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August 2020 Cytosponge-trefoil factor 3 versus usual care to identify Barrett's oesophagus in a primary care setting: a multicentre, pragmatic, randomised controlled trial (full text) "for patients with heartburn-predominant symptoms requiring acid-suppressant therapy for at least 6 months, the Cytosponge-TFF3 procedure is a feasible, safe, and generally acceptable test to administer in the general practice clinic setting. This procedure results in improved detection of Barrett's oesophagus, thus enabling a more proactive approach for the identification and minimally invasive treatment of dysplasia and early cancer." (Lancet)

August 2020 Analysis of major bile acids in saliva samples of patients with Barrett's esophagus using high-performance liquid chromatography-electrospray ionization-mass spectrometry "• Fast, non-invasive HPLC-MS method for bile acids analysis in saliva was developed • Saliva from patients with Barret's esophagus and healthy controls was obtained • Glycochenodeoxycholic acid is a promising biomarker for Barret's esophagus diagnostics • PCA could distinguish the patients with most severe Barret's esophagus condition" (Journal of Chromatography)

30 July 2020 Use of Cytosponge as a triaging tool to upper gastrointestinal endoscopy during the COVID-19 pandemic "The Cytosponge is an example of an innovation that has undergone rigorous evaluation for diagnosing Barrett's oesophagus. The COVID-19 pandemic has offered the opportunity for more rapid adoption of this tool but the different patient group than originally intended merits careful audit." (Lancet correspondence)
30 July 2020 Global prevalence of Barrett's oesophagus and oesophageal cancer in individuals with gastro-oesophageal reflux: a systematic review and meta-analysis "The prevalence of Barrett's oesophagus among individuals with gastro-oesophageal reflux varied strikingly among countries, broadly resembling the geographical distribution of gastro-oesophageal reflux itself. Prevalence of BO was significantly higher in men." (Gut)

30 July 2020 Association between proton pump inhibitor use and risk of fracture: A population-based case-control study "Concomitant use of bisphosphonates and proton pump inhibitors will likely increase the risk of osteoporotic fractures in women aged 65 and over, and caution should be exercised in this high-risk group of patients." (PLoS One)

29 July 2020 Molecular biomarker identification for esophageal adenocarcinoma using endoscopic brushing and magnified endoscopy (full text"Barrett's esophagus (BE) is a predisposing factor for esophageal adenocarcinoma (EAC); however, the precise mechanism underlying this association remains unclear. The identification of biomarkers that are associated with an increased risk of BE progression to EAC would facilitate diagnosis and early treatment. Toward this goal, we aimed to identify biomarkers associated with BE and EAC in patients." (Endoscopy)

29 July 2020 Does Sleeve Gastrectomy Increase the Risk of Barret's Esophagus? "This study highlights the incidence of postoperative GERD and endoscopic lesions following SG. Even though SG is not contraindicated in case of reflux, GERD patients who undergo SG may be supervised by a close endoscopic surveillance." (Obesity Surgery)

25 July 2020 Safety and feasibility of same-day discharge after esophageal endoscopic submucosal dissection "SDD after esophageal ESD is safe and feasible. An experienced endoscopist can determine if SDD can be considered in patients with ASA physical classification status ≤2 who undergo resections off antiplatelet/anticoagulant therapy and do not experience intraprocedural adverse events." (Gastrointestinal Endoscopy)

25 July 2020 Effect of food on the pharmacokinetics of omeprazole, pantoprazole and rabeprazole (full text) "As food delays the absorption of PPIs and increases their variability, it would be better to administer these drugs under fasting conditions." (BMC Pharmacology and Toxicology)

24 July 2020 The Role of Biomarkers In the Management of Barrett’s Esophagus (full text) "There is an unmet need to identify which patients may benefit from endoscopic therapy, closer surveillance intervals, or a screening endoscopy. Although additional larger validation studies are required, recent activity in the development and validation of biomarkers is paving the way from the laboratory setting to the clinical arena. This promising body of data demonstrates that biomarker panels have the potential to be clinically integrated in an accessible and acceptable manner into treatment, surveillance, and screening paradigms for Barrett’s esophagus." (Gastroenterology & Endoscopy News)

23 July 2020 The Nissen Unwrapped: Predictors and Outcomes of Nissen Fundoplication in Congenital Heart Disease (full text) "Prematurity was the only factor associated with an NF. Surprisingly, cyanotic heart disease, neurologic comorbidities, age at first cardiac surgery, and vocal cord dysfunction were not associated with an NF. We identified an area for quality improvement at our institution given the lack of standardized work-up for the NF in this high-risk population." (Journal of Surgical Research)

23 July 2020 Acid Exposure Time > 6% Might Not Improve the Therapeutic Outcome in Chinese Gastroesophageal Reflux Disease Patients "The efficacy of PPI therapy was similar in patients with AET > 6% and 4-6%. The increase of the AET threshold did not influence the clinical outcome of Chinese GERD patients." (Journal of Neurogastroenterology and Motility)

22 July 2020 Five-Year Outcome of Laparoscopic Fundoplication in Pediatric GERD Patients: a Multicenter, Prospective Cohort Study (full text) "LARS is effective for therapy-resistant GERD in children. Five years after surgery, reflux symptoms are still improved. However, we observed a decline in symptom-free patients over time. The initial increase in HRQoL shortly after LARS appears to decline over time." (Journal of Gastrointestinal Surgery)

22 July 2020 Prior tonsillectomy is associated with an increased risk of esophageal adenocarcinoma (full text) "A prior history of tonsillectomy was significantly associated with HGD/EAC and may represent an independent risk factor for the development of EAC. However, the underlying biology driving this association remains unclear." (PLoS One)

22 July 2020 Hospital volume of esophageal cancer surgery in relation to outcomes from primary anti-reflux surgery "Compared with hospitals not performing esophagectomy, hospitals in the highest volume group of esophagectomy showed no decreased risks of 30-day re-intervention (HR = 1.46, 95% CI 0.89-2.39) or surgical re-intervention (HR = 1.21, 95%CI 0.91-1.60) during follow-up. Similarly, the intermediate hospital volume categories of esophageal cancer surgery had no decreased risk of surgical re-interventions after anti-reflux surgery. This study provides no evidence for centralization of primary anti-reflux surgery to centers for esophageal cancer surgery." (Diseases of the Esophagus)

21 July 2020 Non-invasive early detection of cancer four years before conventional diagnosis using a blood test (full text) "Here we report the preliminary results of PanSeer, a noninvasive blood test based on circulating tumor DNA methylation, on TZL plasma samples from 605 asymptomatic individuals, 191 of whom were later diagnosed with stomach, esophageal, colorectal, lung or liver cancer within four years of blood draw." (Nature Communications)

21 July 2020 The Impact of Artificial Intelligence in the Endoscopic Assessment of Premalignant and Malignant Esophageal Lesions: Present and Future (full text) "This paper presents an overview of the literature and the current knowledge of the usefulness of different types of machine learning systems in the assessment of premalignant and malignant esophageal lesions via conventional and advanced endoscopic procedures." (Medicina)

