GERD evaluation: time for a new paradigm?

Abstract:

:In the past there has been reliance on heartburn and acid regurgitation as the cardinal symptoms of gastro-esophageal reflux. Now it is recognized that diverse additional symptoms including extraesophageal manifestations are essential components of gastroesophageal reflux disease (GERD). Furthermore, previous reliance in mucosal damage at endoscopy as evidence of therapeutic success in the management of GERD has proven of only limited value in the diverse world of GERD symptoms. Indeed is now apparent that the relationship between symptoms and lesions is modest at best. Most patients with GERD have no overt erosions or ulceration at endoscopy and they frequently suffer from a wide array of complaints other than heartburn that contribute to their diminished perception of life's quality. To address these problems, multidimensional questionnaires designed to encompass the diverse symptomatology of GERD have been investigated, principally, to provide a reproducible metric of change in the subjective response to pharmacologic therapy during trials for patients with nonerosive reflux disease. The most promising of these instruments is The ReQuest questionnaire, because it has been extensively validated in multiple patient groups and cultures, appears highly promising in this regard and for erosive disease too and may ultimately prove to be of value for the initial evaluation of patients with GERD. We propose that accurate symptom delineation complemented with endoscopy performed in selected groups of patients will become the mainstay in diagnosis of GERD and the assessment of therapy efficacy.

journal_name

J Clin Gastroenterol

authors

Modlin IM,Malfertheiner P,Hunt RH,Armstrong D,Holtmann G,Quigley EM,Spechler SJ

doi

10.1097/01.mcg.0000225693.69745.49

subject

Has Abstract

pub_date

2007-03-01 00:00:00

pages

237-41

issue

3

eissn

0192-0790

issn

1539-2031

pii

00004836-200703000-00003

journal_volume

41

pub_type

杂志文章,评审
  • Patients With Inflammatory Bowel Diseases Are at Higher Risk for Meningitis.

    abstract:BACKGROUND:The epidemiology of meningitis is unknown in inflammatory bowel disease (IBD) patients. GOALS:We aimed to determine the incidence of and risk factors for meningitis in IBD patients. STUDY:We conducted a retrospective cohort and nested case-control study in the Quintiles IMS Legacy PharMetrics Adjudicated C...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/MCG.0000000000001365

    authors: Kochar B,Jiang Y,Long MD

    更新日期:2020-05-29 00:00:00

  • Endoscopic Treatment of Gastrointestinal Perforations, Leaks, and Fistulae.

    abstract::Gastrointestinal leaks and fistulae are common postoperative complications, whereas intestinal perforation more commonly complicates advanced endoscopic procedures. Although these complications have classically been managed surgically, there exists an ever-expanding role for endoscopic therapy and the involvement of a...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/MCG.0000000000000409

    authors: Rustagi T,McCarty TR,Aslanian HR

    更新日期:2015-11-01 00:00:00

  • "Healed" experimental gastric ulcers remain histologically and ultrastructurally abnormal.

    abstract::The present study was designed to assess histologic and ultrastructural features of gastric mucosa in the areas of grossly healed ulcers (acetic acid-induced gastric ulcers) in rats. The specific question we studied was whether the structure and cellular composition of the gastric mucosa in an area of grossly healed u...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-199001001-00024

    authors: Tarnawski A,Hollander D,Krause WJ,Dabros W,Stachura J,Gergely H

    更新日期:1990-01-01 00:00:00

  • Evaluation of the Esophagogastric Junction on High Resolution Manometry.

    abstract::The esophagogastric junction (EGJ) is a complex barrier between the thoracic and abdominal luminal gut compartments, comprised primarily of the lower esophageal sphincter (LES) and crural diaphragm. Although closed at rest, the EGJ relaxes to allow antegrade bolus transit and retrograde venting of air. Abnormal relaxa...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/MCG.0000000000001474

    authors: Rogers BD,Gyawali CP

    更新日期:2021-02-01 00:00:00

  • Percutaneous endoscopic gastrostomy sites infected by methicillin-resistant Staphylococcus aureus: impact on outcome.

    abstract:BACKGROUND:The impact of methicillin-resistant Staphylococcus aureus (MRSA) colonization of percutaneous endoscopic gastrostomy (PEG) sites on morbidity and mortality is uncertain. AIM:We investigated the impact of known prior MRSA colonization on the incidence of symptomatic PEG site wound infection and mortality. M...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/01.mcg.0000210096.44123.b6

    authors: Mainie I,Loughrey A,Watson J,Tham TC

    更新日期:2006-04-01 00:00:00

  • The differential diagnosis of eosinophilic esophagitis.

