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At least 19 recordsLinked to original sources

PubMed1979

Pulmonary functional in patients with gastroesophageal reflux.

Gastroesophageal reflux has been suggested to play a causal role in a variety of chronic pulmonary disorders. This hypothesis has been supported by the increased incidence of reflux in patients with idiopathic pulmonary disorders and by the anecdotal reports of symptomatic improvement following surgical correction of the reflux. In an effort to determine whether patients with reflux as a group demonstrated a significant degree of pulmonary dysfunction, 100 patients with reflux were compared with another group of 100 control patients, matched for age and sex and without demonstrable reflux. Standard pulmonary function studies were used for this comparison. No difference could be detected between the two groups, which suggested that the isolated findings of reflux in patients with pulmonary disorders should not be considered etiologic by virtue of the association alone. Alternate explanations for the relationship are given.

Adult↗

PubMed1978

Aspiration and gastroesophageal reflux.

Gastroesophageal reflux is the commonest esophageal cause of chronic intermittent aspiration. The authors investigated 1000 consecutive patients with reflux with reference to their medical history, and by barium esophagography, esophageal manometry and pH studies. In patients with respiratory complications, chest roentgenography and pulmonary function tests were also performed. Of the total number, 279 patients aspirated either by coughing and choking during swallowing or as a result of night reflux; of these, 159 had associated respiratory symptoms, which included cough, voice change, recurrent respiratory infection, bronchiectasis and asthma. Of the patients with aspiration, 120 had surgical correction of reflux because conservative management failed. This form of reflux control improved the symptoms of cough and voice change and the condition of patients with recurrent infections or bronchiectasis, but alleviated the symptoms in only 8 of 28 asthmatic persons.

Deglutition Disorders↗

PubMed1979

The gastroesophageal scintiscan. Comparison of methods to demonstrate gastroesophageal reflux.

The gastroesophageal (GE) scintiscan method of detecting GE reflux was evaluated in a series of 54 patients. Twenty-nine patients had evidence of GE reflux by fluoroscopically monitored barium swallow, esophagogastroscopy, or esophageal biopsy. The pH reflux study showed pathological reflux in four patients. The GE scintiscan demonstrated reflux in only four of these 29 patients. Although the GE scintiscan is a safe, noninvasive technique, in our experience, GE reflux was demonstrated only in those patients in whom reflux was easily verified by barium swallow, esophagoscopy, or esophageal mucosal biopsy. This study indicates that the GE scintiscan, like the pH reflux study, is too insersitive to be of consistent value in the diagnosis of GE reflux.

Barium Sulfate↗

PubMed1979

Assessment of a technique for scintigraphic monitoring of pulmonary aspiration of gastric contents in asthmatics with gastroesophageal reflux.

Ten asthmatics with gastroesophageal reflux had scintigraphic evaluation of gastropulmonary aspiration. Five mCi of Tc99m sulfur colloid diluted in 50 ml of isotonic saline were administered by nasogastric tube at bed time and the lungs were imaged the following morning. Imaging in 20 studies yielded no evidence of gastropulmonary aspiration. Scintigraphic evaluation has previously been reported to demonstrate gastropulmonary aspiration in some patients with gastroesophageal reflux and pulmonary disease. This study indicates that the technique may lack adequate sensitivity or that gastropulmonary aspiration in asthmatics with gastroesophageal reflux occurs in only a small subgroup of these patients or at infrequent intervals and is difficult to detect.

Adult↗

PubMed1979

The mode of action alginic acid compound in the reduction of gastroesophageal reflux.