21 July 2020 Neoplasia Detection Rate (NDR) in Barrett's Esophagus and Its Impact on Missed Dysplasia: Results from a Large Population-Based Database "In an analysis of 1066 patients with BE in a population-based cohort, we found a lower NDR and lower rate of missed dysplasia than previously reported. NDR may have value as a quality metric in BE surveillance if validated in other cohorts." (Clinical Gastroenterology & Hepatology)

21 July 2020 The utility of a methylation panel in the assessment of clinical response to radiofrequency ablation for Barrett's esophagus (full text pdf) "A DNA methylation panel can discriminate between the extent of histological IM in esophageal and junctional biopsies and could be used to objectively quantify residual disease following RFA." (EBioMedicine)

21 July 2020 Optimal management of severe symptomatic gastroesophageal reflux disease (full text) "Medical options then may include adding a H2 receptor antagonist, alginates, baclofen or antidepressant therapy, and there is emerging evidence for bile acid sequestrants and diaphragmatic breathing. The demonstration of a temporal association of symptoms with reflux events on pH-impedance testing (reflux hypersensitivity) serves to focus the management on modulating oesophageal perception and reducing the reflux burden, or identifies those with no obvious pathophysiologic abnormalities (functional heartburn). Anti-reflux surgery based on randomized controlled trial evidence has a role in reflux hypersensitivity or continued pathological acid reflux despite PPI in carefully considered, fully worked up cases that have failed medical therapy; approximately two of three cases will respond but there is a small risk of complications." (Journal of Internal Medicine)

20 July 2020 Does Risk of Progression from Barrett's Esophagus to Esophageal Adenocarcinoma Change Based on the Number of Non-dysplastic Endoscopies? "The lower risk of malignant progression in individuals with persistent non-dysplastic Barrett's esophagus over two consecutive endoscopic biopsies but not for longer term persistence does not support hypotheses of persistence being an indicator of less biologically aggressive lesions. Instead, the initial difference may be attributable to post-endoscopy cancers and support the necessity of adhering to robust quality standards for endoscopic procedures." (Digestive Diseases and Sciences)

20 July 2020 Non-active implantable device treating acid reflux with a new dynamic treatment approach: 1-year results : RefluxStop™ device; a new method in acid reflux surgery obtaining CE mark (full text) "The new principle of RefluxStop™ is safe and effective to treat GERD according to investigation results. At 1-year follow-up, both the GERD-HRQL score and 24-h pH monitoring results indicate success for the new treatment principle. In addition, with the dynamic treatment for acid reflux, which avoids compressing the food passageway, prevalence of dysphagia and gas bloating are significantly reduced." (BMC Surgery)

20 July 2020 Efficacy and patient satisfaction of single-session transoral incisionless fundoplication and laparoscopic hernia repair "Patients reported significant decreases in common GERD symptoms including heartburn, regurgitation, cough, and hoarse voice. Eighty-one percent (27/33) of patients were off daily PPIs. Ninety-four percent (31/33) of patients reported 75% or greater satisfaction with the procedure and outcomes. One patient had a superficial mucosal laceration after the procedure, likely due to vomiting, which was treated conservatively." (Surgical Endoscopy)

19 July 2020 Molecular Dynamics in Esophageal Adenocarcinoma: Who’s in Control? "TRAIL is one of the cytokines produced in response to GERD episodes and it can kill cancer cells selectively, but its clinical use has not been as successful as expected, because some highly sophisticated defense mechanisms against TRAIL have developed during the malignancy." (Current Cancer Drug Targets)

18 July 2020 Reflux as a Risk Factor for Morbidity after Pediatric Tonsillectomy: A National Cohort of Inpatients "Children with GER were significantly more likely to experience inpatient complications following tonsillectomy. Further, length of admission was higher compared to children without reflux. These results suggest that children with GER experience poorer outcomes after tonsillectomy and highlight the role for appropriate preoperative counseling and planning in this patient population." (Laryngoscope)

18 July 2020 Esophageal Columnar Metaplasia in Childhood: A Population-Based Case Series Analysis "Over 18 years, 42 pediatric BE patients (< 16 years) were identified, equivalent to an age-adjusted incidence of < 2 per 100,000 children. There was a clear age differential, with BE incidence increasing with age within the pediatric population. The majority (85.7%) of patients were male, a significantly higher male/female ratio than adult BE patients (p < 0.001). No pediatric BE patients progressed to high-grade dysplasia (HGD) or EAC, although the eldest patient was aged 34 years by the end of follow-up." (Digestive Diseases and Sciences)

18 July 2020 The predicative clinical features associated with chronic cough that has a single underlying cause "Cough timing, several concomitant symptoms associated with gastroesophageal reflux or rhinitis/sinusitis, and medical history are useful to indicate common causes of chronic cough." (Journal of Allergy & Clinical Immunology in Practice)

17 July 2020 Short Meal-to-Bed Time Is a Predominant Risk Factor of Gastroesophageal Reflux Disease in Pregnancy "We reported for the first time that short MTBT was a predominant risk factor of GERD in pregnancy. This dieting habit was significantly associated with reflux symptom frequency and reflux-related insomnia." (Journal of Clinical Gastroenterology)

17 July 2020 Recent insights into the biology of Barrett's esophagus "This review outlines current insights into the biology of BE and addresses controversies surrounding cell of origin, cellular reprogramming theories, updates on esophageal epithelial barrier function, and the significance of goblet cell metaplasia and its association with malignant change." (Annals of New York Academy of Sciences)

16 July 2020 Three-year clinical experience with magnetic sphincter augmentation and laparoscopic fundoplication (full text) "This 3-year prospective observational registry study contributes to the mounting evidence for the effectiveness of MSA and LF. Despite the more severe nature of GERD in the LF group, the clinical outcomes for MSA and LF were favorable from an effectiveness and safety standpoint." (Surgical Endoscopy)

2020 ENDOSCOPIC TREATMENT OF ESOPHAGEAL NEOPLASIA: A DECADE OF EVOLUTION (full text) "A revolution in the treatment approach for early esophageal neoplasia has taken place in the past decade. Esophagectomy has gone from being the primary treatment for such patients to a rarely used salvage therapy. Multiple modalities, including EMR, ESD, RFA, cryotherapy, and APC, often used in combination, yield complete eradication of dysplasia and Barrett's in over 90% of treated patients. Due to the efficacy of endoscopic therapy, timely diagnosis of esophageal neoplasia to allow for the application of these less-invasive therapies is receiving more emphasis now than ever. The next important breakthrough in esophageal cancer will involve broadscale screening methods, to allow for early detection of esophageal neoplasia." (American Clinical and Climatological Association)

15 July 2020 Safety and efficacy of magnetic sphincter augmentation dilation "There is no clinical credence to the manufacturer's recommendation for the use of fluoroscopy and limitation to 15 mm when dilating a patient for dysphagia after MSA implantation. Use of a larger size dilator was not associated with perforation or device erosion, but also did not reduce the need for repeat dilation. Given this, we would recommend that the initial dilation for any size MSA device be done using a 15 mm through-the-scope balloon dilator. Dysphagia prompting dilation after MSA implantation is associated with nearly a 12% risk of device explantation." (Surgical Endoscopy)

