and is most effectively treated with proton-pump inhibitors (PPIs)." (Primary Care)

September 2017 [Approach to chronic cough]. "Chronic cough, that 10-38% outpatients have, is an important cause of morbidity and mortality. This symptom can be seen 3-40% of adult patients and reduces quality of life. 95% patients that cough chronically have one of these three diseases: upper airway cough syndrome, gastroesophageal reflux or asthma." (Tuberkuloz ve toraks)

13 November 2017 Practical gastrointestinal investigation of iron deficiency anaemia. "Gastrointestinal pathology is now a more common cause of IDA than upper GI causes, reflecting better colonoscopy accuracy and completion rates as well as changing disease patterns, and carcinomas are more likely cause IDA than benign adenomas. Increasing use of antiplatelet and anticoagulants is driving greater presentation of IDA." (Expert Review  of Gastroenterology & Hepatology)

12 November 2017 Nonalcoholic Fatty Liver Disease and the Development of Reflux Esophagitis: A Cohort Study. "NAFLD is not independently associated with the risk of the development of reflux esophagitis, but rather reflux esophagitis is primarily the consequence of increased BMI commonly associated with NAFLD" (Journal of Gastroenterology and hepatology)

December 2017 Other Forms of Esophagitis: It Is Not Gastroesophageal Reflux Disease, So Now What Do I Do? "Esophagitis results from diverse causes, including gastroesophageal reflux, immune-mediated or allergic reactions, therapeutic complications, and infections. The appropriate clinical management differs in each of these situations" (Surgical Pathology Clinics)

December 2017 Diagnosis and Management of Barrett-Related Neoplasia in the Modern Era. "current international consensus is that endoscopic treatment is the management for high-grade dysplasia and intramucosal carcinoma. Furthermore, many centers advocate endoscopic ablation for low-grade dysplasia." (Surgical Pathology Clinics)

11 November 2017 Asthma, GERD and Obesity: Triangle of Inflammation. " comorbidities like gastroesophageal reflux disease (GERD) and sleep disordered breathing (SDB) lead to inflammation in airways and contribute to asthma obesity association." (Indian Journal of Pediatrics)

9 November 2017 Substantial Interobserver Agreement in the Diagnosis of Dysplasia in Barrett Esophagus Upon Review of a Patient's Entire Set of Biopsies. "results indicate that pathologists can reliably distinguish between nondysplastic BE and dysplastic BE when a patient's entire set of biopsies is reviewed as a group." (American Journal of Surgical Pathology)

November 2017 Patient decision-making and clinical outcomes following endoscopic therapy or esophagectomy for Barrett's neoplasia. "Patients who have undergone EET or surgery for BE neoplasia report a high degree of involvement in the decision-making process. Although EET patients report fewer symptom-specific outcomes, measures of decision confidence and decision regret do not differ between the two treatment groups." (Endoscopy International Open)

6 November 2017 No Increase in Risk of Acute Myocardial Infarction in Privately Insured Adults Prescribed Proton Pump Inhibitors vs Histamine-2 Receptor Antagonists (2002-2014)  "we found no evidence that prescription PPIs increase risk of MI compared to prescription H2RAs. Physicians and patients should not avoid starting a PPI because of concerns related to MI risk." (Gastroenterology)

6 November 2017 Abnormal esophageal acid exposure on high-dose proton pump inhibitor therapy is common in systemic sclerosis patients. "Abnormal esophageal acid exposure despite high-dose PPI therapy was common among patients with SSc. The lack of increased reflux episodes in the SSc patients, and longer bolus clearance times and lower nocturnal impedance, supports ineffective clearance as the potential mechanism. Systemic sclerosis patients may require adjunctive therapies to PPIs to control acid reflux." (Neurogastroenterology & Motility)

6 November 2017 Recent Advances in the Pharmacological Management of Gastroesophageal Reflux Disease. "The management of proton pump inhibitor-refractory GERD (rGERD) is a challenge in clinical practice. Since up to one-third of patients with typical GERD symptoms (heartburn and/or acid regurgitation) are not satisfied with proton pump inhibitor (PPI) therapy, new drug development targeting different pathophysiologies of GERD is imperative." (Digestive Diseases and Sciences)

6 November 2017 Predicting oesophageal cancer progression using genomic information in pre-malignant oesophageal tissues "Genomic copy number information generated from current surveillance protocols can improve early diagnosis in this disease, and enable better management for Barrett’s patients." (NCRI Cancer Conference abstract)

2 November 2017 Diaphragmatic Breathing Reduces Belching and Proton Pump Inhibitor Refractory Gastroesophageal Reflux Symptoms. "In a prospective study, we found a standardized protocol for diaphragmatic breathing to reduce belching and PPI-refractory gastroesophageal reflux symptoms, and increase QoL in patients with PPI-refractory GERD" (Clinical Gastroenterology & Hepatology)

2 November 2017 Comparison of the human gastric microbiota in hypochlorhydric states arising as a result of Helicobacter pylori-induced atrophic gastritis, autoimmune atrophic gastritis and proton pump inhibitor use. "Several conditions associated with reduced gastric acid secretion confer an altered risk of developing a gastric malignancy. Helicobacter pylori-induced atrophic gastritis predisposes to gastric adenocarcinoma, autoimmune atrophic gastritis is a precursor of type I gastric neuroendocrine tumours, whereas proton pump inhibitor (PPI) use does not affect stomach cancer risk." (PLoS Pathology)

2 November 2017 Association of Proton Pump Inhibitor Use With Serum Biomarkers of Inflammation, Insulin Resistance, Cardiovascular Risk, and Renal Function. "PPI was not associated with clinically significant differences in serum biomarkers of inflammation, insulin resistance, cardiovascular risk, and renal function. Rather, increasing BMI was strongly associated with PPI use and clinically significant differences in these biomarkers." (Journal f Clinical Gastroenterology)

1 November 2017 Proton pump inhibitors and risk of Clostridium difficile infection: association or causation? "In the authors' opinion, systematic discontinuation of PPIs in patients at risk for CDI is not warranted based on current evidence. Well controlled prospective human studies are needed. Careful and repeated consideration should be given to all PPI prescriptions to avoid potential adverse effects." (Current Opiion in Gastroenterology

1 November 2017 Gastroesophageal reflux disease after per-oral endoscopic myotomy as compared with Heller's myotomy with fundoplication: a systematic review with meta-analysis. "Incidence of reflux-disease appears to be significantly more frequent after POEM than after LHM with fundoplication. pH-monitoring and appropriate treatment after POEM should be considered in order to prevent long-term reflux-related adverse events." (Gastrointestinal Endoscopy)