This study was designed to evaluate quantitatively the mode of action of alginic acid compound (AAC) in the treatment of patients with symptomatic gastroesophageal reflux. Gastroesophageal scintigraphy using an orall administered Tc-99m sulfur colloid solution was used to demonstrate that AAC decreased significantly the gastroesophageal reflux index from (9.9 +/- 1.3) % to (6.5 +/- 0.8) % (p less than 0.05). No alteration of lower esophageal sphincter pressure was observed. After ACC was suitably labeled with Sr-87m, a dual-nuclide scintigraphic technique was used to show that most (greater than 75%) of the AAC was located in the upper half of the stomach in both normal subjects and patients with gastroesophageal reflux. In those subjects in whom reflux did occur after treatment with AAC, the Sr-87m-AAC refluxed into the esophagus preferentially compared with the liquid containing Tc-99m sulfur colloid. These findings suggest that AAC dimishes gastroesophageal reflux by means of its foaming, floating, and viscous properties.

Adult↗

PubMed1975

Gastric secretion, gastroesophageal reflux and esophagitis.

Neither gastroesophageal reflux nor esophagitis were found to have a clear-cut relationship with gastric secretory output. Patients with esophagitis had significantly longer periods of reflux than those without esophagitis. It is concluded that the important factor in the genesis of esophagitis is the duration of contact between the esophageal mucosa with gastric contents rather than gastric secretory output.

Adult↗

PubMed1979

Patterns of postcibal gastroesophageal reflux in symptomatic infants.

Symptomatic infants displayed three patterns of gastroesophageal reflux after drinking apple juice (20 ml/kg or 300 ml/m2 of body surface area). The type I pattern occurred in patients who had continuous postcibal gastroesophageal reflux, large hiatal hernias and frequently required an antireflux operation. A functional motility disorder suggesting delayed gastric emptying appeared to be important in infants with discontinuous reflux (type II pattern). These infants had frequent gastroesophageal reflux for only 2 3/4 hours postcibally, antral-pylorospasm, increased low esophageal sphincter pressures, and a high incidence of pulmonary symptoms and non-specific watery diarrhea. The mixed (type III) pattern of gastroesophageal reflux occurred in a small number of infants and exhibited features of both type I and II patterns.

Child, Preschool↗

PubMed2026

Causal Relationships Between Modifiable Risk Factors and Gastroesophageal Reflux Disease: A Two-Sample Mendelian Randomization Study.

INTRODUCTION: Gastroesophageal reflux disease (GERD) is a prevalent digestive disorder, yet the causal roles of modifiable risk factors remain unclear. This study aims to investigate the causal relationships between 28 modifiable risk factors (including obesity traits, mental health disorders, sleep traits, metabolic comorbidities, and serum parameters) and GERD using two-sample Mendelian randomization (MR). Gastroesophageal reflux disease (GERD). Our findings aim to inform targeted prevention and treatment strategies for GERD. METHODS: This study obtained data from extensive genome-wide association studies (GWAS). Pooled data associated with gastroesophageal reflux associations were obtained from the 23andMe Research team's research, which included a total of 129,080 cases of gastroesophageal reflux and 473,524 controls of European ancestry. We conducted a univariable Mendelian randomization (MR) analysis to ascertain whether genetic evidence of exposure demonstrated a statistically significant association with the risk of GERD. Subsequently, a multivariable MR analysis was carried out to estimate the independent effects of the exposures on GERD. RESULTS: Univariable MR analysis utilizing extensive GWAS data suggested that genetic factors such as BMI, Waist circumference, Arm fat mass (left and right), Leg fat mass (left and right), Attention Deficit and Hyperactivity Disorder (ADHD), Major Depressive Disorder (MDD), Schizophrenia, Negative emotions (including nervousness, anxiety, tension, or depression), Insomnia, Sleep apnea syndrome, Sleep duration, and Snoring, as well as Total cholesterol levels and Apolipoprotein B levels, are associated with the development of GERD. Multivariate Mendelian randomization of BMI and Negative emotion as correction factors showed that Waist circumference, Arm fat mass (left and right), Leg fat mass (left and right), ADHD, Insomnia, Sleep apnea syndrome, and Snoring were associated with an increased risk of GERD (p< 0.05). Conversely, longer sleep duration was associated with a reduced risk of GERD (p< 0.05). DISCUSSION: This MR study reveals novel causal mechanisms in GERD pathogenesis: (1) Peripheral adiposity (arm/leg fat mass) exerts independent effects beyond central obesity, indicating site-specific fat distribution significance; (2) ADHD emerges as a distinct psychiatric risk factor independent of mental disorders; (3) Sleep apnea operates through BMI-independent pathways. Collectively, these findings redefine GERD pathophysiology, highlighting fat depot specificity and brain-gut interactions as critical mechanistic drivers. CONCLUSION: Overall, our findings suggest that multiple risk factors are associated with the risk of GERD. These results provide a theoretical basis for controlling body weight and plasticity, improving sleep habits, and preventing and timely seeking medical attention to reduce the occurrence of psychiatric disorders, which will be important strategies to prevent and alleviate GERD.