15 July 2020 Endoscopic Submucosal Tunnel Dissection as a Novel Therapeutic Technique in Patients With Barrett's Esophagus (full text) "The tunneling strategy helped achieve complete en bloc resection at an increased dissection speed, without any procedural complications. This article illustrates that ESTD can be a feasible, safe, and effective treatment for dysplastic Barrett's esophagus." (Journal of Investigative Medicine High Impact Case Reports)

15 July 2020 Adenocarcinoma of the cervical esophagus arising within a long segment of Barrett’s metaplasia (full text) "the incidence of esophageal adenocarcinoma (EAC) has already surpassed that of SCC in several regions of North America and Europe. Similarly to its precursor condition, BE, EAC is typically located in the distal esophagus where inflammation from gastric acid reflux is most profound" (Endoscopy)

July 2020 Gastroesophageal reflux-like symptoms are associated with hyposalivation and oropharyngeal problems in patients with asthma "Age, xerostomia, and GERLS were significantly related to hyposalivation in patients with asthma. To identify oropharyngeal problems in these patients, a careful assessment of the suspected symptoms of gastroesophageal reflux may be useful." (Respiratory Investigation)

14 July 2020 High grade dysplasia or esophageal adenocarcinoma in patients with a history of Roux-en-Y gastric bypass surgery: a case series "RYGB patients are still at risk of developing esophageal cancer. Patients at risk should be screened prior to RYGB and those with Barret's esophagus need to undergo rigorous endoscopic surveillance following surgery. If detected early, EMR and ESD are invaluable in managing those who progress." (Endoscopy)

14 July 2020 Short-term outcome of routine use of EndoFLIP during hiatal hernia repair "The initial DI [distensibility index] was associated with final DI, but it did not correlate with improvement in short-term GERD-HRQL score. Final DI maintained above the cutoff value led to most of the patients not to require intervention for dysphagia. Use of the EndoFLIP can provide objective data during the operation and prevent severe dysphagia after repair." (Surgical Endoscopy)

13 July 2020 Dysplasia in Random Biopsies from Barrett's Surveillance Is an Important Marker for More Severe Pathology "The presence of any grade of dysplasia in random biopsies during surveillance in referral centers is a marker for more severe final pathology. Training in recognition of early neoplastic lesions in Barrett's esophagus imaging is recommended for endoscopists performing Barrett's surveillance." (Digestive Diseases and Sciences)

13 July 2020 Understanding the relationship between esophageal motor disorders and reflux disease "The relationship between esophageal motility and GERD pathogenesis needs to be further evaluated by multicenter outcome studies involving a large number of GERD patients and healthy controls" (Expert Review of Gastroenterology & Hepatology)

10 July 2020 Long-term Outcomes of Per-oral Endoscopic Myotomy in Spastic Esophageal Motility Disorders: A Large, Single-Center Study "POEM is a safe, effective, and durable treatment modality for spastic motility disorders of the esophagus. However, GERD is found in about half of the patients mandating close monitoring after POEM." (Journal of Clinical Gastroenterology)

10 July 2020 Nocturnal Gastroesophageal Reflux Disease (GERD) and Sleep: An Important Relationship That Is Commonly Overlooked "Treatment of nocturnal GER has been shown to improve both subjective and objective sleep measures. The therapeutic approach includes lifestyle modifications and medication individualization and optimization with proton-pump inhibitors serving as the mainstay of treatment. Antireflux surgery and newer endoscopic procedures have been demonstrated to control nocturnal GER." (Journal of Clinical Gastroenterology)

10 July 2020 Reflux Hypersensitivity: How to Approach Diagnosis and Management "Though there is no definitive therapy for reflux hypersensitivity, several anti-secretory agents and neuromodulators have shown some efficacy in therapeutic trials. The lack of large-scale, randomized controlled trials, however, reinforces the need for further research into the pharmacotherapy of reflux hypersensitivity." (Current Gastroenterology Reports)

10 July 2020 Non-acid Reflux: When It Matters and Approach to Management "Potential treatments include lifestyle modification, increased acid suppression, alginates, treatment of esophageal hypersensitivity, baclofen, buspirone, prokinetics, and anti-reflux surgery in highly selected individuals." (Current Gastroenterology Reports)

10 July 2020 Argon Plasma Coagulation for Barrett's Esophagus With Low-Grade Dysplasia: A Randomized Trial With Long-Term Follow-Up on the Impact of Power Setting and Proton Pump Inhibitor Dose "APC power setting and PPI dose did not impact efficacy and safety of BE ablation. Complete ablation of BE with LGD was durable in > 90 % of patients, without any evidence of neoplasia progression in the long term." (Endoscopy)

9 July 2020 Long-term use of proton pump inhibitors as a risk factor for various adverse manifestations "The clinicians and patients should be cautious about these effects so that they can avoid the serious outcomes. PPIs should be avoided for long-term use mainly in older adults unless there is a proper indication." (Therapies)

9 July 2020 Failure to Cure in Patients Undergoing Surgery for Esophageal Carcinoma "The incidence of failure to cure was 10.7%. Given the significant hospital variation in the percentage of failure to cure, improvement is needed. Since salvage procedures are more often successful in high-volume hospitals, further centralization of this procedure is warranted." (Annals of Surgery)

8 July 2020 Postoperative Gastrointestinal Complaints After Laparoscopic Nissen Fundoplication  "Satisfaction level and preference for surgery were 82.8% and 91.6%, respectively." "This is the first study in which postoperative reflux-related and nonspecific gastrointestinal complaints are analyzed together for a long follow-up period. We found a significant decrease in many reflux-related and nonspecific symptoms. Although some disturbing complaints like inability to belch, early satiety, and flatulence emerged, the preference for surgery did not change." (Surgical Laparoscopy, Endoscopy & Percutaneous Techniques)

8 July 2020 Distinct Microbiota Dysbiosis in Patients With Non-Erosive Reflux Disease and Esophageal Adenocarcinoma (full text) "Non-erosive reflux disease (NERD) and esophageal adenocarcinoma (EAC) are often regarded as bookends in the gastroesophageal reflux disease spectrum. However, there is limited clinical evidence to support this disease paradigm" (Journal of Clinical medicine)

7 July 2020 Increased Risk of COVID-19 Among Users of Proton Pump Inhibitors  (full text pdf) ", there is biological plausibility for our findings as the similar SARS-CoV-1 is pH-sensitive and remains infective at a pH >3 (3); twice daily PPI use can lead to 24-hour median intragastric pH >6 and sustain pH >4 for more than 20 hours (20-22). We also found evidence of a dose-response relationship as those using PPIs twice daily have higher odds for COVID-19 positivity when compared to those taking lower-dose PPIs or those not using PPIs at all. Moreover, individuals taking the less potent H2RAs are not at increased risk." (American Journal of Gastroenterology) 

6 July 2020 Straight Leg Raise Metrics on High-Resolution Manometry Associate With Esophageal Reflux Burden "Analysis of intra-esophageal pressure gradients during SLR, a simple HRM maneuver, may augment evaluation of symptomatic GERD, and provide adjunctive evidence supporting GERD." (Neurogastroenterology & Motility)