    abstract::Eosinophilic esophagitis is a morphologic finding that may result from a wide spectrum of clinical conditions. The distinctive histological features accompanying eosinophilic esophagitis may facilitate the diagnosis of the underlying disease entity. Unfortunately, there are no pathognomonic histologic characteristics ...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/00004836-200004000-00007

    authors: Ahmad M,Soetikno RM,Ahmed A

    更新日期:2000-04-01 00:00:00

  • Managing acid peptic disease in the Helicobacter pylori era.

    abstract::The advent of new diagnostic and therapeutic modalities for Helicobacter pylori allows any physician to offer curative antibiotic regimens to patients with peptic ulcer disease and gastritis. This article describes new management strategies and discusses the advantages of each. In the old strategy, endoscopy was perfo...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审

    doi:

    authors: Marshall BJ

    更新日期:1995-01-01 00:00:00

  • Acute pancreatitis associated with anomalous union of the pancreaticobiliary ductal system.

    abstract::Between 1978 and 1989, 13 of 48 patients with anomalous union of the pancreaticobiliary ductal system (AUPBD) were diagnosed as having acute pancreatitis. We have studied the clinical, radiologic, and surgical features of these 13 patients. A transient rise in the intraductal pressure of the pancreatic duct during an ...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-199112000-00012

    authors: Mori K,Nagakawa T,Ohta T,Nakano T,Kadoya N,Kayahara M,Kanno M,Akiyama T,Ueno K,Konishi I

    更新日期:1991-12-01 00:00:00

  • Esophageal Function Abnormalities in Patients With Barrett's Esophagus.

    abstract::Various esophageal functional abnormalities have been described in patients with Barrett's esophagus (BE). A significantly higher esophageal acid exposure especially in the supine position has been documented in BE, as compared with the other gastroesophageal reflux disease phenotypes. In addition, weakly acidic reflu...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/MCG.0000000000001358

    authors: Fass R,Teramoto O,Kurin M,Khalessi A,Kitayama Y,Shibli F

    更新日期:2020-07-01 00:00:00

  • Treating Budd-Chiari Syndrome: making rational choices from a myriad of options.

    abstract::Budd-Chiari syndrome represents a spectrum of disorders characterized by obstruction to hepatic venous drainage. Originally described as an "obliterating endophlebitis of the hepatic veins," this condition has come to refer to the manifestations of hepatic venous outflow obstruction anywhere above the level of the hep...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/00004836-200003000-00007

    authors: Olzinski AT,Sanyal AJ

    更新日期:2000-03-01 00:00:00

  • Detection and localization of active gastrointestinal bleeding with multidetector row computed tomography angiography: a 5-year prospective study in one medical center.

    abstract:GOAL:To prospectively assess the utility of multidetector row computed tomography angiography (MDCTA) in the diagnosis of active gastrointestinal bleeding (GIB). BACKGROUND:MDCTA is a relatively recent advance in CT scanning technology enabling excellent vascular visualization and detection of various vascular abnorma...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/MCG.0b013e31823337ee

    authors: Sun H,Jin Z,Li X,Qian J,Yu J,Zhu F,Zhu H

    更新日期:2012-01-01 00:00:00

  • Predictive factors for metachronous recurrence of early gastric cancer after endoscopic treatment.

    abstract::Since endoscopic treatment has been evaluated and become established as treatment for early gastric cancer, metachronous recurrence has become a major problem. In this report, predictive factors for recurrence were studied using the Kaplan-Meier method and Cox's proportional hazards regression model in 76 patients who...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-199907000-00011

    authors: Arima N,Adachi K,Katsube T,Amano K,Ishihara S,Watanabe M,Kinoshita Y

    更新日期:1999-07-01 00:00:00

  • Ursodeoxycholic acid for adjuvant therapy with extracorporeal shock wave lithotripsy of gallstones.

    abstract::Extracorporeal shock wave lithotripsy (ESWL) of gallstones is a new and experimental treatment. Recent data seem to indicate that the use of ursodeoxycholic acid (UDCA) after ESWL may optimize the results of the shock wave treatment. Most of the published data on the clinical use of such therapy emanate from two studi...

    journal_title:Journal of clinical gastroenterology

    pub_type: 临床试验,杂志文章,评审

    doi:

    authors: Fromm H

    更新日期:1988-01-01 00:00:00

  • Vertical banded gastroplasty for the treatment of morbid obesity.

    abstract::We report the technique and results of vertical banded gastroplasty in 86 morbidly obese patients. At 12 months, the patients had lost a mean of 57% of their excess body weight; 36 months, they had lost 70%. The most severe early complication was perforation of the esophagus. Other complications included disruption of...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-198812000-00017

    authors: Bogokowsky H,Slutzki S,Waron M,Abramsohn R,Halpern Z,Negri M,Zaidenstein L

