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April 2018 TreatmentWith Proton Pump Inhibitors Is Associated With Increased Mortality inPatients With Pyogenic Liver Abscess (full text) "PPI treatment is associated with higher index mortality in patients with pyogenic liver abscess. Therefore, critical evaluation of the indication for PPI treatment is particularly important in patients at high risk for pyogenic liver abscess." (Alimentary Phamacology & Therapeutics)

23 April 2018 Lack of improvement of impaired chemical clearance characterizes PPI-refractory reflux-related heartburn. "Lack of improvement of impaired chemical clearance is a major determinant of PPI refractoriness. Timely post-reflux salivary swallowing represents a key defensive mechanism and a potential target for future treatment modalities in PPI-refractory reflux-related heartburn." (American Journal of Gastroenterology)

21 April 2018 Future of diagnosing neoplasia in Barrett's esophagus: volumetric laser endomicroscopy. "It is a second-generation optical coherence tomography (OCT) that provides high-resolution cross-sectional imaging of the esophageal mucosa using near-infrared light. The principle is similar to endosonography, but image formation in OCT depends on variations in the reflection of light from different tissue layers rather than ultrasonic waves." (Clinical journal of gastroenterology)

21 April 2018 High-Percentage Pathological Findings in Obese Patients Suggest that Esophago-gastro-duodenoscopy Should Be Made Mandatory Prior to Bariatric Surgery. "Our study suggests that a large percentage of patients undergoing bariatric surgery have pathologically significant endoscopic findings of which a significant number are asymptomatic; this can lead to a change in the planned bariatric procedure in a section of patients; hence, we believe that EGD should be made mandatory as a pre-operative investigation in all bariatric surgery patients." (Obesity Surgery)

20 April 2018 Proton-Pump Inhibitors and Long-Term Risk of Community-Acquired Pneumonia in Older Adults. "In a large cohort of older adults in primary care, PPI prescription was associated with greater risk of pneumonia in the second year of treatment. Results were robust across alternative analysis approaches. Controversies about the validity of reported short-term harms of PPIs should not divert attention from potential long-term effects of PPI prescriptions on older adults." (Journal of American Geriatrics Society)

May 2018 Endoscopic submucosal dissection for early Barrett's esophagus neoplasia. " the author concluded that the rate of esophageal perforation was 1.5%. However, Desai et al6 found the rate of perforation after focal EMR followed by radiofrequency ablation was only 0.2%; this illustrates that the risk of perforation of ESD for BE is relatively high, so that ESD should be comprehensively and carefully selected for the treatment of BE neoplasia" (Gastrointestinal Endoscopy)

May 2018 Improving quality of care in patients with Barrett's esophagus by measuring and improving neoplasia detection rates. (full text) "The goal of screening and surveillance endoscopy in patients with Barrett’s esophagus (BE) is to reduce the rising incidence of esophageal adenocarcinoma (EAC) and ultimately mortality from this lethal cancer. However, despite all advances in the field of screening, surveillance, and treatment of BE, we have not made a significant dent in the incidence of this cancer." (Gastrointestinal Endoscopy)

April-June 2018 Evaluation of p53 protein expression in Barrett esophagus. (full text) "The technical simplicity, easy availability, and comparatively lower cost enhance the role of p53 as a biomarker in risk stratification for patients with BE." (Indian Journal of Pathology & Microbiology)

19 April 2018 Dose Dependent Impact of Proton Pump Inhibitors on the Clinical Course of Spontaneous Bacterial Peritonitis. "High dosages of PPI are associated with an adverse outcome in patients with SBP. Thus, indication for high dosage PPI therapy should be evaluated carefully in these patients" (Liver International)

19 April 2018 Origins of Metaplasia in Barrett's Esophagus: Is this an Esophageal Stem or Progenitor Cell Disease? "Previously, it was hypothesized that terminally differentiated esophageal squamous cells might undergo direct conversion into specialized intestinal columnar cells via the process of transdifferentiation. However, there is increasing evidence that stem and/or progenitor cells are molecularly reprogrammed through the process of transcommitment to differentiate into the columnar cell lineages that characterize Barrett's esophagus." (Digestive Diseases & Sciences)

19 April 2018 How Should We Report Endoscopic Results in Patient's with Barrett's Esophagus? " cross-sectional data demonstrate that there is still inconsistency among gastroenterologists in performance and reporting of endoscopic findings in patients with Barrett's esophagus" (Digestive Diseases & Sciences)

19 April 2018 Mucosal Two-Step Pathogenesis in Gastroesophageal Reflux Disease: Repeated Weakly Acidic Stimulation and Activation of Protease-Activated Receptor-2 on Mucosal Interleukin-8 Secretion. "We propose a 2-step mechanism in which repeated weakly acidic exposure leads to the upregulation of epithelial PAR2 expression. The subsequent activation of upregulated PAR2 contributes to the initiation of mucosal inflammation, which underlies the important role of esophageal epithelium in GERD pathogenesis." (Digestion)

18 April 2018 Cardiac Metaplasia: Follow, Treat, or Ignore? "Although cardiac mucosa lacks the goblet cells commonly required for a histologic diagnosis of intestinal metaplasia, cardiac mucosa has many molecular features of an intestinal-type mucosa, and appears to be the precursor of intestinal metaplasia with goblet cells. ... Presently, the risk of adenocarcinoma imposed by cardiac mucosa is not clear, but appears to be far less than that of intestinal metaplasis with goblet cells" (Digestive Diseases & Sciences)

18 April 2018 Clinical Guidelines Update on the Diagnosis and Management of Barrett's Esophagus. " there has been an evolution over the years in diagnostic criteria, screening and endoscopic therapy with a variety of subtle differences among the different guidelines." (Digestive Diseases & Sciences)

18 April 2018 Barrett's Esophagus and Esophageal Adenocarcinoma: How Common Are They Really?  "EA and BE occur more frequently in white men over 50 years old, as well as in people with frequent symptoms of gastroesophageal reflux, in smokers, and in people who are obese. Conversely, EA and BE are less common in persons using nonsteroidal anti-inflammatory drugs and in person with Helicobacter pylori infection." (Digestive Diseases & Sciences)

18 April 2018 Natural History of the Post-ablation Esophagus. " Recent findings demonstrate that recurrent intestinal metaplasia (IM) following RFA is relatively frequent. However, dysplastic BE and EAC subsequent to the complete eradication of intestinal metaplasia (CEIM) are uncommon. Moreover, data suggest that the risk of recurrent disease is probably highest in the first year following CEIM. Recurrent IM and dysplasia are usually successfully eradicated with repeat RFA." (Digestive Diseases & Sciences)

17 April 2018 Bowel symptoms in patients that receive proton pump inhibitors. Results of a multicenter survey in Mexico. "The association of PPIs with bowel symptoms and IBS is frequent in Mexico. Diarrhea and bloating predominate, and antibiotics produce the greatest treatment satisfaction, suggesting that SIBO or dysbiosis is the cause of the PPI-related bowel symptoms. However, that remains to be confirmed." (Revista de Gastroenterologia de Mexico)

17 April 2018 The Association Between Proton Pump Inhibitor Use With Acute Kidney Injury and Chronic Kidney Disease. "This paper reviews the currently available literature about these associations and considers their possible underlying pathophysiological mechanisms. The level of evidence-linking PPI use with acute kidney injury and chronic kidney disease is weak and does not establish causality." (Journal of Clinical Gastroenterology)

17 April 2018 Tailored Fundoplication With Endoluminal Functional Lumen Imaging Probe Allows for Successful Minimally Invasive Hiatal Hernia Repair. "Forty patients underwent minimally invasive hiatal hernia repair with fundoplication. ... After 1 month, none of the patients had reflux or significant dysphagia. EndoFLIP can be used to tailor fundoplication with good functional outcome." (Surgical laparoscogy, endoscopy and percutaneous techniques)

17 April 2018 Worldwide Experience with Erosion of the Magnetic Sphincter Augmentation Device  "Erosion of the LINX device is an important but rare complication to recognize that has been safely managed via minimally invasive approaches without long-term consequences." (Journal of Gastrointestinal Surgery).