6 July 2020 The Global Prevalence of Barrett's Esophagus: A Systematic Review of the Published Literature "There is a need to reassess the true prevalence of Barrett's esophagus using the current guidelines in most regions. Having knowledge about the precise Barrett's esophagus prevalence, diverse attitudes from educational to screening programs could be taken." (United European Gastroenterology Journal)

6 July 2020 Guideline on screening for esophageal adenocarcinoma in patients with chronic gastroesophageal reflux disease (full text) "The Canadian Task Force on Preventive Health Care recommends not screening adults with chronic gastroesophageal reflux disease (GERD) for esophageal adenocarcinoma and precursor conditions (Barrett esophagus or dysplasia), because there is an absence of evidence for benefit, and there are uncertain harms, important resource implications and variable patient values and preferences." (Canadian Medical Association)

6 July 2020 Chronic GERD and risk of esophageal adenocarcinoma: Should we screen with gastroscopy? (full text) " Esophageal cancer, including esophageal adenocarcinoma, is uncommon in Canada. Having symptoms of chronic gastroesophageal reflux disease (GERD) increases the risk of developing Barrett esophagus and esophageal adenocarcinoma." (Canadian Medical Association)

6 July 2020 Investigations and Management of Chronic Cough: Update From the European Respiratory Society Chronic Cough Taskforce 2020 (full text pdf) "The ERS guidelines do not suggest a trial of anti-acid medications for 2 months (proton pump inhibitors [PPI] and H2 antagonists) unless there is objective evidence of reflux or at least symptoms of acid reflux [7]. Randomized controlled trials of PPI in chronic cough are small and systematic reviews of PPI trials have not shown significant benefit in reducing severity of cough in patients without evidence of GERD [59, 60]. In subgroup analyses, patients with symptoms of reflux or objective evidence of reflux on esophageal pH monitoring may have a modest benefit from PPI therapy. The duration of PPI trial is not well defined however a minimum of 8 weeks is likely required to derive benefit [61]. Guidelines also recommend an anti-reflux diet including elimination of coffee, tea, alcohol, chocolate, mints and citrus products based on expert opinion" (Polish Archives of Internal Medicine)

5 July 2020 Chromoendoscopy: Role in Modern Endoscopic Imaging (full text) "This review will discuss some of the indications and modern applications of chromoendoscopy in various conditions including Barrett's oesophagus, oesophageal squamous cell carcinoma, early gastric cancer, inflammatory bowel disease and neoplastic colonic lesions. In carefully selected situations, chromoendoscopy could still be a useful adjunct to white light endoscopy in day-to-day clinical practice." (Translational Gastroenterology and Hepatology)

5 July 2020 New Developments in Esophageal Function Testing and Esophageal Manifestations of Connective Tissue Disorders "This work summarizes new and emerging metrics and tools in esophageal function testing and their potential clinical impact. Because the diagnostic sensitivity and reliability of conventional impedance-pH variables are suboptimal, several novel impedance parameters, such as the postreflux swallow-induced peristaltic wave index and the mean nocturnal baseline impedance, as well as mucosal impedance, are entering a validation stage prior to general clinical use" (Annals of New York Academy of Sciences)

2 July 2020 Bariatric Surgery and the Mechanisms of Gastroesophageal Reflux Disease "For those with moderate reflux, since specific procedure guidelines are missing, surgical treatment for morbid obese patients must be selected according to the clinical characteristics of the patient, his eating habits and patient willingness. It should be based on a preoperative workup with shared decision making, with the double purpose of treating both GERD and obesity." (Journal of Laparoendoscopic & Advanced Surgical Techniques)

2 July 2020 Necrosis of the Nissen-Sleeve Gastrectomy (N-SG) Wrap "Wrap necrosis is a life-threatening complication after N-SG. This case is shared to raise awareness of this complication. This was successfully managed by prompt laparoscopy and wrap resection. Ideally such complications should be referred to experts or centers with high volume of bariatric surgery." (Obesity Surgery)

2 July 2020 When did gastro-esophageal reflux become a disease? A historical perspective on GER(D) nomenclature "those actively involved in treating the reflux, first surgeons in the 1960s and then gastroenterologists in the 1970s, initiated naming it a disease. In pediatrics, the possible correlation between reflux events and sudden infant death syndrome accelerated the management of reflux associated with respiratory symptoms with surgery in the 1970s" (International Journal of Pediatric Otorhinolaryngology)

1 July 2020 Esophageal extracellular matrix hydrogel mitigates metaplastic change in a dog model of Barrett's esophagus (full text) "The results suggest that in vivo alteration of the microenvironment with a site-appropriate, mucoadhesive ECM hydrogel can mitigate the inflammatory and metaplastic response in a dog model of BE." (Science Advances)

1 July 2020 STATE OF EVIDENCE IN MINIMALLY INVASIVE MANAGEMENT OF GASTROESOPHAGEAL REFLUX: Findings of a Scoping Review "The majority of studies showed symptomatic and objective improvement of GERD with the device therapies. Adverse events were minimal. However, normalization of acid exposure occurred in about 50% of patients and, for some modalities, long term durability is uncertain." (Gastroenetrology)

1 July 2020 Safety and Efficacy of a Novel Powered Endoscopic Debridement Tissue Resection Device for Management of Difficult Colon and Foregut Lesions: First Multicenter USA Experience "Endorotor is a novel, effective and safe PED device for endoscopic resection of flat and polypoid lesions in the colon and foregut. It may have a promising role in the endoscopic management of naïve and scarred mucosal lesions based on this initial experience." (Gastrointestinal endoscopy)

1 July 2020 The Relationship Between the Interruption of the Lower Esophageal Sphincter and Relief of Dysphagia After Per-Oral Endoscopic Myotomy for Achalasia "POEM was largely effective in the treatment of esophageal achalasia in this study. Patients with larger defects of the muscularis propria at the LES after myotomy had greater relief of dysphagia without an increased incidence of postoperative complications." (Endoscopic Ultrasound)

1 July 2020 Multicenter Study on the Diagnostic Performance of Multiframe Volumetric Laser Endomicroscopy Targets for Barrett's Esophagus Neoplasia With Histopathology Correlation (full text) "VLE assessors can identify BE neoplasia with reasonable diagnostic accuracy in histopathology-correlated VLE ROIs, and accuracy is enhanced when BE neoplasia is identified with high level of confidence." (Diseases of the Esophagus)

1 July 2020 Clinical Utility of Wide-Area Transepithelial Sampling With Three-Dimensional Computer-Assisted Analysis (WATS3D) in Identifying Barrett's Esophagus and Associated Neoplasia "We demonstrate that WATS3D has high clinical utility. By prompting physicians to change their clinical management in patients with negative FB results, WATS3D, used adjunctively to FB, directly impacts patient management, and improves patient outcomes." (Diseases of the Esophagus)

1 July 2020 Esophageal Contractile Segment Impedance From High-Resolution Impedance Manometry Correlates With Mean Nocturnal Baseline Impedance and Acid Exposure Time From 24-hour pH-impedance Monitoring "Esophageal baseline impedance (BI) acquired during esophageal contraction (contractile segment impedance [CSI]) is proposed to improve BI accuracy in gastroesophageal reflux disease (GERD). We evaluated associations between CSI and conventional and novel GERD metrics." (Diseases of the Esophagus)