14 October 2017 Chronic use of proton pump inhibitors, adverse events and potential biological mechanisms: A translational analysis. "Even if PPI are usually considered as safe, there is a growing concern for a range of adverse effects of chronic PPI therapy often in the absence of appropriate indications. We propose, after a summary of renal, cardiovascular and neurological complications (dementia, chronic kidney disease, myocardial infarction and stroke), an integrative overview of the potential biological mechanisms involved." (Therapie)

October 2017 Screening and prevention strategies and endoscopic management of early esophageal cancer. "Advances in endoscopic ablative techniques and endoscopic resection via endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) have proven to be effective in eradicating dysplasia and early stage cancer." (Chinese Clinical Oncology)

October 2017 Gastroesophageal Reflux Disease Associated With Anxiety: Efficacy and Safety of Fixed Dose Combination of Amitriptyline and Pantoprazole. "we found that adding low-dose amitriptyline to a conventional dose of PPI resulted in significantly decreased symptoms, with no reported side effects." (Gastroenterology Research)

October 2017 Proton Pump Inhibitor Use Is Associated With an Increased Frequency of Hospitalization in Patients With Cystic Fibrosis."PPI use is highly prevalent in CF patients. Exposure to PPI therapy is independently associated with a higher number of hospitalizations for pulmonary exacerbation in CF patients." (Gastroenterology Research)

2017 Drugs for improving esophageal mucosa defense: where are we now and where are we going?  "increasing evidence that 20-40% of reflux patients respond not at all or only partially to proton pump inhibitors (PPIs) has underlined the concept that factors other than acid are implicated in its development and the elicitation of symptoms" (Annals of Gastroenterology)

30 October 2017 Maintenance therapy with proton pump inhibitors and risk of gastric cancer: a nationwide population-based cohort study in Sweden. "Of all 5823 patients with gastric cancer diagnosed during the study period, 38.1% occurred among maintenance PPI users." (BMJ open)

30 October 2017 Methylation panel is a diagnostic biomarker for Barrett's oesophagus in endoscopic biopsies and non-endoscopic cytology specimens. "Eighteen genes were differentially methylated in patients with Barrett'soesophagus compared with squamous controls. Hypermethylation of TFPI2, TWIST1, ZNF345 and ZNF569 was confirmed in Barrett's biopsies compared with biopsies from squamous oesophagus and gastric cardia (p<0.05). When tested in Cytosponge samples" (Gut)

August 2017 Application of a multi-gene next-generation sequencing panel to a non-invasive oesophageal cell-sampling device to diagnose dysplastic Barrett's oesophagus. "it is possible to apply a multi-gene cancer hot-spot panel and next-generation sequencing to microdissected, FFPE samples collected by the Cytosponge™, in order to distinguish non-dysplastic from dysplastic Barrett's oesophagus" (Journal of Pathology: Clinical Research)

30 October 2017 Response to TNF-α Is Increasing Along with the Progression in Barrett's Esophagus.  "An anti-inflammatory compound, such as curcumin, could create an anti-inflammatory microenvironment and thus potentially support an increase chemosensitivity in EAC cells." (Digestive Diseases and Sciences)

28 October 2017 Do Statins Increase the Risk of Esophageal Conditions? Findings from Four Propensity Score-Matched Analyses. "statin users were more likely to be diagnosed with esophagitis .. and gastroesophageal reflux disease/dyspepsia .. compared with non-users. ... In sensitivity analyses, which excluded patients with obesity, statin use was not associated with an increased odds ratio of gastroesophageal reflux disease/dyspepsia." (Clinical Drug Investigation)

October 2017 Persistent severe hypomagnesemia caused by proton pump inhibitor resolved after laparoscopic fundoplication. " long-term PPI user with persistent hypomagnesemia with severe symptoms at presentation. He was unable to stop PPI treatment because of severe reflux symptoms, and was dependent on weekly intravenous magnesium infusions, until his magnesium levels finally normalized without the need for supplementation after a successful laparoscopic fundoplication." (World Journal of Gastroenterology)

November [GASTROESOPHAGEAL REFLUX DISEASE – A MULTIFACETED DISEASE]. "Extraesophageal reflux disease represents a wide range of symptoms connected to the upper and lower respiratory system, such as cough, laryngitis, asthma, chronic obstructive pulmonary disease, hoarseness, sinusitis-postnasal drip syndrome, otitis media, recurrent pneumonia and laryngeal carcinoma." (Acta Medica Croatia)

26 October 2017 Endoscopic therapy for Barrett's high grade dysplasia and intramucosal esophageal cancer is effective in community clinical practice by advanced endoscopists following multidisciplinary approach. "Endoscopic management of BEHGD and IMC can be safely and effectively performed in a community clinical practice similarly to high-volume academic medical centers when performed by advanced endoscopists following multidisciplinary approach." (Diseases of the Esophagus)

24 October 2017 Surgical vs Endoscopic Management of T1 Esophageal Adenocarcinoma: a Modeling Decision Analysis. "In the T1a base case, esophagectomy yielded more unadjusted life years than endoscopic therapy (6.97 vs 6.81), but fewer quality-adjusted life years (QALYs, 4.95 for esophagectomy vs 5.22 for endoscopic therapy). In the T1b base case, esophagectomy yielded more unadjusted life years than endoscopic therapy (5.73 vs 5.01) and QALYs (4.07 vs 3.85 for endoscopic therapy), but was not cost effective" (Clinical Gastroenterology & Hepatology)

22 October 2017 Cancer, Esophageal (Free full text book) "When stratified by anatomical location, the incidence of adenocarcinoma of the distal esophagus and gastroesophageal junction (GEJ) continues to increase rapidly due to Barrett’s esophagus." (StatPearls)

18 October 2017 Barrett Metaplasia (Free full text book) "The incidence of esophageal adenocarcinoma is on the rise. Therefore, timely evaluation and treatment of Barrett’s esophagus and its consequences are more important than ever." (StatPearls)

16 October 2017 Esophagitis, Eosinophilic (Free full text book)   "Eosinophilic esophagitis was once thought to be a component of gastroesophageal reflux disease (GERD). However, it is now known to be a separate entity" (StatPearls)