    更新日期:1988-12-01 00:00:00

  • Risk factors for nocturnal reflux in a large GERD cohort.

    abstract:BACKGROUND:Nocturnal gastroesophageal reflux disease (GERD) has been associated with severe complications including erosive esophagitis, peptic stricture, and even esophageal adenocarcinoma and is known to cause a decreased health-related quality of life. However, there is limited information on independent predictors ...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/MCG.0b013e318205e164

    authors: Gaddam S,Maddur H,Wani S,Gupta N,Singh M,Singh V,Moloney B,Puli SR,Rastogi A,Bansal A,Sharma P

    更新日期:2011-10-01 00:00:00

  • Pseudolipoma of Glisson's capsule. Report of six cases and review of the literature.

    abstract::We report six cases of pseudolipoma of Glisson's capsule. The patients ranged from 53 to 83 years old (mean 67.7 years), and all were men. Pseudolipoma of Glisson's capsule was detected by imaging studies before operation in two cases, and noted incidentally in the remaining four. Computed tomography demonstrated a su...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审

    doi:

    authors: Sasaki M,Harada K,Nakanuma Y,Watanabe K

    更新日期:1994-07-01 00:00:00

  • Alcohol-related injury to peribiliary glands is a cause of peribiliary cysts: based on analysis of clinical and autopsy cases.

    abstract:BACKGROUND AND GOAL:Peribiliary cysts, which are known to be associated with various hepatobiliary diseases including alcoholic liver disease, have been reported to originate in the peribiliary glands along the biliary tree. The causal relationship between the peribiliary cysts and alcohol-related hepatic and pancreati...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/MCG.0b013e318299c8c1

    authors: Matsubara T,Sato Y,Igarashi S,Matsui O,Gabata T,Nakanuma Y

    更新日期:2014-02-01 00:00:00

  • Clinical Profile and Natural Course in a Large Cohort of Patients With Hypertriglyceridemia and Pancreatitis.

    abstract:GOALS:To report the clinical profile and natural course in a large series of patients with hypertriglyceridemia (HTG) and acute pancreatitis (AP). BACKGROUND:The natural history of HTG-related pancreatitis is poorly defined. STUDY:Medical records of 121 patients with serum triglycerides (TG) levels of ≥500 mg/dL suff...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/MCG.0000000000000579

    authors: Vipperla K,Somerville C,Furlan A,Koutroumpakis E,Saul M,Chennat J,Rabinovitz M,Whitcomb DC,Slivka A,Papachristou GI,Yadav D

    更新日期:2017-01-01 00:00:00

  • Life-threatening enterocolitis after gold salt therapy.

    abstract::Two patients developed life-threatening enterocolitis after receiving gold salt therapy. This disorder is attended by a mortality rate of 50% but the intestinal lesion appears to be reversible. The mechanism of the drug toxicity is not known. The course may be fulminant and recovery may occur only after many weeks. To...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-197906000-00006

    authors: Sckolnick BR,Katz LA,Kozower M

    更新日期:1979-06-01 00:00:00

  • Chronic Epstein-Barr virus infection: a cause of granulomatous hepatitis?

    abstract::A 37-year-old man had fever, weight loss, malaise, right upper quadrant pain, lymphadenopathy, and a twofold elevation of serum alkaline phosphatase, transaminases, and gamma glutamyl transpeptidase. Granulomas were found on liver biopsy after 2 1/2 months of illness. Treatment with isoniazid and rifampin for 2 months...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-198906000-00021

    authors: Biest S,Schubert TT

    更新日期:1989-06-01 00:00:00

  • Peroxisome proliferator-activated receptor gamma in the colon: inflammation and innate antimicrobial immunity.

    abstract::Peroxisome proliferator-activated receptor γ (PPARγ) is a nuclear receptor, originally described in adipose tissue, which controls the expression of a large number of regulatory genes in lipid metabolism and insulin sensitization. Well known by endocrinologists, thiazolidinedionesare classical PPARγ synthetic agonists...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/MCG.0000000000000253

    authors: Speca S,Dubuquoy L,Desreumaux P

    更新日期:2014-11-01 00:00:00

  • Hyper-CK-emia in pediatric celiac disease: prevalence and clinical importance.

    abstract::Hyper-transaminasemia (HT) is a well-known laboratory sign of celiac disease (CD); however, hyper-creatine phosphokinase (CK)-emia (HCK) is not so familiar. As there are reported cases of myopathy associated CD in the literature, we aimed to investigate serum CK levels of children with CD. Newly diagnosed 126 children...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/MCG.0b013e31802cb87a

    authors: Selimoglu MA,Ertekin V,Altinkaynak S

    更新日期:2007-08-01 00:00:00

  • Brain-gut response to stress and cholinergic stimulation in irritable bowel syndrome. A preliminary study.