1 July 2020 [Gastroesophageal Reflux Disease in Obese Patients ; Current Management] "Roux-en-Y gastric bypass is the intervention of choice for obese patients suffering from GERD, while sleeve gastrectomy can on the contrary induce increased reflux in the long term. Classic anti-reflux surgery (fundoplication) can also be offered to these patients, while being aware of the high risk of recurrent symptoms for BMI > 30-35 kg/m2." (Revue Medicale Suisse)

July 2020 Postprandial Proximal Gastric Acid Pocket and Its Association With Gastroesophageal Acid Reflux in Patients With Short-Segment Barrett's Esophagus "In patients with short-segment BE, a PPGAP is commonly seen. Its length and acidity of PPGAP are associated with gastroesophageal acid reflux, the DeMeester score, and the GerdQ score in patients with short-segment BE." (Journal of Zhejiang University)

July 2020 The Impact of the Policy-Practice Gap on Costs and Benefits of Barrett's Esophagus Management "Compared with no surveillance, the Dutch guideline incurred an additional €5.0 ($5.7) million per 1,000 patients with BE for surveillance and treatment, whereas 57 esophageal adenocarcinoma (EAC) cases (>T1a) were prevented. With intensive and very intensive surveillance strategies for both nondysplastic BE and low-grade dysplasia, the net costs increased by another €2.5–5.6 ($2.8–6.5) million while preventing 10–19 more EAC cases and gaining 33–60 more QALYs." "The policy-practice gap in BE surveillance intervals results in 50%–114% higher net costs for BE management for only 10%–18% increase in QALYs gained, depending on actual intensity of surveillance. Incentives to eliminate this policy-practice gap should be developed" (American College of Gastroenterology)

July 2020 Overutilization of Endoscopic Surveillance in Barrett's Esophagus: The Perils of Too Much of a Good Thing "A cost-utility analysis in the current issue of AJG examines the ramifications of the overuse of surveillance endoscopy in Barrett's esophagus (BE). This study suggests that excess surveillance is expensive, increasing costs by 50% or more, with only nominal increases in quality-adjusted life expectancy." (American College of Gastroenterology)

July 2020 Is It Time to Revisit Surgery and Endoscopic Therapy for Refractory GERD? (full text pdf) "Careful evaluation of patients who are unresponsive to PPIs remains mandatory, objective documentation of GERD at baseline necessary, and the presence of continued reflux on impedance/pH ideal. In patients with symptoms other than heartburn or regurgitation in whom PPIs have failed, we should remain reluctant to offer surgery or TIF." (GASTROINTESTINAL ENDOSCOPY)

July 2020 Changes in the Disease-Specific Quality of Life Following Dor Fundoplication. A Multicentre Cross-Sectional Study (full text) "Dor Fundoplication improves the overall disease-specific quality of life in patients with refractory GERD in the short term period. Recurrence of symptoms causing a deterioration in the quality of life is seen in patients followed up beyond four years of index surgery." (Annals of Medicine and Surgery)

June 2020 Symptomatic response to GERDOFF® in patients with gastro-esophageal reflux disease and poor response to alginates: an exploratory, post-market, open-label study "Forty patients were included, 22 were on stable therapy with proton pump inhibitor (PPI). Compared to baseline, the days with heartburn episodes and the GIS [GERD Impact Scale] score progressively decreased during the first (p<0.0001) and the second week of treatment (p<0.0001). Heartburn episodes per week (p<0.0001) and the GIS score (p<0.0001) decreased in the first and the last 7 days of 14-day treatment and did not differ between patients on and off PPI. The treatment was safe and well-tolerated, and it was rated as very good (46.2%) or good (43.6%) on the satisfaction questionnaire." (Turkish Journal of Gastroenterology)

April - June 2020 ORAL AND PHARYNGEAL TRANSIT IN FUNCTIONAL HEARTBURN (full text) "Oral, pharyngeal and upper esophageal sphincter transit time are similar in patients with functional heartburn to healthy controls." (Arquivos de Gastroenterologia)

30 June 2020 Adequacy of EGD Reporting: A Review of 100 Reports From 100 Endoscopists "Endoscopy reports frequently do not include the use of a grading system for esophagitis or the Prague system for CLE. This hampers the assessment of change with therapy or over time. ... A consistent reporting system is recommended for routine use with upper endoscopy." (Journal of Gastrointestinal Surgery)

30 June 2020 Outcomes in Bariatric and Metabolic Surgery: An Updated 5-Year Review   "Gastroesophageal reflux disease (GERD) and dysphagia following SG [Sleeve gastrectomy] are common, and routine endoscopic surveillance for Barrett's esophagus may be of significant utility." (Current Obesity Reports)

30 June 2020 The Lyon Consensus: Does It Differ From the Previous Ones? "Definition of individual patient phenotype, based on the level of refluxate exposure, mechanism of reflux, efficacy of clearance, underlying anatomy of the esophagogastric junction, and clinical presentation, will lead to manage GERD patients with a tailored approach chosen among different types of therapy." (Journal of Neurogastroenterology and Motility)

26 June 2020 Endoscopic and Surgical Treatments for Achalasia: Who to Treat and How? "Per oral endoscopic myotomy is a new endoscopic procedure that allows division of the LES via transoral route. It has several advantages including less invasiveness, cosmesis, and tailored approach to the length on the myotomy. However, it is associated with increased rate of post-procedural reflux." (Gastroenterology Clinics of North America)

26 June 2020 Mystery Solving: Acid Reflux and Cell Mobility in Barrett's Esophagus and Esophageal Adenocarcinoma (full text pdf - EDITORIAL) "Gastroesophageal reflux disease is remarkably common and usually benign, and yet it is a risk factor for Barrett’s esophagus (BE), the precursor of potentially lethal esophageal adenocarcinoma (EAC). Many efforts have yielded exciting insights into how BE, as the archetypal precursor lesion, undergoes a mutational maturation and clonal competition to become more dangerous entities such as dysplasia and EAC" (Cellular and Molecular Gastroenterology and Hepatology)

26 June 2020 Mucosal Impedance for Esophageal Disease: Evaluating the Evidence "Our paper reviews the history of impedance in esophageal disease, the means of assessing baseline and mucosal impedance, data with regard to the newly developed mucosal impedance probes, the clinical utility of mucosal impedance in specific clinical conditions, and limitations in our existing knowledge, along with suggestions for future studies." (Annals of the New York Academy of Sciences)

25 June 2020 [Therapeutic Response to 20 Mg of Esomeprazole Twice Daily in Patients With Gastroesophageal Reflux Disease-related Non-cardiac Chest Pain: An Open-Label Randomized Pilot Study] (full text - Korean) "Esomeprazole BD was as effective as esomeprazole OD in improving GERD-related NCCP. Although statistically insignificant, the percentage of patients with >50% reduction in the chest pain score was higher in the esomeprazole BD group than in the esomeprazole OD group. Large-scale studies will be needed to assess these findings further." (The Korean Journal of Gastroenterology)