15 September 2017 Endoscopic mucosal ablation and resection of Barrett's esophagus and related diseases. "Early detection of dysplastic changes or EAC will prompt the use of endoscopic therapies such as RFA and EMR. These techniques have shown excellent results in the eradication of dysplasia and intramucosal carcinoma with a significant reduction in the recurrence of the disease and low rate of complications." (Journal of Vizualised Surgery)

14 September 2017 Endoscopic fundoplication: patient selection and technique. "The TIF procedure is a good alternative to medical therapy. It is safe and effective but not as profound as with a laparoscopic approach. On the other hand, patients may experience less bloating and dysphagia compared to a Nissen fundoplication and this may be preferable to many patients." (Journal of Vizualised Surgery)

November 2017 Adherence to quality indicators of Barrett's esophagus surveillance: where do we stand? "In summary, adherence to quality measures for the evaluation and management of BE is low in clinical practice. ... dedicated training and adequate time allocation will likely improve the quality of BE surveillance and thereby improve clinical outcomes." (Endoscopy)

27 October 2017 Additive Effects of Rebamipide Plus Proton Pump Inhibitors on the Expression of Tight Junction Proteins in a Rat Model of Gastro-Esophageal Reflux Disease. "Rebamipide may exert an additive effect in combination with PPI to modify the tight junction proteins of the esophageal mucosa in a rat model of GERD. This treatment might be associated with the relief of GERD symptoms." (Gut & Liver)

26 October 2017 Genomic regions associated with susceptibility to Barrett's esophagus and esophageal adenocarcinoma in African Americans: The cross BETRNet admixture study. "Chromosomal regions on 11p15 and 8q22-24 are associated with excess European ancestry in African Americans with BE and EAC. Because GWAS [Genome Wide Association Study] have not reported any variants in these two regions, low frequency and/or rare disease associated variants that confer susceptibility to developing BE and EAC may be driving the observed European ancestry association evidence." (PLoS One)

25 October 2017 Longitudinal study of gastroesophageal reflux and erosive tooth wear. "In this longitudinal study in patients with erosive tooth wear and oligosymptomatic GERD receiving esomeprazole for one year, erosive tooth wear did not progress further in the majority of patients. Background acidic esophageal reflux exposure appeared stable over time, whereas weakly acidic exposure decreased significantly in patients without erosion progression" (BMC Gastroenterology)

October 2017 The 2015 upper gastrointestinal "Be Clear on Cancer" campaign: its impact on gastroenterology services and malignant and premalignant diagnoses. "The 'Be Clear on Cancer' campaign led to a 48% increase in demand for 2WW [2 week wait] gastroscopies but did not significantly affect the incidence of target diagnoses, cancer staging or 1-year survival." (Frontline gastroenterology)

24 October 2017 Hot avulsion may be effective as salvage treatment for focal Barrett's esophagus remaining after endoscopic therapy for dysplasia or early cancer: a preliminary study. "Hot avulsion appears to be effective and safe in removing focal BE ≤ 1 cm at its greatest length remaining after endoscopic treatment for dysplasia or early cancer" (Endoscopy)

24 October 2017 A gastroenterologist's perspective on the role of barium esophagography in gastroesophageal reflux disease. "esophagography and esophagoscopy are complementary procedures that provide a more comprehensive and therapeutically actionable plan for patients with GERD than either diagnostic test alone." (Abdominal radiology)

23 October 2017 The association between physical activity and the risk of symptomatic Barrett's oesophagus: a UK prospective cohort study.  "Heavy manual occupations were positively associated with disease risk, but conventional statistical significance was not reached. No associations were found between recreational activity and the risk of Barrett's oesophagus" "Our study suggests that occupational levels of physical activity may be associated with the risk Barrett's oesophagus. However, further work is required to confirm and describe specific occupations that may be protective."  (European Journal of Gastroenterology & Hepatology)

23 October 2017 Nonalcoholic Fatty Liver Disease Is Associated with Increased Risk of Reflux Esophagitis. "In this large cohort of Korean men and women, participants with NAFLD exhibited increased incidence of reflux esophagitis independent of possible confounders, suggesting that NAFLD contributes to the development of reflux esophagitis." (Digestive Diseases & Sciences)

November 2017 Are we ready to move toward digital image interpretation in Barrett's esophagus surveillance? " In the near the future, computer-aided image analysis combined with the use of biomarkers for cancer risk will probably change current surveillance protocols, both reducing the number of useless random biopsies in healthy low-risk individuals and improving the detection of neoplastic progression in high-risk patients." (Gastrointestinal Endoscopy)

July 2017 System design and experimental research of lower esophageal sphincter stimulator for treatment of gastroesophageal reflux disease. "In this paper, an implantable LES stimulator with wireless power transmission is proposed for the treatment of GERD." "results show that the electrical stimulation delivered by the LES stimulator can safely and effectively increase resting LES pressure in acute animal models, suggesting that the implantable LES stimulator is a perspective approach for treating GERD in clinics" (Conference proceedings IEEE Medicine & Biology)

July 2017 Convolutional neural network classifier for distinguishing Barrett's esophagus and neoplasia endomicroscopy images. "Intestinal metaplasia (IM) and gastric metaplasia (GM) are two sub-classes of Barrett's esophagus. As IM can progress to the esophageal cancer, the neoplasia (NPL), developing methods for classifying between IM and GM are important issues in clinical practice." (Conference proceedings IEEE Medicine & Biology)

2017 Gastroesophageal reflux disease: the results of videolaparoscopic fundoplication at five years after surgery. "Videolaparoscopic antireflux surgery for GERD is an equally effective alternative to medical therapy and should be offered to appropriately selected patients by skilled surgeons." (Wiadomosci Lekarskie)

2017 Gerd: clinical solutions of problems in general practice. "GERD patients with hypertension and without are demonstrating an equal number of acid and all (nonacid + acid) reflux ... . But the difference between the two groups was that in patients with concomitant hypertension longer refluxes ... were observed and the total acid exposure tends to be prolonged ... . Our analysis of the state of gastric secretion on the results of 200-minute intra gastric pH monitoring, showed as expected more intensive acid in both groups of patients with GERD. The most "acidic" patients were GERD patients with hypertension" (Wiadomosci Lekarskie)

19 October 2017 Eating Behaviours and Prevalence of Gastroesophageal Reflux Disease in Japanese Patients with Type 2 Diabetes Mellitus: The Dogo Study. "The prevalence values of GERD, skipping breakfast, bedtime snacking, late-night dinner and fast eating were 32.0%, 13.7%, 27.1%, 28.8%, and 44.4%, respectively. Late-night dinner was independently positively associated with GERD in patients with type 2 diabetes. ... No relationships were found between skipping breakfast, bedtime snacking or fast eating and GERD." (Canadian Journal of Diabetes)