    abstract::To investigate the influence of the brain-gut interactions on the pathophysiology of irritable bowel syndrome (IBS), we compared such patients (n = 10) with healthy control subjects (n = 11) by measuring the pressure of the colon and small intestine simultaneously with analysis of power spectrum of the electroencephal...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-199309000-00009

    authors: Fukudo S,Nomura T,Muranaka M,Taguchi F

    更新日期:1993-09-01 00:00:00

  • Comparative pharmacodynamics and pharmacokinetics of cimetidine and ranitidine.

    abstract::Ranitidine and cimetidine are competitive antagonists of histamine at H2-receptor sites in the gastric mucosa. Both drugs reduce output of basal and stimulated gastric acid and pepsin secretion in normal healthy subjects and duodenal ulcer patients. Pharmacodynamic and pharmacokinetic differences exist between the dru...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/00004836-198312001-00008

    authors: Richards DA

    更新日期:1983-01-01 00:00:00

  • Tacrolimus therapy as an alternative to thiopurines for maintaining remission in patients with refractory ulcerative colitis.

    abstract:BACKGROUND:Although the efficacy of tacrolimus for inducing remission of refractory ulcerative colitis (UC) is established, its efficacy for maintaining remission of UC has not been evaluated. AIM:The aim of this study was to evaluate the efficacy of tacrolimus compared with thiopurines for maintaining remission in pa...

    journal_title:Journal of clinical gastroenterology

    pub_type: 临床试验,杂志文章

    doi:10.1097/MCG.0b013e318209cdc4

    authors: Yamamoto S,Nakase H,Matsuura M,Masuda S,Inui K,Chiba T

    更新日期:2011-07-01 00:00:00

  • Hepatitis C virus seroconversion and genotype prevalence in patients and staff on chronic hemodialysis.

    abstract::The prevalence of hepatitis C virus (HCV)-RNA positivity among hemodialysis patients varies between 10 and 70%. Few previous surveys revealed high frequency of seroconversion of HCV-RNA-negative patients over the years of hemodialysis. Only few studies reported HCV genotype variability. We evaluated all 65 patients on...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-199901000-00005

    authors: Zamir D,Storch S,Zonder HB,Zamir C,Weiner P

    更新日期:1999-01-01 00:00:00

  • Colonic variceal hemorrhage: diagnosis and management.

    abstract::Lower gastrointestinal bleeding colonic varices is infrequent. We report a patient in whom the diagnosis was made by angiography and in whom portosystemic shunt has been helpful. We believe that the treatment of choice for colonic varices is portosystemic shunt, as attempts at resection, judged by the reports in the l...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-198502000-00011

    authors: Katz LB,Shakeed A,Messer J

    更新日期:1985-02-01 00:00:00

  • Surveillance for hepatocellular carcinoma in a Medicaid cirrhotic population.

    abstract:GOALS:To estimate the hepatocellular carcinoma surveillance in the Medicaid cirrhotic population. BACKGROUND:Most studies predate 2005 American Association for the Study of Liver Diseases surveillance recommendations and do not examine the primary target population, cirrhotics. STUDY:From 2006 to 2007, we identified ...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/MCG.0b013e318286fd97

    authors: Palmer LB,Kappelman MD,Sandler RS,Hayashi PH

    更新日期:2013-09-01 00:00:00

  • Association of helicobacter pylori dupA with the failure of primary eradication.

    abstract:GOALS:To determine whether the presence of dupA Helicobacter pylori (H. pylori) influences the cure rate of primary eradication therapy. BACKGROUND:Several virulence factors of H. pylori have been reported to affect the efficacy of the eradication rate. However, no study has investigated whether the presence of dupA a...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/MCG.0b013e318243201c

    authors: Shiota S,Nguyen LT,Murakami K,Kuroda A,Mizukami K,Okimoto T,Kodama M,Fujioka T,Yamaoka Y

    更新日期:2012-04-01 00:00:00

  • Turcot syndrome in an elderly adult.

    abstract::A 67-year-old woman presented with hematochezia and an episode of transient expressive dysphasia. She was found to have multiple colonic polyps with adenocarcinomatous changes. Computed tomography brain scan and computed tomography-guided biopsy revealed a left frontoparietal glioblastoma multiforme. This case illustr...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-200204000-00014

    authors: Castillo R,Wilson MM

    更新日期:2002-04-01 00:00:00