Humans↗

PubMed1979

[Studies about influence of food on gastroesophageal reflux. I. pH measurements before and after standardized meal (author's transl)].

Continuous pH measurements were undertaken by 87 patients (17 without, 30 with small, 40 with heavy symptons of reflux) for the study of gastroesophageal reflux 1 hour before and after standardized meal. A significant increase of reflux was shown by 19 patients with reflux under dry conditions, whereas reflux was demonstrated by 47 patients for the first time. After meal provocation of reflux was shown by patients with typical symptoms of reflux. An increase of reflux was shown the heavier reflux sumptoms were. pH measurements of gastroesophageal reflux seem to improve the evidence of results after such standardized meal.

Esophagogastric Junction↗

PubMed1978

Antireflux surgery for symptomatic gastroesophageal reflux: mechanism of action.

To determine the effects of Nissen fundoplication upon the symptoms of reflux and the diagnostic tests employed to evaluate reflux and to examine the relationship between gastroesophageal reflux and lower esophageal sphincter pressure before and after fundoplication, 10 patients with symptomatic reflux were studied before and after operation. Clinical evaluation, barium esophagography, endoscopy with mucosal biopsy, esophageal manometry, acid-perfusion and acid-reflux testing, and gastroesophageal scintiscaning were performed on each patient before and after surgery. Following fundoplication, marked symptomatic, radiographic, endoscopic, and histologic improvement was observed. Serial acid-reflux tests at increasing gastroesophageal pressure gradients returned to normal after surgery. Lower-esophageal-sphincter (LES) pressure increased from 8.2 +/- 1.3 to 12.0 +/- 1.5 mm Hg (P less than 0.01). In addition, surgery resulted in a significant decrease in the gastroesophageal reflux index from 17.4 +/- 2.4 to 2.7 +/- 1.1% (P less than 0.001). Surprisingly, the pre- and postoperative resting LES pressures did not correlate significantly with corresponding gastroesophageal reflux indices for individual patients. We conclude that increased LES pressure alone does not explain adequately the functional and clinical improvement which follows fundoplication.

Adult↗

PubMed1979

Gastroesophageal reflux and bleeding esophageal varices.

The incidence of gastroesophageal reflux was evaluated with the use of a pH probe in 12 patients with cirrhosis and recent variceal hemorrhage and in 15 healthy control subjects. Short episodes of reflux occurred in 42% of the patients and in 47% of the controls. During an observation period of 1 hr, the cumulative duration of reflux was similar in patients (2.5 +/- 1.3 min) and controls (3.1 +/- 1.4 min). Mean lower esophageal sphincter pressures were normal in both groups but did not show a significant correlation with the duration of reflux. These data support previous observations that gastroesophageal reflux dose not appear to be a contributing factor in the development of variceal hemorrhage.

Adult↗

PubMed1978

[Functional scintigraphy in the diagnosis of gastroesophageal reflux (author's transl)].

The accepted diagnostical procedures to prove a gastroesophageal reflux by direct or indirect methods do not allow any quantification and are of limited sensitivity. A quantification is possible by use of a gamma-camera with a computer-system after application of a small amount of 99m Tc-DPTA (reflux scintiscan). The high accuracy of this method could be proven by evaluation of 51 patients with suspected gastroesophageal reflux esophagitis or after total gastrectomy. The results were compared with the histological findings. With this method we found after total gastrectomy the expected high incidence of relux. The long-term results after semifundoplication were not as good as after fundoplication. The reflux scintiscan is a less invasive, but reliable method to detect the gastroesophageal reflux.