18 October 2017 Esophageal cancer in first-degree relative increases Barrett’s risk "Overall, 6.7% of patients with Barrett’s esophagus had a first-degree relative with a history of esophageal adenocarcinoma. Of these, 21.1% had disease that progressed to esophageal adenocarcinoma compared with 8.7% of patients without a first-degree relative with esophageal adenocarcinoma." (Healio World Congress abstract)

17 October 2017 The diagnostic value of pepsin detection in saliva for gastro-esophageal reflux disease: a preliminary study from China. "Patients with GERD had a higher prevalence of pepsin in saliva and higher pepsin concentration than patients with non-GERD and healthy controls. ... Salivary pepsin test had moderate diagnostic value for GERD. It may be a promising tool to replace the use of currently invasive tools with advantages of non-invasive, easy to perform and cost effective." (BMC Gastroenterology)

17 October 2017 Is gastroesophageal reflux disease associated with primary acquired nasolacrimal duct obstruction? "Based on the results of this study and compared to the general population, GERD has an increased prevalence in patients with PANDO. GERD may have a role in the development of PANDO." (Orbit)

16 October2017 Identification of a key role of widespread epigenetic drift in Barrett's esophagus and esophageal adenocarcinoma. "epigenetic drift not only defines tissue aging (i.e., provides a molecular clock) but also “throttles” the expression and function of developmental genes forcing transitions in tissue characteristics that better cope with the erosive and damaging milieu in BE" (Clinical Epigenetics)

October 2017 Bidirectional association between fibromyalgia and gastroesophageal reflux disease: two population-based retrospective cohort analysis "The present study suggests a bidirectional relationship between fibromyalgia (FM) and gastroesophageal reflux disease (GERD). There is a greater risk of developing GERD for patients with FM than developing FM for patients with GERD" (Pain)

October 2017 Clinical Implications of Associations between Headache and Gastrointestinal Disorders: A Study Using the Hallym Smart Clinical Data Warehouse. "The observed association in this study may suggest that primary headache sufferers who experience migraines or TTH [Tension Type Headache] are more prone to GI disorders, which may have various clinical implications. Further research concerning the etiology of the association between headaches and GI disorders is warranted." (Frontiers in Neurology)

14 October 2017 Dysphagia: Thinking outside the box. "GORD can cause not only a decrement in peristaltic vigour, but may contribute to hyperalgesia, such that whilst food passes freely into the stomach, the patient experiences dysphagia indicating a somatosensory dysfunction. When further investigation is required, reconsideration of the site and the nature of symptoms (e.g., oropharyngeal vs oesophageal), and early recourse to upper gastrointestinal endoscopy is suggested, particularly given the increasing frequency of EoE and thus the need for oesophageal biopsies. HRM is required to exclude major disorders of peristalsis" (World Journal of Gastroenterology)

14 October 2017 Treatment of gastroesophageal reflux disease using radiofrequency ablation (Stretta procedure): An interim analysis of a randomized trial. "Three months after Stretta, 80% reported improvement in QOL compared to 40% in the control group" (Indian Journal of gastroenterology)

13 October 2017 Pathophysiology of Gastroesophageal Reflux Disease. "Esophageal exposure to gastric refluxate is the primary determinant of disease severity. This exposure arises via compromise of the anti-reflux barrier and reduced ability of the esophagus to clear and buffer the refluxate, leading to reflux disease." (Gastroenterology)

13 October 2017 Insights into the Pathophysiology of Esophageal Adenocarcinoma. "We review the features of the luminal and mucosal microenvironment of Barrett's esophagus that promote, in a small proportion of patients, development of esophageal adenocarcinoma. Markers of clonal evolution might be used to determine patient risk for cancer and set surveillance intervals." (Gastroenterology)

11 October 2017 Eight weeks of omeprazole 20 mg significantly reduces both laryngopharyngeal reflux and comorbid chronic rhinosinusitis signs and symptoms: randomized, double blind, placebo controlled trial. "The results of our trial suggest that omeprazole 20 mg OD for 8 weeks was effective in reducing signs and symptoms of both LPR and CRS, although in most patients still present at the end of the trial." (Clinical Otolaryngology)

11 October 2017 Cancer development: Origins in the oesophagus "The cellular origins of a precancerous condition called Barrett's oesophagus "
11 October 2017 Transitional basal cells at the squamous-columnar junction generate Barrett's oesophagus "Our findings reveal a previously unidentified transitional zone in the epithelium of the upper gastrointestinal tract and provide evidence that the p63+KRT5+KRT7+ basal cells in this zone are the cells of origin for multi-layered epithelium and Barrett’s oesophagus." (Nature)

October 2017 Prescribing PPIs. " there are concerns that many people take them for long periods to manage less serious conditions (e.g. indigestion) and may prefer taking them to addressing factors such as diet, obesity or alcohol that may be contributing to their symptoms. Although PPIs are well-tolerated, there is increasing evidence that they may be associated with a range of long-term adverse effects. Here, we review the safety of PPIs and consider whether long-term prescribing needs to be reassessed." (Drug Therapeutics Bulletin - BMJ)

10 October 2017 An Evidence-based Review of Medicinal Herbs for the Treatment of Gastroesophageal Reflux Disease (GERD).. "Although their active components or the mechanism of action were not known by the ancient Persians at that time, their persistent use during different centuries might indicate their effectiveness." (Current Drug Discovery Technologies)

10 October 2017 Popular Acid Reflux Drugs Promote Chronic Liver Disease "The researchers concluded that there is an association between PPI use among people who abuse alcohol and risk of liver disease. However, they can't yet rule out the possibility that there could be other unidentified factors that differ between patients that do and do not take PPIs, which might confound the relationship between PPI use and liver disease." (Genetic Engineering & Biotechnology News)

10 October 2017 Determinants of the Association between Non-Cardiac Chest Pain and Reflux. "The presence of a larger volume of acid refluxate for a longer period of time appears to be an important determinant of perceiving a reflux episode as chest pain. " (American Journl of gastroenterology)

9 October 2017 Definition of Barrett Esophagus in the United States: Support for Retention of a Requirement for Goblet Cells. "CLM with IM in the tubular esophagus is found in association with EAC in 70% to 92% of patients. We believe that based on these data the United States definition of BE should continue to require the presence of IM." (American Journal of Surgical Pathology)