25 June 2020 Laparoscopic Toupet Fundoplication for the Treatment of Laryngopharyngeal Reflux: Results at Medium-Term follow-Up "LTF seems feasible, effective and promising for the treatment of LPR with improved symptoms and disease-specific patients' quality of life perception up to 3-year follow-up." (World Journal of Surgery)

25 June 2020 Prevalence of Endoscopic Findings Before Bariatric Surgery and Their Influence on the Selection of the Surgical Technique "Preoperative UGE allows the diagnosis of asymptomatic esophagitis related to gastroesophageal reflux disease and the identification of asymptomatic polyps and ulcers, with the potential ability for malignant transformation. In up to 3.17% of the cases, the endoscopic findings changed the operative strategy. As the complication rate associated with the procedure is low, we recommend the routine performance of preoperative UGE before bariatric surgery." (Obesity Surgery)

24 June 2020 Elimination of Dietary Triggers Is Successful in Treating Symptoms of Gastroesophageal Reflux Disease "Most patients with GERD can identify at least one food triggering their symptoms. An approach based on abstention from identified food may be effective in the short term." (Digestive Diseases and Sciences)

23 June 2020 Wide Area Transepithelial Sampling With Computer-Assisted Analysis (WATS 3D) Is Cost-Effective in Barrett's Esophagus Screening (full text) "Screening for BE in 60-year-old white male GERD patients is more cost-effective when WATS3D is used adjunctively to the Seattle protocol than with the Seattle protocol alone." (Digestive Diseases and Sciences)

22 June 2020 Bile Reflux in Patients With Nerd Is Associated With More Severe Heartburn and Lower Values of Mean Nocturnal Baseline Impedance and Chemical Clearance "Compared to acid reflux alone, the presence of bile in an acidic esophageal environment is associated with more severe heartburn, lesser relief from PPI therapy, higher impairment of esophageal mucosal integrity and less effective chemical clearance." (Neurogastroenterology & Motility)

22 June 2020 [Screening Gastroscopy in Germany - First Results of the Pilot Phase of the Prä-GIT Study] "The Prä-GIT study was designed to generate a database for premalignant and early cancerous lesions of the uGIT in Germany in asymptomatic individuals presenting for a regular screening colonoscopy. The current pilot study has delivered important insights into the feasibility of the main study protocol. Additionally, the pilot study has shown a high rate of acceptance of an additional uGIT examination in this study population." (Zeitschrift fur Gastroenetrologie)

20 June 2020 A Step in the Right Direction: Trends Over Time in Bariatric Procedures for Patients With Gastroesophageal Reflux Disease "Bariatric patients with pre-existing GERD are increasingly likely to undergo LRYGB, consistent with the literature. LSG is presently more common in the overall cohort and among those undergoing concomitant hiatal hernia repair. Despite the growing recognition of GERD in bariatric patients, a significant discrepancy persists in hiatal hernia management per bariatric procedure type." (Obesity Surgery)

19 June 2020 Pyloroplasty and the Risk of Barrett's Esophagus in Patients With Gastroparesis  "Impaired gastric emptying leads to increased gastric volume and therefore more severe reflux. We seek to investigate the association between gastroparesis and BE and the predictors of BE among patients with gastroparesis. " (Diseases of the Esophagus)

18 June 2020 Metformin and Micronutrient Status in Type 2 Diabetes: Does Polypharmacy Involving Acid-Suppressing Medications Affect Vitamin B12 Levels? (full text) "Literature suggests that drugs which suppress stomach acid production such as PPIs and H₂RAs interfere with vitamin B12 absorption, by reducing dietary B12 release from food proteins. A 53–89% reduction in protein-bound B12 absorption was noted following H₂RA treatment, with ranitidine specifically reported to induce decreases in B12 status. Similarly, there have been other reports of an inverse correlation between vitamin B12 levels and duration of PPI therapy" (Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy)

18 June 2020 Anti-Heartburn Effects of Sugar Cane Flour: A Double-Blind, Randomized, Placebo-Controlled Study (full text) "There is anecdotal evidence of the effectiveness of prebiotic sugarcane flour in controlling symptoms of GERD. This pilot study aimed to investigate the effectiveness of a prebiotic sugarcane flour in alleviating symptoms in medically-diagnosed GERD patients. This pilot study was a single center, double-blinded, placebo-controlled randomized trial conducted on 43 eligible participants." (Nutrients)

18 June 2020 Efficacy of Endoscopic Submucosal Dissection for Superficial Gastric Neoplasia in a Large Cohort in North America "ESD is a highly effective treatment for superficial gastric neoplasia and should be considered as a viable option for patients in North America. The risk of local recurrence is low and occurs exclusively after non-curative resection. Careful endoscopic surveillance is necessary to identify and treat metachronous lesions." (Clinicl Gastroenteroly & Hepatology)

18 June 2020 Prevalence of Barrett's Esophagus and Performance of Societal Screening Guidelines in an Unreferred Primary Care Population of U.S. Veterans "Less than 10% of patients diagnosed with esophageal adenocarcinoma have a pre-existing Barrett's esophagus (BE) diagnosis" "Among 371 patients without GERD symptoms, 25 (6.7%) had BE" "Over half of BE cases were without frequent GERD symptoms, but virtually all had at least one known BE risk factor. Practice guidelines requiring GERD symptoms have low sensitivity, whereas those not requiring GERD have low specificity. We have proposed a screening guideline with better use of known risk factors." (Gastrointestinal Endoscopy)

18 June 2020 Peroral Endoscopic Myotomy Is Highly Effective for Achalasia Patients With Recurrent Symptoms After Pneumatic Dilatation "In achalasia with recurrent symptoms after PD, POEM is a safe and highly effective treatment modality. Prior PD does not seem to influence the outcomes or efficacy of POEM." (Surgical Endoscopy)

18 June 2020 The impact of age on patients undergoing transthoracic esophagectomy for cancer "In <70s with adenocarcinoma, overall survival was 52 months vs 35 months in the ≥ 70. .... Increased peri-operative morbidity and mortality combined with the reduction in the long term survival in the over 70s cohort should be addressed when counselling patients undergoing curative resection for oesophageal cancer." (Diseases of the Esophagus)

17 June 2020 Accuracy of Artificial Intelligence-Assisted Detection of Upper GI Lesions: A Systematic Review and Meta-Analysis "AI is accurate in the detection of upper GI neoplastic lesions and HP infection status. However, most of these studies were based on retrospective review of selected images, which would require further validation in prospective trials." (Gastrointestinal Endoscopy)

17 June 2020 Laparoscopic Heller Myotomy and Roux-en-Y Gastric Bypass as Treatment for Patients With Achalasia and Morbid Obesity: Outcomes in a Short Series of Patients "HM and RYGB are an excellent treatment for morbidly obese patients with achalasia. All patients reported a marked improvement of their dysphagia and no symptoms of GERD. The %EWL and BMI descent was very good and maintained through time, showing also an excellent control for morbid obesity." (Journal of Laparoendoscopic & Advanced Surgical Techniques)