2018 Meta-analysis of the efficacy and safety of pantoprazole in the treatment and symptom relief of patients with gastroesophageal reflux disease - PAN-STAR. (full text) "Pantoprazole 40 mg was associated with complete relief of GERD-related symptoms in the majority of patients with ERD and NERD. Furthermore, the severity of symptoms was significantly reduced in patients without complete relief of symptoms. Pantoprazole also continuously improved the quality of life of GERD patients over 8 weeks of treatment and was very well tolerated throughout the whole study. Therefore, this meta-analysis suggests that pantoprazole 40 mg once daily is an effective and well-tolerated choice for providing symptom relief of patients with GERD." (Przegląd Gastroenterologiczny

16 April 2018 Evaluation of Symptomatic Esophagogastric Junction Outflow Obstruction. "Anatomical causes are present in 15% of EGJOO. Evaluation is warranted especially in patients presenting with dysphagia. Esophageal biopsies, barium swallows, CT scans and EUS are complementary in EGJOO evaluation. In patients with non-obstructive symptoms and no anatomical etiologies, monitoring for spontaneous resolution is an option." (Journal of Gastroenterology & Hepatology)

16 April 2018 Reduced αGlcNAc glycosylation on gastric gland mucin is a biomarker of malignant potential for gastric cancer, Barrett's adenocarcinoma, and pancreatic cancer. "This review discusses whether relatively reduced levels of αGlcNAc in these lesions could serve as a biomarker to predict malignant potential and cancer progression" (Histochemistry & Cell Biology)

15 April 2018 Proton pump inhibitor use and cancer mortality. "To test the effect of PPIs on tumor growth in a model system free for confounding factors, we investigated the effect of pantoprazole on tumor growth in mice. ...  pantoprazole had no effect on tumor growth alone but it reduced the life-prolonging effect of doxorubicin significantly" (International Journal of Cancer)

15 April 2018 Side Effects of Long-Term Proton Pump Inhibitor Use: A Review. "Suspected side effects are mainly related to increased susceptibility to infections, secondary hypergastrinaemia, impeded absorption of micronutrients or idiosyncratic reactions." (Basic & Clinical Pharmacology & Toxicology)

14 April 2018 Maintenance for healed erosive esophagitis: Phase III comparison of vonoprazan with lansoprazole. (full text) "Our findings confirm the non-inferiority of vonoprazan 10 and 20 mg to lansoprazole 15 mg as maintenance therapy for patients with healed EE." (World Journal of Gastroenterology)

14 April 2018 Hyperinsulinemia Promotes Esophageal Cancer Development in a Surgically-Induced Duodeno-Esophageal Reflux Murine Model. (full text) "Hyperinsulinemia could have a role in the growing incidence of esophageal adenocarcinoma (EAC) and its pre-cancerous lesion, Barrett's Esophagus, a possible consequence of Gastro-Esophageal Reflux Disease. Obesity is known to mediate esophageal carcinogenesis through different mechanisms including insulin-resistance leading to hyperinsulinemia, which may mediate cancer progression via the insulin/insulin-like growth factor axis." (International Journal of Molecular Sciences)

13 April 2018 Predictive features for early cancer detection in Barrett's esophagus using Volumetric Laser Endomicroscopy. "our experiments show that computer-aided methods can achieve a considerably better performance than trained human observers in the analysis of VLE data." (Computerized Medical Imaging & Graphics)

13 April 2018 Prevalence and clinical predictors of LPR among patients diagnosed with GERD according to the reflux symptom index questionnaire. "Contradictory to what is frequently reported, LPR commonly occurs and positively correlates with GERD. Several modifiable clinical predictors of LPR might exist, which highlight the importance of performing a complete clinical assessment of the patients with reflux symptoms." (Saudi Journal of Gastroenterology)

May 2018 Improving quality of care in patients with Barrett's esophagus by measuring and improving neoplasia detection rates. (full text ) "The goal of screening and surveillance endoscopy in patients with Barrett’s esophagus (BE) is to reduce the rising incidence of esophageal adenocarcinoma (EAC) and ultimately mortality from this lethal cancer.1However, despite all advances in the field of screening, surveillance, and treatment of BE, we have not made a significant dent in the incidence of this cancer." (Gastrointestinal Endoscopy)

May 2018 Emerging optical methods for endoscopic surveillance of Barrett's oesophagus. "The currently accepted surveillance regime uses white light endoscopy together with random biopsies, but has poor sensitivity and discards information from numerous light-tissue interactions that could be exploited to probe structural, functional, and molecular changes in the tissue. Advanced optical methods are now emerging that are highly sensitive to these changes and hold potential to improve surveillance of Barrett's oesophagus if they can be applied endoscopically." (Lancet Gastroenterology & Hepatology)

12 April 2018 Development of Evidence Based Surveillance Intervals following Radiofrequency Ablation of Barrett's Esophagus. "In analyses of data from the US RFA and UK NHR for BE, a much-attenuated schedule of surveillance endoscopy would provide protection from invasive adenocarcinoma. Adherence to the recommended surveillance intervals could decrease the number of endoscopies performed yet identify unresectable cancers at rates less than 1/1000 endoscopies" (Gastroenterology)

12 April 2018 Acid-suppressive drugs and risk of kidney disease: A systematic review and meta-analysis. "PPI therapy significantly increased the risks of AIN, AKI, CKD and ESRD. Similar risks were not identified for H2 RA therapy. More clinical trials are needed to confirm our findings." (Journal of Gastroenterology & Hepatology)

12 April 2018 [Cost-Effectiveness and Cost-Utility Analyses of Antireflux Medicine]. "Future prospective, randomized trials should examine this comparison in greater detail [Laparoscopic antireflux surgery and medical therapy with proton pump inhibitors]. Additionally, there is a large potential for further research in the health economics assessment of early diagnosis and prevention measures of reflux disease and Barrett's esophagus/carcinoma." (Geshundheitswesen)

11 April 2018 Correlation between novel 3D high-resolution manometry esophagogastric junction metrics and pH-metry in reflux disease patients. "Both 3D-EGJ metrics were correlated with AET [Acid Exposure Time] emphasizing the importance of both LES and CD [Crural Diaphragm] function as a determinant of EGJ competence." (Neurogastroenterology & Motility)

7 April 2018 New recommendations for endoscopic eradication therapy in Barrett's esophagus "with dysplasia (abnormal growth of cells or tissue) and intramucosal EAC; comparison of EET with esophagectomy; the role of EMR and ablation; and recommendations for surveillance after achieving complete removal of lesions." (American Society for Gastroentestinal Endoscopy)

6 April 2018 Glucose transporter 1 expression as a marker of prognosis in oesophageal adenocarcinoma  "GLUT1 staining combined with CRM and nodal status identifies a poor prognosis sub-group of OAC patients and is a novel prognostic marker following potentially curative surgical resection." (Oncotarget)

6 April 2018 Efficacy of transoral incisionless fundoplication for refractory gastroesophageal reflux disease: a systematic review and meta-analysis. "TIF appears to be a safe and effective endoscopic procedure for patients with refractory GERD. Future controlled trials are needed to directly compare efficacy, long-term durability, and safety between TIF and Nissen fundoplication." (Endoscopy)

5 April 2018 OptimalTiming of PPIs Can Improve Efficacy, Reduce Cost “One of the biggest reasons that I find when patients aren’t responding to the medication has to do with timing of the drug,” (Gastroenterology & Endoscopy News)

5 April 2018 Proton Pump Inhibitors: from CYP2C19 Pharmacogenetics to Precision Medicine. "here is a large body of evidence describing the impact of CYP2C19 variability on PPIs and its potential role in individualizing PPI therapy, yet, CYP2C19 pharmacogenetics has not been widely implemented into clinical practice. More data are needed but CYP2C19 genotype-guided dosing of PPIs is likely to become increasingly common and is expected to improve clinical outcomes, and minimize side effects related to PPIs." (Expert Opinion on Drug Metabolism & Toxicology)

4 April 2018 Multifocal nitrous oxide cryoballoon ablation with or without EMR for treatment of neoplastic Barrett's esophagus. (full text pdf) "Multifocal nitrous oxide cryotherapy using CbFAS is a promising, highly effective, and safe endoscopic treatment for primary or rescue therapy of BE-associated neoplasia and intestinal metaplasia." (Gastrointestinal Endoscopy)

4 April 2018 Results of Magnetic Sphincter Augmentation for Gastroesophageal Reflux Disease.   "Sphincter augmentation results in significantly reduced reflux symptoms, increased GERD-specific Quality of Life and excellent alimentary satisfaction with low perioperative morbidity. This procedure should be considered an excellent alternative to fundoplication in the treatment of GERD." (World Journal of Suregry)

3 April 2018 Validation of a biomarker panel in Barrett's esophagus to predict progression to esophageal adenocarcinoma. "The utility of the ML [Mutational Load] to stratify BE patients for risk of progression was not confirmed in this study." (Diseases of the Esophagus)

2 April 2018 Comparative Molecular Analysis of Gastrointestinal Adenocarcinomas. "We analyzed 921 adenocarcinomas of the esophagus, stomach, colon, and rectum to examine shared and distinguishing molecular characteristics of gastrointestinal tract adenocarcinomas (GIACs)." (Cancer Cell)