6 October 2017 Detection of genetic alterations in cfDNA as a possible strategy to monitor the neoplastic progression of Barrett's esophagus "Altogether, our data suggest that the use of liquid biopsy could become a minimally invasive diagnostic tool to implement BE patient monitoring." (Translational Research)

6 October 2017 Endoscopic submucosal dissection for early Barrett's neoplasia: a meta-analysis. "ESD for early BE neoplasia is associated with a high en bloc resection rate, acceptable safety profile and low recurrence after curative resection. ESD should be considered as part of the armamentarium for the management of BE neoplasia" (Gastrointestinal Endoscopy)

5 October 2017 Incidence and predictors of osteoporotic fractures in patients with Barrett's oesophagus: a population-based nested case-control study. "The incidence of osteoporotic fractures was not increased in BO patients compared to the general population. In addition, PPI use was not associated with increased fracture risk regardless of the duration of therapy or dose." (Alimentary Pharmacology & Therapeutics)

2 October 2017 Oesophageal disease in systemic sclerosis: does heritability play a role? "These data suggest that independent of GERD, oesophagitis in SSc patients and their relatives may have both a hereditable and environmental etiology. There does not seem to be a heritable component to Barrett's oesophagus." (Clinical & Experimental Rheumatology)

September 2017 Efficacy and safety of liquid nitrogen cryotherapy for treatment of Barrett's esophagus. "Cryotherapy is an efficacious and safe treatment modality for Barrett's esophagus with and without dysplasia or intramucosal adenocarcinoma." (Journal of Gastroenterology & Hepatology)

July 2017 Overview of idiopathic pulmonary fibrosis (IPF) and evidence-based guidelines. " Most patients have several comorbid conditions that can affect the course of their disease, including gastroesophageal reflux disease, obstructive sleep apnea, cardiomyopathy, and pulmonary hypertension." (American Journal of managed care)

June 2017 Laryngopharyngeal Reflux Disease - LPRD. "Out of 2123 examinees who showed symptoms of LPR, 390 tested positive according to the questionnaire. This group of examinees were treated in accordance with all suggested protocols and algorithms. 82% showed signs of improvement as a response to basic treatment provided by their physicians." (Medical Archives - Sarajevo, Bosnia & Herzegovina)

September 2017 Diagnosis and Endoscopic Management of Barrett's Esophagus: an Italian Experts' Opinion based document. "generated statements highlight the Italian contribution to the European Position Statement of the European Society of Gastrointestinal Endoscopy. The Italian statements preserve peculiarities when dealing with the endoscopic management of BE and wishes to be considered as a contribution for the care of BE patients even with a low risk of progression to esophageal neoplasia." (Digestive & Liver Diseases)

29 September 2017 Effect of diagnosis, surveillance, and treatment of Barrett's oesophagus on health-related quality of life "Historically, follow-up care has left some patients with insufficient understanding of the disease, inaccurate perceptions of cancer risk, and an unnecessary psychological burden. A greater understanding of the prevalence of these factors and identification of follow-up needs specific to these patients will help to shape future health-care delivery and improve patient experience." (Gastroenterology & Hepatology)

28 September 2017 International development and validation of a classification system for the identification of Barrett's neoplasia using acetic acid chromoendoscopy: the Portsmouth acetic acid classification (PREDICT). "We developed and validated a classification system known as PREDICT for the diagnosis of Barrett's neoplasia using AAC. The improvement seen in the sensitivity and NPV for detection of Barrett's neoplasia in phase 3 demonstrates the clinical value of PREDICT and the similar improvement seen among non-endoscopists demonstrates the potential for generalisation of PREDICT once proven in real time." (Gut)

28 September 2017 The Role of Gastroesophageal Reflux in Provoking High Blood Pressure Episodes in Patients With Hypertension. "GERD patients had significantly higher nocturnal BP than non-GERD patients. Antiacid therapy brought about significant reduction in all esophageal monitoring parameters as well as in BP parameters in GERD patients." (Journal of Clinical Gastrenterology)

27 September 2017 Longitudinal outcomes of radiofrequency ablation versus surveillance endoscopy for Barrett's esophagus with low-grade dysplasia. "In conclusion, progression to high-grade dysplasia or adenocarcinoma was not significantly reduced in the radiofrequency ablation cohort when compared to surveillance. Despite recent studies suggesting the superiority of radiofrequency ablation in reducing progression, diligent endoscopic surveillance may provide similar long-term outcomes." (International Society for Diseases of the Esophagus)

27 September 2017 Ambulatory pH-impedance-pressure monitoring as a diagnostic tool for the reflux-cough syndrome. "Overall, only approximately one quarter of patients with chronic unexplained cough have reflux-induced cough, explaining the observation that the vast majority of patients with chronic cough do not benefit from antireflux therapy. pH-impedance-pressure monitoring helps to identify patients who are likely to have reflux as a cause of their chronic cough." (International Society for Diseases of the Esophagus)

27 September 2017 Interchageable Use of Proton Pump Inhibitors Based on Relative Potency-Systematic Review and Meta-Analysis. "In a systematic review and meta-analysis, we found that PPIs can be used interchangeably based on omeprazole equivalents. Twice-daily doses are more effective at increasing pH time than once daily doses. Omeprazole and lansoprazole (30 mg) produce the same effects as esomeprazole or rabeprazole (20 mg). Costs of PPIs are unrelated to PPI potency." (Clinical Gastroenterology & Hepatology)

27 September 2017 Expert consensus document: Advances in the physiological assessment and diagnosis of GERD. "This document reflects the collective conclusions of the international GERD working group, incorporating existing data with expert consensus opinion." (Nature Reviews; Gastroenterology and Hepatology)

25 September 2017 Emerging dilemmas in the diagnosis and management of gastroesophageal reflux disease. "response to PPI therapy becomes the major indication for continued PPI therapy. Conversely, in the absence of objective criteria for GERD and the absence of apparent clinical benefit, PPI therapy is not indicated and should be discontinued. PPIs are well tolerated and safe, but nothing is perfectly safe, and in the absence of measurable benefit, even a miniscule risk dominates the risk-benefit assessment." (F1000Research)

25 September 2017 The impact of advanced endoscopic imaging on Barrett's esophagus in daily clinical practice. "Our data show that the use of narrow-band imaging and acetic acid chromo-endoscopy in the imaging of Barrett's esophagus did not result in an increased detection rate of dysplasia in routine clinical practice. These findings concur with the recommendations of existing Barrett's surveillance guidelines, which advocate the continued use of quadrantic biopsies within general surveillance programs." (Gastrointestinal Endoscopy)