Gastroesophageal Reflux↗

PubMedDate not supplied

[Radiological and manometric study of gastroesophageal reflux in normal infants].

The incidence of the gastroesophageal reflux was studied in 39 healthy infants with ages between 2 and 24 months. X-ray studies of gastroesophageal passage and esophageal manometry were practiced in all cases. Only 3 infants showed radiological reflux. The pressure in the gastroesophageal sphincter was normal in all babies and the highest pressures were reached less--than 6 months--old infants. Older infants showed lesser pressures. The same was true for the length of the gastroesophageal sphincter. The factors involved in the genesis of the gastroesophageal reflux are discussed.

Gastroesophageal Reflux↗

PubMed1979

Recurrent pulmonary disease in children: a complication of gastroesophageal reflux.

To evaluate the role of gastroesophageal reflux (GER) as a possible cause of recurrent pulmonary disease, 30 children, aged 1 to 18 years, were studied prospectively with esophageal function tests. These included esophagram (30 patients), esophageal manometry (29 patients), pH probe (Tuttle) test (29 patients), and esophagoscopy with esophageal biopsy (23 patients). The patients studied had either chronic asthma or two or more documented pneumonias within a one-year period. Nineteen (63%) had GER based on two or more positive tests. Eighteen had positive Tuttle tests; 13 had abnormal manometry studies; nine had esophagitis on biopsy; six had esophagitis on esophagoscopy; and five had reflux on esophagram. Of those with GER, 17 had a history of nocturnal cough and eight vomited during infancy. Children with recurrent pulmonary disease should have esophageal function testing to exclude GER as the cause.

Adolescent↗

PubMed1979

[Gastroesophageal reflux: a factor eliciting esophageal variceal hemorrhage?].

Following a hemorrhage, ten patients with esophageal varices were examined by means of gastroscopy and functional analysis of the esophagus with special regard to gastroesophageal reflux. A pathological gastroesophageal reflux was not confirmed. These results plus previously published findings lead to the assumption that reflux is of not importance in the initiation of esophageal variceal bleeding.

Adolescent↗

PubMedDate not supplied

[Hernia hiatal. Detection of gastroesophageal reflux with the telemetric Heidelberg capsule].

120 patients with upper gastrointestinal symptoms were studied and submitted to gastric secretory tests, upper gastrointestinal X-rays and endoscopy. Gastroesophageal reflux was assessed by means of a Heidelberg telemetric capsule. 60 patients had hiatal hernia. Gastroesophageal reflux was present in 63.33%. 76% of the patients with hiatal hernia had gastroesophageal reflux, especially on those with small hernias and on the 5th and 6th decade of life. Gastric hiperacidity facilitates the incidence and presence of reflux. X-rays and endoscopy allowed us to diagnose diseases at the gastroesophageal junction. The correlation between these 2 methods and the presence or not of reflux, allowed differentiation between patients with organic diseases and patients with "functional" symptoms.

Age Factors↗

PubMed2025

Mendel randomization confirmed gastroesophageal reflux disease may increase the risk of mental disorders.