2 April 2018 Association Between Use of Acid-Suppressive Medications and Antibiotics During Infancy and Allergic Diseases in Early Childhood. (full text) "This study found associations between the use of acid-suppressive medications and antibiotics during the first 6 months of infancy and subsequent development of allergic disease. Acid-suppressive medications and antibiotics should be used during infancy only in situations of clear clinical benefit." (JAMA Pediatrics)

April 2018 Peroral endoscopic cardial constriction in gastroesophageal reflux disease. "PECC is a feasible, safe, and effective method to treatment GERD through narrowing the diameter of the cardia and preventing the reflux of stomach contents." (Medicine - Baltimore)

April 2018 Endoscopic eradication therapy for patients with Barrett’sesophagus–associated dysplasia and intramucosal cancer (full text) "These evidence-based ASGE practice guidelines for EET in BE patients were developed using the GRADE methodology.24 In addition, these guidelines comply with the standards for guideline development set forth by the Institute of Medicine for the creation of trustworthy guidelines." (Gastrointestinal Endoscopy)

April 2018 Advantages and Disadvantages of Long-term Proton Pump Inhibitor Use. "Although clinically important adverse effects of PPIs can occur, just as with other drugs, those are not frequently observed during or after administration. Thus, PPIs are regarded as relatively safe and considered to be clinically beneficial." (Journal of Neorugastroenterology & Motility)

April 2018 Accuracy of probe-based confocal laser endomicroscopy (pCLE) compared to random biopsies during endoscopic surveillance of Barrett's esophagus. (full text) "pCLE demonstrates high specificity for detecting dysplasia and cancer, but lower sensitivity may limit its utility in routine BE surveillance. pCLE may have a role in confirming LGD in real-time before eradication therapy." (Endoscopy International Open)

April 2018 Acotiamide Has No Effects on Esophageal Motor Activity or Esophagogastric Junction Compliance. "In both healthy individuals and GERD patients, standard dose acotiamide dose does not have significant effects on esophageal motor activities or EGJ compliance." (Journal of Neurogastroenterology & Motility)

April 2018 Abnormal Gastroesophageal Flap Valve Is Associated With High Gastresophageal Reflux Disease Questionnaire Score and the Severity of Gastroesophageal Reflux Disease in Vietnamese Patients With Upper Gastrointestinal Symptoms. "Abnormal GEFV was significantly associated with high GERDQ score. Its prevalence gradually increased in patients with dyspepsia, NERD, and RE, respectively." (Journal of Neurogastroenterology & Motility)

April 2018 Esophageal Motor Disorders Are a Strong and Independant Associated Factor of Barrett's Esophagus. "The presence of EMD (particularly ineffective motor syndrome and lower esophageal sphincter hypotonia) is a strong independent associated factor of BE. Searching systematically for an EMD in patients suffering from GERD could be a new strategy to organize the endoscopic follow-up." (Journal of Neurogastroenterology & Motility)

April 2018 DeterminingRisk of Barrett’s Esophagus and Esophageal Adenocarcinoma Based onEpidemiologic Factors and Genetic Variants (full text) "We used data from 3 large databases of patients from studies of BE or EAC to develop a risk prediction model based on genetic, clinical, and demographic/lifestyle factors. We identified a PRS that increases discrimination and net reclassification of individuals with vs without BE and EAC. However, the absolute magnitude of improvement is not sufficient to justify its clinical use." (Gastroenterology)

March 2018 Association of proton pump inhibitor use with renal outcomes in patients with coronary artery disease. (full text) "Our results suggest that PPI use increases the risk of AKI development, and that PPI use is more significantly associated with acute and chronic renal injuries in younger patients." (Kidney Research & Clnical Practice)
"Recent studies suggested that PPI use was a significant risk factor for CKD development [810,18]; however, the association between PPI use and CKD development was not conclusive in our study."

March 2018 Proton Pump Inhibitors Intake and Iron and Vitamin B12 Status: A Prospective Comparative Study with a Follow up of 12 Months. (full text pdf) "PPIs use for 12 months did not result in clinically significant iron and/or vitamin B12 deficiency; thus, these findings argue routine screening under normal circumstances, although monitoring in elderly and malnourished may be of precious value." (Open Access Macedonian journal of medical sciences)

31 March 2018 Decreased Risk for Microscopic Colitis and Inflammatory Bowel Disease Among Patients with Reflux Disease. "GERD is inversely associated with all forms of inflammatory bowel diseases, such as MC [Microscopic Colitis], UC [Ulcerative Colitis], or CD [Crohn's Disease]." (Colorectal Diseases)

30 March 2018 Model predicted Barrett’s esophagus progression (full text) "Considering that the overall risk of Barrett’s esophagus progression is low, using this model could help avoid excess costs and burdens of unnecessary surveillance" (Gastroenterology)

30 March 2018 A survey on Barrett's esophagus analysis using machine learning. "This work presents a systematic review concerning recent studies and technologies of machine learning for Barrett's esophagus (BE) diagnosis and treatment." (Computers in Biology & Medicine)

30 March 2018 Barrett Esophagus Length, Nodularity, and Low-grade Dysplasia are Predictive of Progression to Esophageal Adenocarcinoma. "In this well-defined cohort of NDBE and BE-LGD subjects, BE length, presence of LGD, and nodularity were independent predictors of progression to HGD/EAC. These factors may aid in identifying high-risk patients who may benefit from closer endoscopic surveillance/therapy." (Journal of Clinical Gastroenterology)

30 March 2018 Detectionof Mutations in Barrett’s Esophagus Before Progression toHigh-grade Dysplasia or Adenocarcinoma "In genomic analyses of BE tissues from patients with or without later progression to HGD or EAC, we found significantly higher numbers ofTP53 mutations in BE from patients with subsequent progression. These mutations were frequently detected before the onset of dysplasia or substantial changes in copy number." (Gastroenterology)

30 March 2018 Laparoscopic Hill repair: 25-year follow-up. "LHR shows excellent long-term durability and quality of life similar to the open Hill repair, with 85% good to excellent results at a median follow-up of 19 years and a reoperation rate under 10%. It is surmised that Hill suture fixation of the gastroesophageal junction to the preaortic fascia may confer unique structural integrity compared to other repairs." (Surgical Endoscopy)

30 March 2018 Clinical feasibility of a new full-thickness endoscopic plication device (GERDx™) for patients with GERD: results of a prospective trial. (full text) "Endoscopic plication with the GERDx™ device reduced distal acid exposure of the esophagus, reflux-related symptoms, and improved GIQLI scores with minimal side effects in a selected cohort of patients and may be a safe alternative in the treatment of GERD." (surgical Endoscopy)

30 March 2018 Combined multichannel intraluminal impedance-pH monitoring should be used to diagnose reflux-related otitis media with effusion in children. "Both acidic and weakly acidic refluxes seemed to play a significant role in the pathogenesis of OME. Localised nasal eosinophilia may serve as a marker of extraoesophageal reflux in children with suspected reflux-related OME." (Acta Paediatrica)

30 March 2018 Efficacy of Vonoprazan for Gastroesophageal Reflux Symptoms in Patients with Proton Pump Inhibitor-resistant Non-erosive Reflux Disease. (full text pdf) "Changing the medication from a PPI to vonoprazan was significantly associated with an improvement in gastroesophageal reflux symptoms. Vonoprazan is one of the most promising treatment options for patients with PPI-resistant GERD." (Internal Medicine)

29 March 2018 Initial experience with a novel resection and plication (RAP) method for acid reflux: a pilot study. (full text) "The RAP method has potential as an effective anti-reflux option. Its main advantages include a short procedure time, simple approach using readily available equipment, and possible avoidance of general anesthesia." (Endoscopy International Open)

29 March 2018 Mistakes in the endoscopic diagnosis and management of Barrett’s oesophagusand how to avoid them [full text] (N.B. Not research per se but a very instructive article in United European Gastroenterology)

29 March 2018 Proton Pump Inhibitors and Infant Pneumonia/Other Lower Respiratory Tract Infections: National Nested Case-control Study. "In otherwise healthy community-dwelling infants, current use of a PPI does not appear to increase the risk of CAP or other LRTIs." (Journal of Pediatric Gastroenterology & Nutrition)

29 March 2018 Baclofen and gastroesophageal reflux disease: seeing the forest through the trees.   (full) "Baclofen has been shown to decrease reflux events and increase lower esophageal sphincter pressure, yet has never established a clear role in the treatment of gastroesophageal reflux disease (GERD). ... These findings may help explain both the benefit of baclofen in conditions such as rumination and supragastric belching, as well as the apparent lack of benefit of baclofen and other GABAB agonists in long-term treatment of GERD." (Clinical & Translational Gastroenterology)

28 March 2018 Validation of a risk prediction model for Barrett's esophagus in an Australian population. (full text) "We have validated a risk prediction model for BE, developed for use within primary health care to identify individuals who are at potentially higher risk and may benefit from further investigation. (Clinical & Experimental Gastroenterology)

