PubMed HealthSearch

PubMed · 9333502

[Reflux disease].

Abstract

Reflux disease is a very frequent condition; its most frequent symptom, pyrosis, is found daily in 7% of the population. The disease is dut to the aggressive action of the gastroesophageal reflux "faced" by defensive oesophageal mechanisms. Reflux disease is classified as endoscopically positive with an obvious finding of oesophagitis and endoscopically negative with a normal endoscopic finding but detectable histological changes. Complications of the disease include strictures, ulcers, haemorrhage and Barrett's oesophagus. In the therapeutic regime provisions are used, medicamentous treatment (antacids, sucralphate, prokinetics, antagonists of H2 receptors and proton pump inhibitors) and surgical treatment. In the therapeutic strategy two procedures are possible: 1. the method of choice (treatment with a single drug) and 2. stepwise therapy a) step-up-the basis are regime provisions and gradually drugs are added, b) step-down-treatment is started with the most effective drug, the proton pump inhibitor, and is reduced gradually). Treatment has a short-term character (treatment of the acute attack) and long-term (maintenance treatment). Contemporary therapeutic possibilities improve the prognosis of the disease and the quality of life of patients with reflux disease to the quality level of the normal population.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

K Lukás. 1997-05-29. [Reflux disease].. https://pubmed.ncbi.nlm.nih.gov/9333502/

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

Patient response to marketing minimally invasive surgery for heartburn.

BACKGROUND: Over 40% of Americans suffer from "heartburn" at least once a month. This and other manifestations of gastroesophageal reflux (GERD) are often treated with neglect by both patients and their primary care physicians. Diagnostic evaluation is all too often sought only in late stages of the disease. We studied the response to a media campaign promoting minimally invasive surgery as a cure for longstanding heartburn. METHODS: The information was publicized on 14 TV and six radio stations over 4 weeks. Patients were referred to an 800-number and data on the following topics were obtained using a standardized questionnaire: demographics, reflux symptoms, previous specialist referral, diagnostic evaluation and treatment, insurance information, and reasons for and expectations in calling. All questionnaires were screened for likelihood of GERD (high, medium, low). A return call was placed to triage patients (surgical or medical appointment, information only, no contact). RESULTS: We received calls from 1,389 potential patients. Based on symptoms, medical therapy, and previous evaluation, 891 (64%) were judged to likely have GERD and assigned high-priority status. Of the patients providing insurance information, 32% were enrolled in an HMO; 29% commercial; 16% Medicare; 14% employer based; and 9% had no insurance. Six hundred ninety-eight high-priority patients were contacted. Of these, 402 (58%) wanted information only; 228 (33%) desired surgical and 68 (%) medical appointments. Two hundred fifteen patients (16% of callers) were seen by a surgical or medical consultant. One hundred thirty-five underwent diagnostic studies, of which 77 (57%) had pathologic esophageal acid exposure. Eighty-three patients have undergone surgery to date-60 laparoscopic and 14 open antireflux procedures; nine had other surgical procedures. CONCLUSIONS: Surprisingly, 64% of patients responding to a marketing campaign for heartburn have typical symptoms of GERD, have consulted one or more physicians and/or received medical treatment. More than half the patients tested (77/135) were found to have a positive 24-h pH study, and 78% (60/77) of these elected antireflux surgery to control their reflux symptoms.

Gastroesophageal Reflux

Is there a place for laparoscopic antireflux surgery in The Netherlands?

BACKGROUND: Antireflux surgery has not gained wide acceptance in The Netherlands in the past two decades. The introduction of laparoscopic fundoplication seems to have had no impact on the number of antireflux operations performed per year. METHODS: The SIG data were consulted in order to compile an inventory on the number of antireflux operations performed in The Netherlands between 1977 and 1995. The data were compared with those kindly supplied by the Laparoscopic Societies of the Scandinavian countries. RESULTS: The number of antireflux operations per year in The Netherlands, 1.7/100,000 per year, is far less than reported in the four Scandinavian countries, 15/100,000 per year, and also far below the 10/100,000 per year needed for antireflux surgery on a yearly basis. CONCLUSIONS: In The Netherlands, 1.7/100,000 inhabitants per year undergo antireflux surgery. This figure has remained virtually stable in the past two decades, i.e. it has not changed even since the introduction of H2-receptor antagonists, proton-pump inhibitors and laparoscopic antireflux surgery. The success of medical treatment and personal, anecdotal, experience of gastroenterologists with patients they have referred for surgery explain the low number of antireflux operations performed. Currently, a randomized trial is being conducted in The Netherlands comparing the effectivity, costs and quality of life after conventional Nissen fundoplication with the laparoscopic approach. All operations are performed or supervised by a limited number of experienced surgeons who have gone through the learning curve of both the open and conventional technique.

Gastroesophageal Reflux

Nutritional management of regurgitation in infants.

Infantile regurgitation is a frequently occurring problem. Throughout the world, anxious parents are imploring physicians to eliminate their infant's regurgitation. General practitioners, pediatricians and pediatric gastroenterologists strive to alleviate infantile regurgitation and its related parental stress. In this paper we define the scope of the problem and analyze the optimal, cost-efficient management approach to simple regurgitation in infants. The intent of this paper is to disseminate this information to practicing physicians and other health care professionals in an attempt to minimize the impact of this annoying problem of infancy and to eliminate confusion and expensive diagnostic tests and use of sub-optimal treatment modalities. Parental reassurance and dietary management by feeding thickened formula are important components in managing regurgitation in infants while maintaining optimal nutritional intake for adequate growth and development.

Gastroesophageal Reflux