17 June 2020 Impedance in the Evaluation of the Esophagus "These technologies have proven valuable for assessment of the esophagus in recent years. They provide information on esophageal flow properties, mucosal integrity, lumen shape, and distensibility in esophageal disorders, in particular for GERD and achalasia." (Annals of New York Academy of Science)

16 June 2020 Tailoring Endoscopic and Surgical Treatments for Gastroesophageal Reflux Disease "The presence of esophageal dysmotility complicates the choice of surgical fundoplication. Most literature demonstrates that fundoplication is safe in the setting of ineffective or weak peristalsis and that postoperative dysphagia cannot be predicted by preoperative manometry parameters." (Gastroenterology Clinics of North America)

15 June 2020 Accurate Nonendoscopic Detection of Barrett's Esophagus by Methylated DNA Markers: A Multisite Case Control Study "Nonendoscopic Barrett's esophagus (BE) screening may help improve esophageal adenocarcinoma outcomes. We previously demonstrated promising accuracy of methylated DNA markers (MDMs) for the nonendoscopic diagnosis of BE using samples obtained from a capsule sponge-on-string (SOS) device. We aimed to assess the accuracy of these MDMs in an independent cohort using a commercial grade assay." (American College of Gastroenterology)

15 June 2020 Barrett's Esophagus Management in the Elderly: Principles and Best Practice "This review highlights the importance of recognizing the unique aspects of evaluating and managing the geriatric BE patient. Practical recommendations are discussed which will help the provider individualize and optimize care for their geriatric BE patient." (Current Gastroenterology Reports)

14 June 2020 Circulating Exosomal miRNAs as Potential Biomarkers for Barrett's Esophagus and Esophageal Adenocarcinoma "This review summarizes recent findings on the features of circulating exosomal miRNAs in BE/EAC, which could be valuable for the early diagnosis, therapeutic approaches, and outcome prediction of BE/EAC." (World Journal of Gastroenterology)

12 June 2020 Gastroesophageal Reflux and Laparoscopic Sleeve Gastrectomy: Results of the First International Consensus Conference "The importance of pre- and postoperative endoscopy has been emphasized. The role of specialized tests for GERD and the exact surveillance programs need to be further defined. LSG is viewed as contra-indicated in higher degrees of endoscopic and clinical GERD. LSG with anti-reflux fundoplication emerges as a new valid option in patients with GERD." (Obesity Surgery)

12 June 2020 Immune Microenvironment in Barrett's Esophagus Adjacent to Esophageal Adenocarcinoma: Possible Influence of Adjacent Mucosa on Cancer Development and Progression "Results of our present study firstly revealed the potential influence of the tissue immune microenvironment of BE adjacent to EAC on cancer development and eventual clinical outcome of EAC patients. T cell infiltration could play pivotal roles in facilitating the dysplasia-adenocarcinoma sequence in BE." (Virchows Archiv)

11 June 2020 IsLocal Endoscopic Resection a Viable Therapeutic Option forEarly Clinical Stage T1a and T1b Esophageal Adenocarcinoma? "This study demonstrates ER has comparable long-term outcomes for clinical T1aN0 and T1bN0 esophageal adenocarcinoma. However, 15% of patients with cT1b esophageal cancer were found to have positive nodal disease. Future research should seek to identify the subset of T1b cancers at high risk of nodal metastasis and thus would benefit from esophagectomy with lymphadenectomy." (Annals of Surgery)

11 June 2020 National Oesophgo-Gastric Cancer Audit – Short Report 2020 (full text pdf) "This report details the results of a comparison into how the cohort of patients with epithelial oesophago-gastric cancer in the National Oesophago-Gastric Cancer Audit (NOGCA) compares with the population of OG cancer captured by the English cancer registration process." (Health Quality Improvement Partnership)

10 June 2020 Anti-reflux Surgery for Controlling Respiratory Symptoms of Gastro-Esophageal Reflux Disease: A Systematic Review and Meta-Analysis (full text) "Of the included patients, 83.4% (95% CI 78.3-87.5%) patients reported improvement in cough symptoms after surgery. For the wheezing symptom, 71.5% (95% CI 62.9-78.8%) reported improvement after surgery. Moreover, surgery presented better results in improving respiratory symptoms than medical therapy (risk difference: -0.46; 95% CI -0.77, -0.16). Physicians should strongly consider surgical anti-reflux procedures for controlling respiratory symptoms in GERD patients after proper patient selection. Anti-reflux surgery has shown high efficacy in improving respiratory symptoms related to GERD, even when compared to medical therapy." (Asian Journal of Surgery)

10 June 2020 Clinical Uses of 5-aminolaevulinic Acid in Photodynamic Treatment and Photodetection of Cancer: A Review "ALA-PDT has been employed for palliative and even curative treatment of endoscopically accessible tumours. Lung, oesophagus, gastric and bladder carcinomas, and also oral premalignant lesions, gynaecological intraepithelial neoplasias and Barrett's oesophagus are the conditions mostly treated with ALA-PDT" (Cancer Letters)

10 June 2020 The Treatment Efficacy of Adding Prokinetics to PPIs for Gastroesophageal Reflux Disease: A Meta-Analysis "Adding prokinetics to PPIs achieves symptomatic improvement compared to PPI monotherapy, thus can enhance life quality of GERD patients. However, the combined treatment seems to have no significant effect on mucosal healing." (Endoscopy)

9 June 2020 Long-Term Quality of Life Following Endoscopic Therapy Compared to Esophagectomy for Neoplastic Barrett's Esophagus "Multiple measures of symptom status were better with ET compared to esophagectomy following treatment of BE with HGD or T1a EAC. We observed worse long-term physical and role functioning in ET patients which could reflect unmeasured baseline functional status rather than a causal effect of ET." (Digestive Diseases & Sciences)

8 June 2020 Peroral Endoscopic Myotomy Versus Pneumatic Dilation for Achalasia: A Systematic Review and Meta-Analysis "Our current evidence suggests that the long-term efficacy of POEM was superior to that of pneumatic dilation, but accompanied by higher complications." (European Journal of Gastroenterology & Hepatology)

8 June 2020 Expert Assessment on Volumetric Laser Endomicroscopy Full-Scans in Barrett's Esophagus Patients With or Without High-Grade Dysplasia or Early Cancer "Identification of subtle neoplastic lesions in VLE full-scans by experts was disappointing. Future studies should focus on improving methodologies for reviewing full-scans, development of refined VLE-criteria for neoplasia, and computer-aided diagnosis in VLE-scans." (Endoscopy)

8 June 2020 Combined Healthy Lifestyle Is Inversely Associated With Upper Gastrointestinal Disorders Among Iranian Adults "We found that adherence to a healthy lifestyle was associated with lower odds of GERD, FD and its symptoms in this group of Iranian adults, in a dose-response manner. Individual lifestyle-related factors were also associated with these conditions." (Digestive Diseases)

6 June 2020 Quality Indicators for Barrett's Endotherapy (QBET): UK Consensus Statements for Patients Undergoing Endoscopic Therapy for Barrett's Neoplasia "This UK national consensus project has successfully developed QIs for patients undergoing Barrett's endotherapy. These QIs can be used by service providers to ensure that all patients with BE neoplasia receive uniform and high-quality care." (Frontline Gastroenterology)