28 March 2018 Randomized controlled trial: PPI-based triple therapy containing metronidazole versus clarithromycin as first-line treatment for Helicobacter pylori in adolescents and young adults in Japan.  (full text) "In Japan, PAM may be selected as a first-line treatment for young people with H. pylori if antibiotic susceptibility tests cannot be performed." (Journal of Infection & Chemotherapy)

26 March 2018 Cough reflex sensitivity does not correlate with the esophageal sensitivity to acid in patients with gastroesophageal reflux disease. "There was no correlation between CRS and esophageal sensitivity to acid at any pH tested. PPI treatment substantially reduced esophageal sensitivity to acid but did not affect CRS. We conclude that a simple direct relationship between CRS and esophageal sensitivity to acid is unlikely." (Respiratory Physiology & Neurobiology)

25 March 2018 Empirical treatment of outpatients with gastroesophageal reflux disease with proton pump inhibitors: a survey of Chinese patients (the ENLIGHT Study). "Short-term empirical PPI treatment can provide an effective relief of GERD symptoms in most Chinese patients in real-world practice." (Journal of gastroenterology & Hepatology)

22 March 2018 Preventive effect of oral hangeshashinto (TJ-14) on the development of reflux-induced esophageal cancer. (full text)  "TJ-14 reduced the incidence of reflux-induced esophageal cancer and the infiltration of M2 macrophages in a surgical rat model or suppressed prostaglandin E2 production in esophageal squamous cell carcinoma cell. Further investigation is required regarding the potential clinical use of TJ-14 as an esophageal cancer chemopreventive agent." (Surgery)

21 March 2018 Proton pump inhibitor-refractory gastroesophageal reflux disease: challenges and solutions. (full text) "Pharmacologic treatments can include antacids, prokinetics, alginates, bile acid binders, reflux inhibitors, and antidepressants. Procedural options include laparoscopic fundoplication and LINX as well as endoscopic procedures, such as transoral incisionless fundoplication and Stretta." (Clinical & Experimental Gastroenterolog)

March 2018 Gastroesophageal Reflux Disease and Aerodigestive Disorders. "Co-incidence of gastroesophageal reflux and airway disorders does not necessarily infer causality. While much of our focus has been on managing acidity, controlling refluxate is an area that has not been traditionally aggressively pursued." (Current Problems in Pediatric & Adolescent Health Care)

19 March 2018 Management of failure after surgery for gastro-esophageal reflux disease. "The most frequent causes of failure of ST-GERD [Surgical Treatment of GERD] include errors in the initial indication, which often only need medical treatment, and surgical technical errors, for which surgical redo surgery can be difficult. Multidisciplinary management is necessary in order to offer the best-adapted treatment." (Journal of Visceral Surgery)

15 March 2018 Interactions Between Genetic Variants and Environmental Factors Affect Risk of Esophageal Adenocarcinoma and Barrett's Esophagus. (Full text pdf) "We aimed to identify single nucleotide polymorphisms (SNPs) that may modify the associations of body mass index (BMI), smoking, and gastroesophageal reflux disease (GERD), with risks of EA and BE." (Clinical Gastroenterology & Hepatology)

15 March 2018 Beer effects on postprandial digestive symptoms and gastroesophagic physiology. "Moderate consumption of traditional and alcohol-free beer does not increase dyspeptic symptoms or GER in healthy subjects, whether in a controlled-intake or real-life situation. Neither gastric accommodation nor reflux episodes are modified in this context." (Neurogastroenterology & Motility)

15 March 2018 Decline in perception of acid regurgitation symptoms from gastroesophageal reflux disease in diabetes mellitus patients. (full tet) "There is a discrepancy between subjective symptoms and endoscopic GERD grade in DM patients. The ability of DM patients to feel acid regurgitation may be decreased." (PLoS One)

15 March 2018 Impaired motility in Barrett's esophagus: A study using high-resolution manometry with physiologic challenge. "Reduced contractile effectiveness persisted in BE with the more representative esophageal challenge of swallowing solids and free drinking; while in ENRD and FHC peristalsis usually improved, demonstrating peristaltic reserve. Furthermore, symptom association and refluxate clearance were reduced in BE. These factors may underlie BE pathogenesis." (Neurogastroenterology & Motility)

14 March 2018 Efficacy of omeprazole/sodium bicarbonate treatment in gastroesophageal reflux disease: a systematic review. "This review included information of four studies. Two trials compared the efficacy of omeprazole/sodium bicarbonate versus omeprazole. One study compared the efficacy of once-daily morning or nighttime dosing. And another study compared omeprazole/sodium bicarbonate/alginate versus omeprazole. In total, there was no difference between omeprazole/sodium bicarbonate and omeprazole. However, there is a trend towards more sustained response and a greater proportion of patients with sustained total relief by 30 minutes with omeprazole/sodium bicarbonate." (Medwave)

14 March 2018 Treatment Outcomes of Endoscopic Submucosal Dissection for Adenocarcinoma Originating from Long-Segment Barrett's Esophagus versus Short-Segment Barrett's Esophagus. "ESD for LSBE cancer achieved procedure outcomes and short-term prognosis comparable to SSBE. ESD has the potential to be an effective therapeutic option for esophageal neoplasms in patients with LSBE." (Digestion)

13 March 2018 Prognosis of patients with superficial T1 esophageal cancer who underwent endoscopic resection before esophagectomy-A propensity score-matched comparison. "As the disease-free survival was inferior in the ER + S compared to the PS group the indication for ER, especially repeated ERs, should be restricted to cases with high expectation of success." (Surgical Endoscopy)

13 March 2018 Identification of Individuals with Functional Dyspepsia With a Simple, Minimally Invasive Test: A Single Center Cohort Study of the Oral Capsaicin Test. "Hypersensitivity for capsaicin discriminates functional dyspepsia from patients with other GI disorders. The capsaicin test is a simple and non invasive method to detect a large subgroup of functional dyspepsia with chemical hypersensitivity." (American Journal of Gastroenterology)

12 March 2018 Relation between globus pharyngeus and OSA in patients examined simultaneously by PSG and pH monitor: A cross sectional study. "Although the relation between OSA and globus phayngeus is still controversial, these findings suggest that OSA may be a previously undetected cause of globus pharyngeus. By improving OSA, it may offer an additional option of treatment for those globus pharyngeus cases combined with OSA" (Auris, Nasus, Larynx)

11 March 2018 A randomized, double blind, controlled, multi center study of Ilaparazole in the treatment of reflux esophagitis-Phase III clinical trial. "The efficacy and safety of Ilaparazole (10 mg/day) in treating reflux esophagitis was similar to esomeprazole (40 mg/day). Ilaparazole (10 mg/day) can be used in the treatment of esophagitis." (Contemporary Clinical Trials)

April 2018 Maintenance proton pump inhibition therapy and risk of oesophageal cancer "In conclusion, the long term use of PPIs is associated with increased risk of oesophageal adenocarcinoma in the absence of other risk factors. Long term use of PPIs should be addressed with caution." (Cancer Epidemiology)

2018 [Rhabdomyolysis associated with long-term treatment of esomeprazole]. "Early diagnosis of PPI-induced rhabdomyolysis is required even in long-term PPI users." (Nihon Shokakibyo Gakkai Zasshi)

9 March 2018 Elevated cancer risk perceptions among patients with Barrett's esophagus: do psychological factors play a role? "The results indicate that patients greatly overestimate their cancer risk and are willing to accept low success rates and high risks of complications to undergo endoscopic therapy." (Diseases of the Esophagus)

9 March 2018 In Vivo Short-Term Topical Application of BAY 11-7082 Prevents the Acidic Bile-Induced mRNA and miRNA Oncogenic Phenotypes in Exposed Murine Hypopharyngeal Mucosa. (full text) "There is novel evidence that acidic bile-induced NF-κB-related oncogenic mRNA and miRNA phenotypes are generated after short-term 7-day mucosal exposure and that topical mucosal application of BAY 11-7082 can prevent the acidic bile-induced molecular alterations associated with unregulated cell growth and proliferation of hypopharyngeal cells." (Neoplasia)

9 March 2018 Cryotherapy and Radiofrequency Ablation for Eradication of Barrett's Esophagus with Dysplasia or Intramucosal Cancer. "Endoscopic therapy is highly effective in eradication of Barrett's associated neoplasia. Patients who underwent cryotherapy were equally likely to achieve CE-D but not CE-IM than patients who underwent RFA. Patient characteristics and preferences may effect choice of treatment selection and outcomes." (Digestive Diseases & Sciences)