23 September 2017 Proton pump inhibitors and the risk of severe cognitive impairment: The role of posttraumatic stress disorder. "Being-dispensed PPIs were associated with SCI in this analysis of WTC [World Trade center] responders. Results suggest that clinicians treating GERD seek to both understand patients' mental health history and monitor cognitive functioning when designing treatment routines" (Alzheimers & Dementia - New York)

23 September 2017 A pooled analysis of dietary sugar/carbohydrate intake and esophageal and gastric cardia adenocarcinoma incidence and survival in the USA. "EA incidence was increased by 51-58% in association with sucrose, sweetened desserts/beverages and the dietary glycaemic index" (International Journal of epidemiology)

21 September 2017 Perceptions of risk and therapy among patients with Barrett's esophagus: a patient survey study. "Patients with Barrett's esophagus overestimate their risk of developing esophageal adenocarcinoma and will accept low success rates and high risk of complications to undergo endoscopic therapy. Baseline risk perception correlates with the desire for endoscopic therapy." (International Society for Diseases of the Esophagus)

September 2017 Gastroesophageal reflux disease: An important consideration for respiratory disorders. "GERD has been associated with a wide range of respiratory disorders, including asthma, chronic cough, and idiopathic pulmonary fibrosis (IPF) [1], as well as chronic obstructive pulmonary disease (COPD) and cystic fibrosis [3]." (Respiratory Investgation)

November 2017 Porcine Esophageal Submucosal Gland Culture Model Shows Capacity for Proliferation and Differentiation. "Our results suggest that the activated ESMG [esophageal submucosal glands] state ... may provide a source of cells to repopulate damaged epithelium in a normal manner (squamous) or abnormally (columnar epithelium)." (Cellular & Molecular gastroenterology & Hepatology)

22 September 2017 Deoxycholic acid promotes development of gastroesophageal reflux disease and Barrett's oesophagus by modulating integrin-αv trafficking. "This study highlights that targeting the bile acid component of gastric refluxate should be considered in the clinical management of patients with GORD to prevent erosion of the oesophagus and development of BO." (Journal of cellular and molecular medicine)

22 September 2017 [Esophageal Adenocarcinoma - Appraisal of a Rapidly Increasing Disease] "The incidence of esophageal adenocarcinoma is dramatically increasing in several Western countries. In Germany, the incidence increased by sevenfold since 1991. The most important risk factors for esophageal adenocarcinoma are gastroesophageal reflux and obesity. Early diagnosis is possible within surveillance programs for Barrett metaplasia." (Deutsche medizinische Wochenschrift)

21 September 2017 LOW PREVALENCE OF BARRETT'S ESOPHAGUS IN A RISK AREA FOR ESOPHAGEAL CANCER IN SOUTH OF BRAZIL. "GERD patients had a risk 30-folds greater to present columnar lined esophagus than patients without GERD symptoms. Long segments of columnar lined esophagus, had a risk eight-folds higher to have Barrett's esophagus than short segments. Barrett's esophagus overall prevalence was 0.7%. In GERD patients, the prevalence was 2.7%. Long Barrett's esophagus represented globally 0.3% and 1.1% in GERD patients." (Arquivos de gastroenterologia)

21 September 2017 Favorable results from a prospective evaluation of 200 patients with large hiatal hernias undergoing LINX magnetic sphincter augmentation. "This prospective study of 200 patients with >3 cm hernias undergoing MSA with hiatoplasty resulted in favorable outcomes with median of 9 months follow-up. " (Surgical Endoscopy)

21 September 2017 Proton-pump inhibitors: understanding the complications and risks " a causal relationship remains unproven in most associations, and further studies are needed" (Gastroenterology & Hepatology)

20 September 2017 Quality of life after nissen fundoplication in patients with gastroesophageal reflux disease: Comparison between long- and short-term follow-up. "Despite the re-operation rate of 13.6%, we found excellent long-term symptomatic outcome. There was no difference between short- and long-term results." (Journal of Minimal Access Surgery)

December 2017 Relationship between sleeping difficulties and airway symptoms severity with the health-related quality of life in patients with GERD. "The severity of these reflux-related disorders is well correlated with a significant negative impact on the normal daily activity. The cases with advanced severity of sleeping difficulties had the worst well-being." (Minerva Gastroenterologica)

September 2017 Esophageal Cancer: Genomic and Molecular Characterization, Stem Cell Compartment and Clonal Evolution. "The cellular origins of BE and EAC are still not understood: animal models supported a cellular origin either from stem cells located in the basal layer of esophageal epithelium or from progenitors present in the cardia region." (Medicines - Basel)

  • Patients after successful EET [Endoscopic eradication therapy] should have endoscopic surveillance at intervals dictated by their baseline degree of dysplasia.
  • Surveillance endoscopy requires careful endoscopic examination of the high cardia and the distal esophagus with targeted biopsies of any abnormalities, as well as random surveillance biopsies of the distal esophagus and the high cardia.
  • All patients should remain on PPI to control acid exposure.
  • Recurrent EET should be performed and is usually successful in recurrences of BE or intramucosal EAC after initially successful EET." (American Journal of Gastroenterology)

18 September 2017 Dor Vs Toupet Fundoplication After Laparoscopic Heller Myotomy: Long-Term Randomized Controlled Trial Evaluated by High-Resolution Manometry. "There were no differences in symptom scores or HRM [High Resolution manometry] between fundoplications in the long term. A higher percentage of abnormal 24-h pH test were found for the Toupet group, with no difference in the long term." (Journal of Gastrointestinal Surgery)

18 September 2017 A nonrandomized trial of vitamin D supplementation for Barrett's esophagus.  "BE subjects were vitamin D insufficient. Despite improved vitamin D status with supplementation, no significant alterations in gene expression profiles were noted. If vitamin D supplementation benefits BE, a longer duration or higher dose of supplementation may be needed." (PLoS One)

September 2017 Volumetric Laser Endomicroscopy for Barrett's Esophagus - Looking at the Fine Print. "the sensitivity, specificity, positive predictive value and negative predictive value (NPV) of VLE for diagnosis of dysplasia, buried Barrett's or intramucosal carcinoma was 92.3%, 23.8%, 42.9% and 83.3%, respectively. ... Volumetric laser endomicroscopy is a safe and sensitive test to identify mucosal lesions in patients with BE which are invisible under standard white light endoscopy." (Journal of Gastrointestinal and Liver Diseases)