6 June 2020 Latest Insights Into the Hot Question of Proton Pump Inhibitor Safety - A Narrative Review "Although they have been shown to combine high therapeutic efficacy and good safety profile in many studies, in last years we have witnessed the publication of many articles reporting the possible association of long-term PPI therapy with important unexpected adverse events and these observations have created alarmism in both patients and physicians." "Nowadays we can reasonably exclude cardiovascular diseases, community-acquired pneumonia, all-cause mortality, dementia and bone fractures from PPI-related adverse events." (Digestive & Liver Disease)

6 June 2020 Detection of Barrett’s oesophagus through exhaled breath using an electronic nose device (full text) "This electronic nose was able to distinguish between patients with and without BO with good diagnostic accuracy (sensitivity 91% specificity 74%) and seemed to be independent of proton pump inhibitor use, the presence of hiatal hernia, and reflux. This technique may enable an efficient, well-tolerated, and sensitive and specific screening method to select high-risk individuals to undergo upper endoscopy." (Endoscopy)

5 June 2020 Spatial Distribution of Dysplasia in Barrett's Esophagus Segments Before and After Endoscopic Ablation Therapy: A Meta-Analysis "Before ablation, dysplasia in Barrett's esophagus is found more frequently in the right half of the esophagus versus the left. Post-ablation recurrence is more commonly found in the top of the gastric folds and is non-visible as compared to the tubular esophagus, which is mainly visible." (Endoscopy)

4 June 2020 Gastroesophageal Reflux Disease: A Cause for Eustachian Tube Dysfunction in Obstructive Sleep Apnea (full text) "Given the high concomitance rate in patients with OSA, GERD might be an important association factor of Eustachian tube dysfunction in patients with OSA." (Ear, Nose & Throat Journal)

3 June 2020 A Computer-Assisted Algorithm for Narrow-Band-Imaging-Based Tissue Characterization in Barrett's Esophagus "We have demonstrated promising diagnostic accuracy of predicting the presence/absence of Barrett's neoplasia on histologically confirmed unaltered NBI-zoom videos with fast corresponding assessment time." (Gastrointestinal Endoscopy)

3 June 2020 Towards Screening Barrett's Oesophagus: Current Guidelines, Imaging Modalities and Future Developments (full text) "Oesophagogastroduodenoscopy (OGD) is the gold standard method in screening for Barrett's oesophagus. This invasive method is expensive with associated risks negating its use as a current screening tool for Barrett's oesophagus. This review explores current definitions, epidemiology, biomarkers, surveillance, and screening in Barrett's oesophagus" (Digestive Diseases and Sciences)

3 June 2020 The Meaning of Incidental Goblet Cells at the Gastroesophageal Junction "With respect to its demographic and histopathologic features, GEJ-GC likely represents gastric intestinal metaplasia as opposed to BE and should prompt gastric intestinal metaplasia screening and management." (Digestive Diseases and Sciences)

2 June 2020 Reoperation after antireflux surgery: a population‐based cohort study "In this population‐based study in Denmark, the reoperation rate 15 years after antireflux surgery was 12·8 per cent. Reoperations were associated with more complications." (British Journal of Surgery)

1 June 2020 Management of Regurgitation in Patients With Gastroesophageal Reflux Disease "The therapeutic gain of proton pump inhibitors (PPIs) above placebo averages 17% for regurgitation compared with 41% for heartburn. Increased dosing of medication is commonly, yet futilely, used. The symptom is probably mediated more by fluid volume than by the acidity of the refluxate. PPIs significantly decrease gastric acid secretion and to some extent volume of gastric juice. Significantly, doubling the PPI dose does not incrementally decrease gastric juice volume though it may decrease gastric acid secretion further. Studies on refractory regurgitation using some of the newer antireflux procedures (magnetic sphincter augmentation and transoral fundoplication) demonstrated success in over 85% of patients whereas increased PPI dosing helped in approximately 15%." (Current Opinion in Gastroenterology)

1 June 2020 Endoscopic Eradication Therapy for Barrett's Oesophagus: State of the Art "EET is now standard of care and endorsed by societal guidelines for the treatment of Barrett's oesophagus related neoplasia. Future studies should focus on risk stratification models using a combination of clinical data and biomarkers to identify ideal candidates for EET, and to predict recurrence. Optimal therapy for T1b cancer and surveillance strategy after CE-IM are topics that require further study." (Current Opinion in Gastroenterology)

June 2020 Clinical Profile of Patients Presenting With Dysphagia - An Experience From a Tertiary Care Center in North India (full text) "Dysphagia has diverse etiology, and a majority can be diagnosed by endoscopy and barium swallow. Malignancy is an important cause of dysphagia in elderly. Esophageal squamous cell carcinoma remains the most common malignancy, but the incidence of gastroesophageal junctional adenocarcinoma is increasing." (JGH Open)

June 2020 Prevalence of Reflux Esophagitis in Obese Japanese Undergoing Bariatric Surgery (full text) "Our study shows that the prevalence of RE in severely obese Japanese patients was significantly higher than the average prevalence of RE in Japan. However, the prevalence of RE did not increase with BMI in our cohort." (JGH open)

June 2020 Children With Gastroesophageal Reflux Disease Consume More Calories and Fat Compared to Controls of Same Weight and Age "The rations of children with GERD are characterized by higher calorie values and larger amounts of fat intake compared to the control group in the regard to z score BMI. Low dietary fiber consumption is additional factor associated with GERD in children with excessive weight and obesity. Compared to nonerosive GERD, higher intake of energy, protein, and total fat and lower of polyunsaturated fats revealed in patients with GERD with erosive esophagitis." (Journal of Pediatric Gastroenterology & Nutrition)

June 2020 Peroral Endoscopic Fundoplication: A Brand-New Intervention for GERD (full text pdf) "In summary, we achieved pure natural orifice transluminal endoscopic surgery fundoplication with EHS. POEF is a novel procedure and may become one of the solutions for refractory GERD" (VideoGIE)

May-June 2020 Gastroesophageal Reflux Disease (GERD) (full text) "Acid suppressive therapy provides symptomatic relief and prevents complications in many individuals with GERD. Advances in diagnostic and therapeutic modalities have improved our ability to identify and manage disease complications. Here, we discuss the pathophysiology and effects of GERD, and provide information on the clinical approach to this common disorder." (Missouri Medicine)

2020 Management of Refractory Heartburn: Are We Convinced That Surgery Is Better Than Medical Treatment? (full text) "Overall, the treatment success of surgery (18 out of 27 patients, 67%) was significantly superior to that of active medical treatment (eight out of 25 patients, 28%; p = 0.007) and of control medical treatment (three out of 26 patients, 12%; p < 0.001). The difference in treatment success rate between active and control medical therapy was 16% (95% confidence interval -5–38; p = 0.17). There were no reported deaths, only one patient required repeated surgery. In addition, surgery also benefitted patients with reflux hypersensitivity (71% improvement)." (Journal Royal College Physicians, Edincburgh)