8 March 2018 Simultaneous laryngopharyngeal pH monitoring (Restech) and conventional esophageal pH monitoring-correlation using a large patient cohort of more than 100 patients with suspected gastroesophageal reflux disease. "As demonstrated by four reflux scenarios, esophageal pH-metry and Restech do not necessarily need to correspond. Especially in patients with borderline abnormal 24-hour pH-metry, Restech may help to support the decision for or against laparoscopic anti-reflux surgery." (Diseases of the Esophagus)

8 March 2018 Radiologic, endoscopic, and functional patterns in patients with symptomatic gastroesophageal reflux disease after Roux-en-Y gastric bypass. "The evaluation for persistent GERD after RYGB revealed a high percentage of hiatal hernias, hypotensive lower esophageal sphincter, and severe esophageal motility disorders. These findings might have an influence on hiatal hernia closure concomitant with RYGB and the role of pH manometry in the preoperative bariatric assessment." (Surgery for Obesity & Related Diseases)

7 March 2018 Dysregulation of PARP1 is involved in development of Barrett's esophagus. (full text) "The dysfunction of PARP1 in esophageal epithelial cells increases the levels of reactive oxygen species and oxidative DNA damage, and downregulation of PARP1 or PARP1 inhibitor may be a potential therapeutic strategy for Barrett’s esophagus." (World Journal of Gastroenterology)

7 March 2018 Association of sporadic and familial Barrett's esophagus with breast cancer. "Selected families with BE/EAC show segregation of breast cancer. A breast cancer diagnosis is marginally associated with BE. We postulate a common susceptibility between BE/EAC and breast cancer." (Diseases of the Esophagus)

7 March 2018 Proton pump inhibitors are not associated with hypomagnesemia, regardless of dose or concomitant diuretic use. "there were also no significant differences in serum magnesium levels between those taking PPIs of varying doses, with or without concomitant diuretics, and those not taking PPIs or diuretics. CONCLUSION>: Regardless of PPI dosage or concomitant diuretics prescribed, magnesium levels were unaffected. Routine screening of serum magnesium in PPI patients appears unnecessary." (Journal of Gastroenterology & Hepatology)

7 March 2018 Lacrimal Drainage Obstruction and Gastroesophageal Reflux Disease: A Nationwide Longitudinal Cohort Study. "Patients with GERD had a higher risk of LDO than those without GERD, irrespective of history of proton-pump inhibitor use. In the sensitivity analysis, GERD patients with esophagitis had a higher risk of LDO than those without esophagitis." (Journal of Clinical gastroenterology)

7 March 2018 ProtonPump Inhibitor Use and Dementia Risk (full text) "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)

6 March 2018 The Impact of Vocal and Laryngeal Pathologies Among Professional Singers: A Meta-analysis. "Professional singers are at an increased risk of laryngeal pathologies and symptoms associated with vocal misuse and overuse, particularly hoarseness, GERD, edema, and polyps." (Journal of Voice)

6 March 2018 Proton pump inhibitor use and risk of hip fractures among community-dwelling persons with Alzheimer's disease-a nested case-control study. "our findings do not support previous assumptions that long-term proton pump inhibitor use would be associated with an increased risk of hip fractures." (Alimentary Pharmacology & Therapeutics)

3 March 2018 How to perform a high-quality examination in patients with Barrett's oesophagus. "The 5-year survival of OAC remains low at <20% overall, but is particularly poor for patients presenting late in the disease course. Patients with early neoplasia confined to the mucosa, however, are potential candidates for Barrett’s endoscopic therapy, which has impressive eradication rates of >80% to 90%, without the attendant morbidity and mortality of surgical management options." (Gastroenterology)

3 March 2018 The metaplastic mosaic of Barrett's oesophagus. (full text) "Understanding the ecological conditions that drive malignant evolution in Barrett’s may help us avoid burdensome and costly surveillance in patients at low risk of transformation and intervene in patients at increased risk." (Virchows Archiv)

2 March 2018 Gamblingwith esophageal cancer: May the odds be in your favor! (full text) "Esophagectomy offers high likelihood of cure for patients with T1b tumors, even in the presence of nodal metastases. Surgery, however, is associated with not insignificant morbidity, a 3% to 4% chance of mortality, and lifestyle changes. Endoscopic therapy offers the great advantage of organ sparing, low morbidity, and virtually no mortality. The trade-off, however, is the potential of leaving untreated disease behind" (Journal of Thoracic & Cardiovascular Surgery)

1 March 2018 High rate of over-staging of Barrett's neoplasia with endoscopic ultrasound: Systemic review and meta-analysis. "The use of EUS in BE patients with dysplasia and early neoplasia results in a large proportion of patients falsely over-staged and under-staged." (Digestive & Liver Diseases)

1 March 2018 Adherence to quality indicators and surveillance guidelines in the management of Barrett's esophagus: a retrospective analysis. (full text) "Adherence to quality indicators and surveillance guidelines in BE is low. Operator characteristics, including experience with endoscopic therapy for BE and time in practice predicted practice pattern. Future efforts are needed to reduce variability in practice and promote high-value care" (Endoscopy)

1 March 2018 Management of Barrett's esophagus with low-grade dysplasia. "Progression to cancer from low grade dysplasia is highly variable in the literature due to high inter-observer variability between pathologists in diagnosing it." (Diseases of the Esophagus)

Clinical Practice Guideline: Hoarseness (Dysphonia) (Update) Executive Summary. (full text) ""This guideline provides evidence-based recommendations on treating patients presenting with dysphonia, which is characterized by altered vocal quality, pitch, loudness, or vocal effort that impairs communication and/or quality of life." (Otolaryngology - head & neck surgery)

March 2018 [Gastro-Oesophageal Reflux Disease - How to Manage if PPI are not Sufficiently Effective, not Tolerated, or not Wished?] "The standard treatment for GERD with PPI is less effective than thought: At least 30% of patients have persistent symptoms and lesions (treatment gap). When symptoms persist or request an alternative treatment, a stratified diagnosis is required. Alginates and new surgical procedures expand the therapeutic options" (Translated from German) (Larygo-rhino-otologie)

March 2018 Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition. (full text) "recommendations regarding evaluation and management of infants and children with GERD to standardize and improve quality of care were formulated. Additionally, 2 algorithms were developed, 1 for infants <12 months of age and the other for older infants and children." (Journal of pediatric Gastroenterology & Nutrition)

January - March 2018 Gastro Oesophageal Reflux Diseases In Chronic Obstructive Pulmonary Disease Patients. "Our study shows that a higher proportion of gastro oesophageal reflux (GERD) symptoms are present in COPD patients and it also shows that GERD is more common in severe COPD patients." (Journal of Ayub Medical College)

January - February 2018 New Minimally Invasive Endoscopic and Surgical Therapies for Gastroesophageal Reflux Disease (GERD). (full text) "Stretta utilizes radiofrequence therapy, a novel technique describes mucosal resection at the level of the cardia, while a partial fundoplication from within the stomach can be realized with EsophyX, Muse or Gerd-X. Form all these procedures, EsophyX is the most advanced with more than 20,000 patients treated worldwide, with good clinical outcomes and with no de novo symptoms. The laparoscopic techniques treat hiatal hernias larger than 2 cm. Linx utilizes a magnetic ring at the LES level. EndoStim utilizes electrodes in order to stimulate the LES muscle. These procedures are effective on short term and there are few patients treated with Linx or EndoStim." (Chirurgia - Bucharest)

January - February 2018 Gastroesophageal Reflux Before Metabolic Surgery. (full text) "The study demonstrates that GERD is more frequent then expected in asymptomatic obese patients undergoing metabolic surgery. The clinical impact of these findings is important for the proper procedure selection and for a correct evaluation of the postoperative evolution." (Chirurgia - Bucharest)

January - February 2018 Barrett's Esophagus - State of the Art. (full text) " Certain groups suggest a screening of the patients who exhibit more risk factors for the development of esophageal adenocarcinoma (for instance, gastroesophageal reflux disease, age 50, male, high body mass index with abdominal fat distribution). The main reason behind the treatment of acid reflux is that it may lead to chronic esophageal inflammation, which in its turn may predispose to the development of cancer." (Chirurgia - Bucharest)

28 February 2018 Proton pump inhibitor use and the risk of fractures among an older adult cohort. "No association was observed between PPI use and fracture risk among older adults." (Pharmacoepidemiology & Drug Safety)

28 February 2018 Endoscopic management of refractory gastroesophageal reflux disease. "In EBL group; 58 patients (77.3%) needed 1 session, 17 patients (22.7%) needed 2 sessions. 4 rubber bands were utilized in 44 patients (58.7%), 3 rubber bands in 31 patients (41.3%). Follow-up for 1 year revealed a highly significant improvement of the GERD- QoL score, the site of Z line with significant reduction of reflux episodes and symptom index when compared to the medical treatment group. In EBL [Endoscopic Band Ligation] group; there were no major adverse events including bleeding, post band ulcers, stenosis at one year follow up." (Scandinavian Journal of Gastroenterology)