October 2017 Long-term outcomes for cryotherapy in Barrett's esophagus with high-grade dysplasia: just cracking the ice. "Although careful examination of multiple prospective and retrospective series have demonstrated the superiority of EMR for the management of nodular dysplasia and RFA for the management of flat dysplasia, and their combination to be superior to the use of sequential EMR for the management of BE with HGD,6 this level of data is lacking for LNSCT in conjunction with these existing technologies." (Gastrointestinal Endoscopy)

October 2017 Endoscopic submucosal dissection in endotherapy for Barrett's esophagus-related dysplasia and neoplasia: An essential or optional technique? "although ESD is a useful addition to the BE endotherapy toolkit, its use at this time will likely be limited to expert endoscopists in high-volume tertiary or quarternary referral centers and needed only in a subset of cases. Its primary advantage may be in extending the spectrum of cases that can potentially be managed endoscopically without surgery. However, in the absence of expertise in ESD, conventional cap-assisted EMR followed by ablation remains a time-tested and validated strategy in the evaluation and treatment of BE-related dysplasia and carcinoma." (Gastrointestinal Endoscopy)

September 2017 Laparoscopic Nissen (total) versus anterior 180° fundoplication for gastro-esophageal reflux disease: A meta-analysis and systematic review. "LNF and 180° LAF are equally effective in controlling reflux symptoms and obtain a comparable prevalence of patient satisfaction. 180° LAF can reduce the incidence of postoperative dysphagia while this is offset by a higher risk of reoperation for recurrent symptoms. The risk of recurrent symptoms should need to be balanced against the risk of dysphagia when surgeons choose surgical procedures for each individual with GERD." (Medicine Baltimore)

September 2017 Reflux episodes and esophageal impedance levels in patients with typical and atypical symptoms of gastroesophageal reflux disease.  "Atypical symptoms were more frequently associated with NAR [Non Acid Reflux] than typical symptoms (P < .01). Among patients with positive symptom-association probability (SAP) for NAR, median proximal MNBI [Mean Nocturnal Baseline Impedance] tended to be lower in patients with typical symptoms" (Medicine Baltimore)

12 September 2017 Psychosocial Distress and Quality of Life Impairment Are Associated With Symptom Severity in PPI Non-Responders With Normal Impedance-pH Profiles "Perceptions of reflux symptoms are associated with psychosocial distress, reduced QOL, and sensation of dysphagia among PPI non-responders with normal impedance-pH. Among PPI refractory GERD patients, patient-reported symptom severity is associated with physiological differences, as opposed to psychosocial factors." (American Journal of Gstroenterology)

12 September 2017 Influence of prucalopride on esophageal secondary peristalsis in reflux patients with ineffective motility. "Prucalopride enhances primary peristalsis as well as mechanosensitivity of secondary peristalsis with limited impact on secondary peristaltic activities in IEM [Ineffective Esophageal Motility] patients." (Journal of Gastroenterology & Hepatology)

September 2017 Vonoprazan 10 mg daily is effective for the treatment of patients with proton pump inhibitor-resistant gastroesophageal reflux disease. "vonoprazan 10 mg daily is effective for the treatment of patients with PPI-resistant GERD. Vonoprazan resolves GERD symptoms in patients with erosions more than in those without erosions" (Biomedical reports)

12 September 2017 AssociationBetween Laparoscopic Antireflux Surgery and Recurrence ofGastroesophageal Reflux "Among patients who underwent primary laparoscopic antireflux surgery, 17.7% experienced recurrent gastroesophageal reflux requiring long-term medication use or secondary antireflux surgery. Risk factors for recurrence were older age, female sex, and comorbidity. Laparoscopic antireflux surgery was associated with a relatively high rate of recurrent gastroesophageal reflux disease requiring treatment, diminishing some of the benefits of the operation." (JAMA) 

11 September 2017 Gastroesophageal reflux disease: A clinical overview for primary care physicians.  "This paper helps primary care physicians understand the disease's pathophysiology, and when, how, and with what to treat GERD before referring patients to gastroenterologists or surgeons." (Pathophysiology)

11 September 2017 Postprandial High Resolution Impedance Manometry Identifies Mechanisms of Non-Response to Proton Pump Inhibitors. "In a retrospective analysis of 94 non-responders to PPI therapy evaluated by PP-HRIM [Postprandial high-resolution impedance manometry], we detected an abnormal post-prandial pattern in 76% of cases: 42% of these were characterized as supragastric belching, 20% as rumination, and 14% as reflux only." (Clinical gastroenterology & Hepatology)

7 September 2017 High yield reproducible rat model recapitulating human Barrett's carcinogenesis ."Esophagojejunostomy was successfully replicated in rats with low mortality and a high tumor burden, which may facilitate broader adoption to study EAC development, progression, and therapeutics." (World Journal of Gastroenterology)

4 September 2017 Long-term outcome of laparoscopic Nissen fundoplication in a regional hospital setting. "Laparoscopic Nissen fundoplication is a safe method with significant long-term efficacy in terms of symptom control and quality of life, even when; performed in a low-volume, community-hospital setting." (International Journal of surgery)

November 2017 Endoscopic submucosal dissection in the West: current status and future directions. "the experience of ESD in Eastern countries is significant, and excellent outcomes from high volume centres are reported. The potential benefits of ESD are recognised by Western endoscopists, but its adoption has been limited." (Diseases of the Esophagus)

November 2017 Does physical activity protect against the development of gastroesophageal reflux disease, Barrett's esophagus, and esophageal adenocarcinoma? A review of the literature with a meta-analysis. "Although limited, there is some evidence that higher levels of recreational physical activity may reduce the risk of both GORD and esophageal adenocarcinoma, but further large cohort studies examining the type, intensity and duration of activities that may be beneficial are needed." (Diseases of the Esophagus)

November 2017 Human papillomavirus does not play a role in the Barrett esophagus: a French cohort.  "HPV positive status was not associated with BE. No factors were associated with HPV, in particular the degree of BE dysplasia. HPV infection appears unlikely to be significant in the etiology of BE" (Diseases of the Esophagus)

November 2017 Frequency of endoscopic surveillance for Barrett's esophagus is influenced by health insurance status: results from a population-based analysis. "This study identified a difference in frequency of surveillance esophagogastroduodenoscopy for Barrett's esophagus by payer status. Patients without health insurance and those whose primary insurance was Medicaid were at increased odds for under-surveillance." (Diseases of the Esophagus)