BACKGROUND: The potential causal relationship between gastroesophageal reflux disease (GERD) and mental disorder was analyzed using the mendelian randomization (MR) method. METHODS: Data are derived from genome-wide association study (GWAS) summary data, using gastroesophageal reflux disease (GERD) as the exposure factor. Single nucleotide polymorphisms (SNPs) significantly associated with GERD were selected as instrumental variables (IVs), and mental disorders (bipolar disorder, major depression, Alzheimer's disease, anorexia nervosa, anxiety, and obsessive-compulsive disorder) were used as outcome variables. The inverse variance weighted (IVW) method is used as the main analysis method, and MR-Egger regression, weighted median (WM) method, simple mode and weighted mode are used as supplementary methods for Mendelian randomization (MR) analysis. Cochran's Q test and P value are used to quantify heterogeneity, MR-Egger regression was used to evaluate the multilevel effect test of SNPs, and leave-one-out method to determine whether there are potential SNPs, and to evaluate the stability of the results. Odds ratio (OR) and 95% confidence interval (CI) were used as effect indicators to evaluate whether there is a causal relationship between GERD and mental disorders. RESULTS: IVW demonstrated a causal relationship between GERD and bipolar disorder (OR = 1.70, 95%CI = 1.39-2.09, P < 0.05) and anorexia nervosa (OR = 0.71, 95%CI = 0.52-0.99, P < 0.05). Furthermore, there is a weak causal relationship between GERD and major depression (OR = 1.01, 95%CI = 1.01-1.02, P < 0.05) and anxiety (OR = 1.01, 95%CI = 1.01-1.01, P < 0.05). Similarly, there is no evidence of a causal relationship between GERD and Alzheimer's disease (OR = 0.95, 95%CI = 0.87-1.03, P > 0.05) or obsessive-compulsive disorder (OR = 0.95, 95%CI = 0.67-1.36, P > 0.05). Cochran's Q test for heterogeneity shows that there is no significant heterogeneity (P > 0.05) for bipolar disorder, anxiety, and obsessive-compulsive disorder. However, major depression, Alzheimer's disease, and anorexia nervosa have some degree of heterogeneity (P < 0.05). Horizontal pleiotropic analysis showed that the P values for six mental disorders (0.750, 0.296, 0.154, 0.798, 0.893, 0.451) were all greater than 0.05. Leave-one-out analysis and funnel plot showed that MR analysis results can be considered relatively stable. All F are > 10, indicating no weak IVs bias. CONCLUSION: GERD can obviously increase the risk of bipolar disorder; the increased risk of anxiety disorder is very slight. There is no clear evidence to support the causal relationship between GERD and four other mental disorders, including major depression, Alzheimer's disease, anorexia nervosa, and obsessive-compulsive disorder.

Humans↗

PubMed1979

Gastroesophageal reflux and pulmonary aspiration: incidence, functional abnormality, and results of surgical therapy.

The incidence of aspiration, the causative esophageal pathophysiology, and the results of surgical therapy were evaluated in 100 patients with abnormal gastroesophageal reflux documented by 24-hour esophageal pH monitoring. Based on historical evidence, 48 patients were suspected to be aspirators. Eight patients had documented episodes of aspiration (drop on esophagela pH, followed by acid taste in mouth and onset of cough or wheezing spell) during the monitoring period. Nine patients were considered to be potential aspirators because they presented oral acid regurgitation without development of pulmonary symptoms. In five patients a primary respiratory disorder (PRD) induced gastroesophageal reflux. The remaining 78 patients had abnormal reflux without aspiartion or regurgitation. Aspirators had a 75% incidence of esophageal motor abnormality on manometry, and the clearance of refluxed acid was significantly delayed in the supine position. A history of heartburn and endoscopic evidence of esophagitis were present in only half of the patients who were documented aspirators. Potential aspirators were spared from aspiration by rapid esophageal clearance of refluxed acid unaffected by changes in body position. Patients with a PRD had higher distal esophageal segment (DES) pressure and normal esophageal motility with minimal esophagitis. Nonaspirators significantly improved their clearance while in the supine position, emphasizing the protective effect of esophageal peristalsis against aspiration. An antireflux procedure in five aspirators raised the DES pressure significantly and returned the reflux status to normal by 24-hour pH-monitoring standards. The incidence of aspiration appears to be less than that suspected by history and is due to a motor disorder that interferes with the ability of the esophagus to clear reflex acid. Abnormal pulmonary symptoms can induce or result from gastroesophageal reflux and, when the latter occurs, an antireflex procedure stops both reflux and aspiration.

Cough↗