27 February 2018 Effect of Concomitant pH-Elevating Medications with Pazopanib on Progression-Free Survival and Overall Survival in Patients with Metastatic Renal Cell Carcinoma. "Concomitant PPI or H2RA usage was not shown to be associated with a reduction in PFS [Progression-Free Survival] or OS [Overall Survval] for patients receiving pazopanib for mRCC, with a similar toxicity profile in each group. Based on the results of this retrospective cohort study and the palliative nature of the treatment of patients with mRCC, clinicians should consider allowing patients to remain on concomitant pazopanib and acid-reducing therapy." (Oncologist)

27 February 2018 Juice Test for Identification of Nonerosive Reflux Disease in Heartburn Patients. "A juice test with calculation of Delta5 helps in the identification of true NERD among heartburn patients with endoscopy-negative reflux disease." (Journal of Neurogastroenterology & Motility)

27 February 2018 NSAID use and somatic exomic mutations in Barrett's esophagus. (full text) "NSAID users had, on average, a 50% reduction in functional gene mutations in nine cancer-associated pathways and also had less diversity in pathway mutational burden compared to non-users." (Genome Medicine)

27 February 2018 ProtonPump Inhibitors Are Associated With Accelerated Development ofCirrhosis, Hepatic Decompensation and Hepatocellular Carcinoma in Noncirrhotic Patients With Chronic Hepatitis C Infection  (full text) "our study demonstrates a significant association between proton pump inhibitors and a higher risk of fibrosis progression, cirrhosis, hepatic decompensation and development of hepatocellular carcinoma among individuals with chronic HCV infection. This may be attributable to dysregulation of the gut microbiota leading to increased levels of pathogenic bacteria and bacterial translocation, resulting in increased hepatic inflammation and fibrosis" (Alimentary Pharmacology & Therapeutics)

27 February 2018 Clinical spectrum and risk factors associated with asymptomatic erosive esophagitis as determined by Los Angeles classification: A cross-sectional study. (full text) "A low prevalence of asymptomatic reflux esophagitis (RE) was seen. Most subjects experienced mild to moderate RE. Age remained an independent factor associated with reflux esophagitis, and the odds of being asymptomatic was lower in younger age." (PloS One)

23 February 2018 Immunohistochemical assessment of Survivin and Bcl3 expression as potential biomarkers for NF-κB activation in the Barrett metaplasia-dysplasia-adenocarcinoma sequence. "The study shows the differential expression of Bcl3 between the squamous and Barrett's stage, suggesting that Bcl3 could be a surrogate marker for early event involving constitutive NF-κB activation." (International Journal of Experimental Pathology)

23 February 2018 Evolutionof Barrett’s esophagus through space and time at single-crypt andwhole-biopsy levels (full text) "Our results indicate that most Barrett’s segments are clonal, with similar number and inferred rates of alterations observed for crypts and biopsies. Divergence correlates with geographical location, being higher near the gastro-esophageal junction. Relaxed clock analyses show that genomic instability precedes and is enhanced by genome doubling. These results shed light on the clinically relevant evolutionary dynamics of BE." (Nature Communications)

21 February 2018 Evaluation of a novel cryoballoon swipe ablation system in bench, porcine, and human esophagus models. "CbSAS is a through-the-scope compliant balloon that is simultaneously inflated and cooled by liquid nitrous oxide delivered from a disposable handheld unit. ... Because of its ease of use, this new device merits further clinical study in the treatment of patients with dysplastic Barrett's esophagus." (Diseases of the Esophagus)

21 February 2018 Maintenance proton pump inhibition therapy and risk of oesophageal cancer. "In conclusion, the long term use of PPIs is associated with increased risk of oesophageal adenocarcinoma in the absence of other risk factors. Long term use of PPIs should be addressed with caution." (Cancer Epidemiology)

21 February 2018 Cryotherapy for persistent Barrett’s esophagus after radiofrequency ablation: asystematic review and meta-analysis "Cryotherapy successfully achieves CE-D in three-quarters and CE-IM in half of BE patients who do not respond to initial RFA. Considering its favorable safety profile, cryotherapy may be a viable second-line option for this therapeutically challenging cohort of BE patients, but higher-quality studies validating this remain warranted." (Gastroinestinal Endoscopy)

21 February 2018 Laparoscopic Nissen Fundoplication: An Excellent Treatment of Gerd-Related Respiratory Symptoms in Children-Results of a Multicentric Study. (full text) "Our results confirm that GERD should be investigated as one of the possible etiologic factors in any child with persistent respiratory complaints. In patients with symptoms not responsive to medical therapy, laparoscopic Nissen fundoplication is the treatment of choice with a very high success rate (>90% in our series), a very low morbidity, a significant improvement in airway symptoms, and a marked reduction in the need for medications." (Journal of laparoendoscopic and advanced surgical techniques)

21 February 2018 A Modified Technique to Create a Standardized Floppy Nissen Fundoplication Without a Bougie. (full text) "This modified method for standardized Nissen fundoplication is safe and might reduce postoperative dysphagia. Quality of life after 1 year is excellent. The effect on postoperative dysphagia and the reproducibility of this technique should be established in a large prospective study." (Journal of laparoendoscopic and advanced surgical techniques)

21 February 2018 Comparison of the Effects of Vonoprazan and Lansoprazole for Treating Endoscopic Submucosal Dissection-Induced Artificial Ulcers. "Vonoprazan is as effective as lansoprazole in treating ESD-induced ulcers." (Digestive Diseases and Sciences)

20 February 2018 Barrett's esophagus is associated with a distinct oral microbiome. (full text) "The oral microbiome in BE patients was markedly altered and distinguished BE with relatively high accuracy. The oral microbiome represents a potential screening marker for BE, and validation studies in larger and distinct populations are warranted." (Clinical & Translational gastroenterology)

20 February 2018 Effects of gastroprotectant drugs for the prevention and treatment of peptic ulcer disease and its complications: a meta-analysis of randomised trials. (full text) "Gastroprotectants, in particular PPIs, reduce the risk of peptic ulcer disease and its complications and promote healing of peptic ulcers in a wide range of clinical circumstances" (Lancet Gastroenterology & Hepatology)

20 February 2018 Treatment of supragastric belching with cognitive behavioral therapy improves quality of life and reduces acid gastroesophageal reflux. "Cognitive behavioral therapy reduced the number of SGB and improved social and daily activities. Careful analysis of MII-pH allows identification of a subgroup of GERD patients with acid reflux predominantly driven by SGB. In these patients, CBT can reduce esophageal acid exposure." (American Journal of Gastroenterology)

19 February 2018 Early results of magnetic sphincter augmentation versus fundoplication for gastroesophageal reflux disease: Systematic review and meta-analysis. "Both anti-reflux procedures are safe and effective up to 1-year follow-up. PPI suspension rate, dysphagia requiring endoscopic dilatation, and disease-related quality of life are similar in the two patient groups. MSA is associated with less gas/bloat symptoms and increased ability to vomit and belch." (International Journal of Surgery)

18 February 2018 The Risk of Community-Acquired Enteric Infection in Proton Pump Inhibitor Therapy: Systematic Review and Meta-analysis. "PPI users have an increased risk of developing community-acquired enteric infections compared with nonusers. The heterogeneity was partially explained by type of microorganism; the association is stronger for Salmonella and Campylobacter than for all bacteria combined."  (Annals of Pharmacotherapy)

16 February 2018 The Effect of Endoscopic Surveillance in Patients with Barrett's Esophagus: A Systematic Review and Meta-analysis. "In a systematic review and meta-analysis of the effects of surveillance in patients with BE, surveillance as currently performed was associated with detection of earlier stage EAC and may provide a small survival benefit. However, the effects of confounding biases on these estimates are not fully defined" (Gastroenterology)

16 February 2018 Controversies in Endoscopic Eradication Therapy for Barrett's Esophagus.   "Ultimately, identification of a cost-effective screening modality, biomarkers for risk stratification, and strides to eliminate post surveillance endoscopy after EET are essential to reach our long term goal for eradication of esophageal adenocarcinoma." (Gastroenterology)

16 February 2018 Esophageal hiatal hernia: Risk, Diagnosis and Management. "Severe abdominal penetration into chest cavity demands surgical approaches. Hence, esophagectomy has chances of post-operative morbidity, while minimally invasive laparoscopy entails fewer postoperative difficulties and better visualization of hernia and related vascular damages." (Expert Review Gastroenterology & Hepatology)

15 February 2018 Endoscopic Myotomy for Foregut Motility Disorders. "Gastroesophageal reflux is not infrequent after POEM [PerOral Endoscopic Myotomy] but does not seem significantly different from reflux which occurs after Heller myotomy. POEM also seems to be effective in the treatment of spastic esophageal disorders (e.g. Jackhammer and diffuse esophageal spasm). Lastly, the role of gastric POEM (G-POEM) in the treatment of gastroparesis has been investigated in recent studies with promising results." (Gastroenterology)