November 2017 Digital microscopy as valid alternative to conventional microscopy for histological evaluation of Barrett's esophagus biopsies. "Diagnostic agreement of digital microscopy is comparable to that of conventional microscopy. These outcomes justify the use of digital slides in a nationwide, web-based BE revision platform in the Netherlands." (Diseases of the Esophagus)

November 2017 Performance characteristics of optical coherence tomography in assessment of Barrett's esophagus and esophageal cancer: systematic review. "OCT may identify intestinal metaplasia and dysplasia, but its accuracy may not meet recommended thresholds to replace 4-quadrant biopsies in clinical practice." (Diseases of the Esophagus)

November 2017 Development of a risk prediction model for Barrett's esophagus in an Australian population. "Significant differences were identified for age, gender, reflux history, family reflux history, history of hypertension, alcoholic drinks per week, and body mass index. These were used to develop a risk prediction model." (Diseases of the Esophagus)

November 2017 Balloon-based esophageal cryoablation with a novel focal ablation device: dose-finding and safety in porcine and human models. "CbFAS cryoablation penetrates deeply into the esophageal wall layers resulting in severe early ablation. After 4 weeks, little injury and no fibrosis remain, even after supratherapeutic durations of administration, suggesting that CbFAS combines deep ablation with a potentially favorable safety profile." (Diseases of the Esophagus)

8 September 2017 Additional Benefits of Routine Drugs on Gastrointestinal Cancer: Statins, Metformin, and Proton Pump Inhibitors. "Recent observational studies have demonstrated that PPIs effectively reduce the progression of nondysplastic Barrett's esophagus into esophageal adenocarcinoma in a dose-dependent manner. However, the association between chronic PPI use and CRC or gastric cancer risk is still controversial." (Digestive Diseases)

7 September 2017 Radio frequency ablation in patients with large cervical heterotopic gastric mucosa and globus sensation: closing the treatment gap "This is the first study on RFA focusing on therapy of large symptomatic heterotopic gastric mucosa. Hereby, we demonstrate that this new technique can be successfully implemented in patients where treatment was limited so far." (Digestive Endoscopy)

7 September 2017 A Comparison of Alkaline Water and Mediterranean Diet vs Proton Pump Inhibition for Treatment of Laryngopharyngeal Reflux "Our data suggest that the effect of PPI on the RSI [Reflux Symptom Index] based on proportion reaching a 6-point reduction in RSI is not significantly better than that of alkaline water, a plant-based, Mediterranean-style diet, and standard reflux precautions," (JAMA Otolaryngology - Head & Neck Surgery)
October 2017 Invited CommentaryDietaryModifications in the Treatment of Laryngopharyngeal Reflux—Will “anApple a Day” Keep the Laryngopharyngeal Reflux Away?  "Not only is [LPR] a challenging condition to both define and diagnose, but in the absence of a gold standard diagnostic tool it is also challenging to monitor response to therapy. The Reflux Symptom Index (RSI) is a validated 9-item self-administered questionnaire published in 2002 to assess the severity of LPR symptoms; however, its clinical utility has been questioned and responses are of a subjective nature." (JAMA Otolaryngology - Head & Neck Surgery)

October 2017 Safety and Efficacy of Wireless pH Monitoring in Patients Suspected of Gastroesophageal Reflux Disease: A Systematic Review. "WM [Wireless Monitoring] is usually better tolerated than CBM [Catheter Based Monitoring] but has more technical problems. Test accuracy was highly variable between studies; therefore, conclusions could not be drawn regarding the performance of the 2 tests. To make meaningful comparisons between WM and CBM a consensus is needed on the diagnostic threshold for GERD, monitoring time, appropriate capsule positioning, and the reference standard." (Journal of Clinical gastroenterology)

September 2017 [The Chinese consensus for screening, diagnosis and management of Barrett's esophagus and early adenocarcinoma(2017, Wanning)] "Patients without intestinal metaplasia in the four quadrants of BE and the length <3 cm is recommended to be excluded from the follow-up. BE with intestinal metaplasia<3 cm is recommended only follow-up for 3-5 years. BE and metaplasia≥3 cm is recommended to be observed every 2-3 years." (Zhonghua Nei Ke Za Zhi)

October 2017 Long-term wireless pH monitoring of the distal esophagus: prolonging the test beyond 48 hours is unnecessary and may be misleading. "A good outcome after fundoplication or medical therapy was achieved in 73.7% of patients in the 24 hour group, in 62.5% of those in the 48 hour group, and in only 25% of those in the 96 hour group, P = 0.02. Long-term wireless pH monitoring enables an increase in the diagnostic yield over traditional 24- and 48-hour pH studies, but prolonging the test may constitute an unwanted bias and prompt the recruitment of more complex patients, in whom the outcome of surgical or medical therapy may prove less than satisfactory." (Diseases of the Esophagus)

October 2017 Symptom association latency during ambulatory reflux monitoring: a review of 1445 symptoms. "There was also no significant difference in time window in relation to acid or nonacid reflux." (Diseases of the esophagus)

October 2017 Effect of alginate in patients with GERD hiatal hernia matters. "There was no distinctive effect of alginate on the height of proximal migration of reflux events in patients with HH and without HH. Alginate decreases acid reflux events within a limited time period, especially at the first hour both in patients with and without HH. Alginate has no effect on the height of reflux events along the esophagus both in patients with and without HH." (Diseases of the esophagus)

October 2017 Evaluation of treatment pattern and symptom control in patients with gastroesophageal reflux disease: multihospital questionnaire survey on the current situation in Korea. "Most patients were prescribed adjunctive medications other than PPIs; however, patients' satisfaction was inversely associated with multiple drugs. Patients' satisfaction was superior in extended-release PPIs than conventional PPIs for the relief of nocturnal heartburn" (Diseases of the Esophagus)

1 September 2017 Review of antireflux procedures for proton pump inhibitor non-responsive gastroesophageal reflux disease.   "Laparoscopic fundoplication remains the most proven therapeutic approach. Newer antireflux procedures such as magnetic sphincter augmentation and transoral incisionless fundoplication offer alternatives with varying degrees of success, " 

A review of medical therapy for proton pump inhibitor nonresponsive gastroesophageal reflux disease.  "Twenty-seven publications on 11 adjunctive medications showed mixed results for adjunctive therapies including nocturnal histamine-2 receptor antagonists, promotility agents, transient lower esophageal sphincter relaxation inhibitors, and mucosal protective agents." (Diseases of the Esophagus)