15 February 2018 Less is more: A minimalist approach to endoscopy. " Overusage of endoscopy appears to be common, and 30% or more of procedures performed in some clinical settings have questionable indications. The potential reasons for overuse of endoscopy are multiple, and include cancer phobia, fear of medical malpractice litigation, profit motive, the investigation of "incidentalomas" found on other imaging, and under-appreciation of the delayed harms of endoscopy, among other reasons." (Gastroenterology)

15 February 2018 Predictive Biomarkers of Gastroesophageal Reflux Disease and Barrett's Esophagus in World Trade Center Exposed Firefighters: a 15 Year Longitudinal Study. "full text) "participants with GERD had significantly increased use of short-acting β-agonist compared to controls. Overall, biomarkers sampled prior to GERD/BE presentation showed strong predictive abilities of disease development." (Scientific Reports)

15 February 2018 Influence of hiatal hernia and male sex on the relationship between alcohol intake and occurrence of Barrett's esophagus. (full text) "The effect of alcohol intake on the incidence of eCLE might be associated with hiatal hernia status and male sex." (PLoS One)

14 February 2018 Patient-Centered Outcomes after Laparoscopic Paraesophageal Hernia Repair. "Laparoscopic paraesophageal hernia repair results in significantly improved QOL as measured by SF-36 at both short and long-term intervals. Additionally, RSI and GERD-HRQL scores improved at all postoperative time points." (Journal of American College of Surgeons)

14 February 2018 An esophageal adenocarcinoma susceptibility locus at 9q22 also confers risk to esophageal squamous cell carcinoma by regulating the function of BARX1. "deletion of BARX1 substantially reduced ESCC cells growth, migration and invasion. In conclusion, these results suggest that genetic variants at 9q22 are associated with the risk of both EAC/BE and ESCC, possibly by regulating the function of BARX1." (Cancer Letters)

13 February 2018 Early fundoplication is associated with slower decline in lung function after lung transplantation in patients with gastroesophageal reflux disease. "Gastroesophageal reflux disease (GERD) is prevalent after lung transplantation. Fundoplication slows lung function decline in patients with GERD" (Journal of Thoracic & Cardiovascular Surgery)

January - March 2018 Scintigraphic Evaluation of Esophageal Motility and Gastroesophageal Reflux in Patients Presenting with Upper Respiratory Tract Symptoms. "We hypothesize that primary abnormal esophageal motility leads to delayed esophageal clearance and consequently to URT symptoms." (Indian Journal of Nuclear Medicine)

12 February 2018 Evaluating the Effect of Six Proton Pump Inhibitors on the Antiplatelet Effects of Clopidogrel. "This adds data to a growing body of evidence indicating that the addition of a PPI may have a weak effect on clopidogrel's antiplatelet properties, and may only be relevant in specific clinical circumstances." (Journal of stroke & cerebrovascular diseases)

12 February 2018 Effectsof changes in eating speed on obesity in patients with diabetes: asecondary analysis of longitudinal health check-up data (full text) "Changes in eating speed can affect changes in obesity, BMI and waist circumference. Interventions aimed at reducing eating speed may be effective in preventing obesity and lowering the associated health risks." (BMJ)

12 February 2018 Surgery for benign esophageal disorders in the US: risk factors for complications and trends of morbidity. "antireflux surgery has shown an increase in the morbidity rate in the last decade. Patient selection and embracement of laparoscopic techniques are critical to improve the perioperative outcome in surgery for benign esophageal disorders." (Surgical Endoscopy)

12 February 2018 Expanding Role of Third Space Endoscopy in the Management of Esophageal Diseases. ""Third space" endoscopy, also commonly referred as submucosal endoscopy, is founded on the principle that the deeper layers of the gastrointestinal (GI) tract can be accessed by tunneling in the submucosal space without compromising the integrity of the overlying mucosa.  ... While initial results have been very promising, large prospective studies, long-term data, and structured training programs with the establishment of competency parameters are needed before third space endoscopy can be advocated outside of highly specialized centers." (Current Treatment Options in Gastroenterology)

12 February 2018 Surgical management of gastroesophageal reflux disease in patients with systemic sclerosis. "Laparoscopic RYGB as an anti-reflux procedure is safe and may provide an alternative to fundoplication in the treatment of GERD for systemic sclerosis patients with esophageal dysmotility." (Surgical Endoscopy)

12 February 2018 An update on the use of Raman spectroscopy in molecular cancer diagnostics: current challenges and further prospects. "Outcomes for these patients are improved when the disease is diagnosed at an early, or even precancerous, stage. Raman spectroscopy is demonstrating results that show its ability to detect the molecular changes that are diagnostic of precancerous and cancerous tissue." (Expert Review Molecular Diagnostics)

March 2018 Prevalence of Gastroesophageal Reflux Disease in Saudi Arabia. (full text) "The prevalence of GERD among Saudi population is higher than that in Western countries and East Asia. It affects divorced/widow, obese and those with a sedentary lifestyle. It is advocated that national programs and educational campaigns for prevention of this disease and its complications should be established." (Journal of Clinical Medicine research)

10 February 2018 MDM2 Expression in the Progression of Barrett's Oesophagus "dysplasia diagnosis is subject to a significant amount of interobserver variation. Biomarkers may aid the diagnosis of dysplasia and may help predict the risk of progression to OAC. Abnormal expression of p53 can be reproducibly detected by immunohistochemistry (IHC) and it is an effective marker of risk of OAC1 . There is however still a need for additional early stage markers" (Histopathology).

9 February 2018 Systematic review: methodological flaws in racial/ethnic reporting for gastroesophageal reflux disease "Despite recommendations, it appears that GERD researchers around the world struggle with the appropriate and standard way to include, collect, report, and discuss race/ethnicity. Recommendations on ways to address these issues are included with the goal of preventing and identifying health care disparities." (Diseases of the Esophagus)

9 February 2018 Gastroesophageal reflux symptoms are not sufficient to guide esophageal function testing in lung transplant candidates. "These results demonstrate that in patients with advanced lung disease, symptoms of gastroesophageal reflux increase the likelihood of elevated acid exposure on pH-metry but were not associated with dysmotility. Given the proportion of asymptomatic patients with abnormal studies and associated post-transplant risks, a practice of universal high-resolution manometry and pH-metry testing in this population is justifiable." (Diseases of the Esophagus)

9 February 2018 High-resolution esophageal manometry in a Mexican population: diagnostic outcome. "69% of patients were referred for preoperative evaluation of GERD, reflecting the popularity of antireflux surgery. This study confirms the high prevalence of weak peristalsis and highlights the importance of addressing its pathophysiology and management. The finding of achalasia in 50% of our patients with dysphagia is consistent with recent reports" (Diseases of the Esophagus)

9 February 2018 The association of proton pump inhibitors and chronic kidney disease: cause or confounding? "The constellation of evidence from all available studies suggests that PPI use is associated with increased risk of adverse kidney outcomes. Exercising vigilance in the use of PPI is warranted." (Current Opinion in Nephrology & Hypertension)

9 February 2018 Use of Appropriate Surveillance for Patients With Non-Dysplastic Barrett's Esophagus. "Only 15.9% had appropriate surveillance; 37.9% had surveillance overuse, 15.7% had surveillance underuse, and 30.4% received no surveillance. Patients were less likely to be surveillance over-users if their primary care physician referred them for their 3rd endoscopy instead of a gastroenterologist (adjusted odds ratio, 0.51; 95% CI, 0.27-0.95). Male patients or those with an increased number of comorbidities were more likely to have surveillance underuse or no surveillance, whereas patients with long BE segment were more likely to have surveillance overuse." (Clinical Gastroenterology & Hepatology)

8 February 2018 Bioinformatic analyses of microRNA-targeted genes and microarray-identified genes correlated with Barrett's esophagus. "The data presented herein may provide new perspectives for exploring BE pathogenesis and may offer hits with regard to potential biomarkers in BE diagnosis, prediction and therapeutic evaluation." (Cell cycle)

7 February 2018 Comparisonof long-term clinical outcomes between endoscopic and surgicalresection for early-stage adenocarcinoma of the esophagogastricjunction "Once complete resection is achieved in patients with AEG who met the expanded criteria for endoscopic submucosal dissection of gastric cancer, there was no significant difference in clinical outcomes between ER and surgery." (Surgical Endoscopy)

7 February 2018 EXTRAESOPHAGEAL SYMPTOMS AND DISEASES ATTRIBUTED TO GERD: Where is the pendulum swinging now?  "The recommendations outlined in this review are based on expert opinion and on relevant publications from PubMed and EMbase. The Clinical Practice Updates Committee of the American Gastroenterological Association proposes the following recommendations ..." (Clinical Gastroenterology & Hepatology)

7 February 2018 [Prescription of PPI in Germany: too often, too long, too much?] (Article in German) "Although proton pump inhibitors (PPIs) are considered safe drugs. Given the rising number of prescriptions but win even the smallest risks in importance. What side effects are secured? On what to look for in the Regulation / at weaning?" (MMW Advances in Medicine)

7 February 2018 [Gastroesophageal reflux disease beyond PPI] (Article in German). "Around 30% of patients with reflux of the effect of proton pump inhibitors (PPI) dissatisfied.Also, some victims are afraid of the long-term risks. There are a number of treatment alternatives. What can you recommend?" (MMW Advances in Medicine)

February 2018 Risk of histologic Barrett's esophagus between African Americans and non-Hispanic whites: A meta-analysis. (full text) "Histologic BE risk is elevated in nHw by 3.6-4 times compared to AA. Investigation into understanding any clinical, molecular or genetic mechanisms underlying this risk disparity is warranted." (United European journal of Gastroenterology Journal)

February 2018 Proton Pump Inhibitors: Review of Emerging Concerns. (full text) "Use of PPIs has been reported to be associated with increased risk for development of a multitude of adverse effects. The majority of the data are based on results from retrospective observational studies, which have inherent biases, risk for confounding variables, and the inability to demonstrate a definite causal relationship. Most of these studies reported mild to moderate overall associations (with RRs of 1 to 2) between PPI use and the risks of bone fracture, CDI, pneumonia, vitamin and mineral deficiencies, kidney disease, and dementia. Thus, because many of these adverse effects are uncommon, the absolute risk to patients remains quite small.

Based on current recommendations, the American Gastroenterological Association does not recommend routine laboratory monitoring or use of supplemental calcium, vitamin B12, and magnesium in patients taking PPIs daily. ... In summary, the best strategy is to prescribe PPIs at the lowest dose on a short-term basis when appropriately indicated so that the potential benefits outweigh any adverse effects associated with the use of PPIs." (Mayo Clinic Proceedings)

6 February 2018 Effectof Hot Tea Consumption and Its Interactions With Alcohol and TobaccoUse on the Risk for Esophageal Cancer: APopulation-Based Cohort Study "Drinking tea at high temperatures is associated with an increased risk for esophageal cancer when combined with excessive alcohol or tobacco use." (Annals of Internal Medicine)

5 February 2018 Double-blind, placebo-controlled study with alginate suspension for laryngopharyngeal reflux disease. "This study showed that liquid alginate suspension was well tolerated by LPRD patients. It effectively improved symptoms and reflux numbers but was unable to show superiority over placebo. As observed in previous studies, a great placebo effect was present. The importance of lifestyle modification could not be overlooked." (Laryngoscope)

5 February 2018 The Potential Role of Bile Acids in Acquired Laryngotracheal Stenosis. "This implies a potential role for bile acids in laryngotracheal scarring and airway remodeling of potential translational significance in laryngotracheal stenosis." (Laryngoscope)

4 February 2018 Pantoprazole-Induced Delirium: Review of a Case and Associated Literature. (full text) "Given the paucity of literature on this topic, we encourage further research into relationship between PPI and delirium and urge caution while using PPIs in geriatric population." (Case Reports in Psychiatry)

4 February 2018 The TEMPO Trial at 5 Years: Transoral Fundoplication (TIF 2.0) Is Safe, Durable, and Cost-effective. (full text) "In this patient population, the TIF 2.0 procedure provided safe and sustained long-term elimination of troublesome GERD symptoms." (Surgical Innovation)

3 February 2018 Modern diagnosis of GERD: the Lyon Consensus. (full text) "GERD is a complex disease with a heterogeneous symptom profile and a multifaceted pathogenic basis that defies a simple diagnostic algorithm or categorical classification. The Lyon Consensus defines parameters on oesophageal testing that conclusively establish the presence of GERD and characteristics that rule out GERD." (Gut)

3 February 2018 Lackof Association Between Proton Pump Inhibitor Use and CognitiveDecline "In analyzing data from 2 large population-based studies of twins in Denmark, we found no association between PPI use and cognitive decline." (Clinical Gastroenterology & Hepatology)

3 February 2018 The Uncertainty of the Association Between Proton Pump Inhibitor Use and the Risk of Dementia: Prescription Sequence Symmetry Analysis Using a Korean Healthcare Database Between 2002 and 2013 "Our results showed that the aSR [associated Sequence ratio] of dementia and PPIs ... was not higher than that for dementia and H2RAs. ... The risk of PPIs being associated with dementia may be overestimated." (Drug Safety)

2 February 2018 Incremental yield of dysplasia detection in Barrett's esophagus using volumetric laser endomicroscopy with and without laser marking compared with a standardized random biopsy protocol  "A surveillance strategy involving VLEL lead to statistically significant higher yield of dysplasia and neoplasia detection compared with a standard random biopsy protocol. These results support the use of VLEL for surveillance in BE in academic centers." (Gastrointestinal Endoscopy)

2 February 2018 Inhibition of hepatocellular carcinoma tumorigenesis by curcumin may be associated with CDKN1A and CTGF. "curcumin might exert its protective effects against HCC tumorigenesis by downregulating LEF1 and downregulating CTGF regulated by MIR-19A and upregulating CDKN1A expression" (Gene)

1 February 2018 Early diagnostic potential of APC hypermethylation in esophageal cancer. (full text) "The hypermethylation of APC gene is observed in various cancers, including esophageal cancer (EC). ...  Our results imply that APC methylation detection is a potential diagnostic biomarker for EC and BE." (Cancer Management & Research)

1 February 2018 Pharyngeal manifestations of gastroesophageal reflux disease. "This article discusses the extraesophageal manifestations of gastroesophageal reflux disease, " (Abdominal Radiology NY)

1 February 2018 Evaluation of Esophageal Mucosal Integrity in Patients with Gastroesophageal Reflux Disease. (full text) "Key Messages: Endoscopy-guided real-time measurement of MI [Mucosal Integrity] and MA [Mucosal Admittance] may allow the estimation of mucosal integrity and may be a useful diagnostic tool for patients with GERD in a manner similar to 24-h MII-pH monitoring." (Digestion)

February 2018 Rising incidence and prevalence of adult eosinophilic esophagitis in midwestern Spain (2007-2016). (full text) "In midwestern Spain, incidence (13.7 cases/100,000 inhabitants/year) and prevalence (81.73 patients/100,000 inhabitants) in 2016 have grown remarkably in just one decade, coming closer to those figures recently reported for Crohn's disease in Spain." (United European Gastroenterology Journal)

February 2018 Efficacy of vonoprazan for 24-week maintenance therapy of patients with healed reflux esophagitis refractory to proton pump inhibitors. (full text) "In conclusion, the results of the present study indicate that vonoprazan 10 mg once daily is effective for 24-week maintenance therapy of healed RE refractory to PPIs." (Biomedical Reports)

February 2018 Dietary assessment and counseling for dental erosion. "Exposure to intrinsic gastrointestinal acids is associated with anorexia nervosa, bulimia nervosa, rumination syndrome, or gastroesophageal reflux. " (American Dental Association)

February 2018 The psychological results of 438 patients with persisting GERD symptoms by Symptom Checklist 90-Revised (SCL-90-R) questionnaire. "(full text) We think that psychological factors have an unignorable significance in the research field. For these patients, the treatment for psychological disorder may help them alleviating symptom and improving the quality of life." (Medicine)

January - February 2018 Gastric reflux: comparison between the gastroenterologist and the otorhinolaryngologist’s approach. Pragmatic conclusive remarks. "the term GERD covers a number of specific conditions that have different effects and present in different ways. This makes it difficult to identify the person who genuinely has GERD, and to estimate the real prevalence and burden of the problem." (Journal of Biological Regulators & Homeostatic Agents)

January - February 2018 Focus on gastroesophageal reflux (GER) and laryngopharyngeal reflux (LPR): new pragmatic insights in clinical practice. "laryngopharyngeal reflux (LPR) is considered an extraesophageal manifestation of the gastroesophageal reflux disease (GERD). Both GERD and its extraesophageal manifestation are very common in clinical practice. Both disorders have a relevant burden for the society" (Journal of Biological Regulators & Homeostatic Agents)

January 2018 Tongue diagnosis indices for upper gastrointestinal disorders: Protocol for a cross-sectional, case-controlled observational study. (full text) "Traditional Chinese medicine tongue diagnosis plays an important role in differentiation of symptoms because the tongue reflects the physiological and pathological condition of the body. The automatic tongue diagnosis system (ATDS), which noninvasively captures tongue images, can provide objective and reliable diagnostic information." (Medicine - Baltimore)