Abstract:
GOALS:We aimed to quantify pharyngeal exposure to gastric contents in patients diagnosed with reflux-related hoarseness and healthy controls using new diagnostic techniques. BACKGROUND:Hoarseness with typical signs on laryngoscopy is commonly thought to be caused by esophagopharyngeal reflux. New methods are proposed to assess pharyngeal exposure to gastric contents. They are suggested to measure: (1) liquid or mixed gas-liquid acid and nonacid reflux with impedance pH, (2) aerosolized acid reflux (Dx-pH measuring system), and (3) pepsin in the saliva. STUDY:Twenty-one patients with hoarseness and positive laryngoscopy and 10 controls underwent simultaneous impedance pH, Dx-pH monitoring, and saliva pepsin sampling (5 samples in 24 h). RESULTS:Of the 21 patients, 10 had impedance pH-detected reflux plus at least 1 other test positive. These patients were more likely to have symptomatic relief after proton pump inhibitor therapy. Three of the 21 patients had all 3 tests positive and 4 had all tests negative. None of the controls had impedance pH-detected reflux. Two controls had a positive Dx-pH "RYAN score" and 1 control had >1 saliva sample positive for pepsin. Only 11% of Dx-pH drops to pH<4, 15% pH drops to pH<5, and 10% of pH drops to pH<5.5 coincided with impedance pH-detected reflux in the esophageal body. Positive pepsin saliva samples were preceded by more reflux events [3 (range, 0 to 10)] in the previous 60 minutes than negative samples [0 (range, 0 to 7)] (P<0.0001). CONCLUSION:A subgroup of patients with hoarseness (10/21) had objective detection of the esophagopharyngeal reflux. We propose that these patients are more likely to benefit from further intense antireflux therapy. Detection of pepsin in the saliva may be a useful screening tool in these patients.
journal_name
J Clin Gastroenteroljournal_title
Journal of clinical gastroenterologyauthors
Hayat JO,Yazaki E,Moore AT,Hicklin L,Dettmar P,Kang JY,Sifrim Ddoi
10.1097/MCG.0000000000000011subject
Has Abstractpub_date
2014-04-01 00:00:00pages
318-27issue
4eissn
0192-0790issn
1539-2031journal_volume
48pub_type
杂志文章abstract:BACKGROUND:Guidelines recommend upper endoscopic screening of cirrhotic patients for gastroesophageal varices. Cirrhosis is not always distinguishable from chronic hepatitis. GOALS:To identify low-risk patients who can be spared upper endoscopy irrespective of a diagnosis of cirrhosis. STUDY:We evaluated 13 nonendosc...
journal_title:Journal of clinical gastroenterology
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doi:10.1097/MCG.0b013e318157464b
更新日期:2009-01-01 00:00:00
abstract::Although our current understanding is limited, epidemiologic investigation of Crohn's disease holds great promise. Certain aspects of the epidemiology are clear. The incidence of Crohn's disease, which has increased over the past few decades, may have reached a plateau. The disease has its peak onset in early life, wi...
journal_title:Journal of clinical gastroenterology
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doi:10.1097/00004836-198604000-00011
更新日期:1986-04-01 00:00:00
abstract:BACKGROUND:The clinical effect of probiotics on irritable bowel syndrome (IBS) is still controversial. AIMS:We aimed to evaluate the effects of a probiotic mixture on IBS symptoms and the composition of fecal microbiota in patients with diarrhea-dominant IBS (D-IBS). METHODS:Fifty patients with D-IBS were randomized ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,随机对照试验
doi:10.1097/MCG.0b013e31823712b1
更新日期:2012-03-01 00:00:00
abstract::A spontaneous intramural esophagogastric hematoma developed in a patient with hemophilia A. The hematoma did not resolve after antihemophiliac factor replacement but ruptured into the stomach causing massive gastrointestinal bleeding. The associated enlarged right tracheobronchial gland and the histopathological findi...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199203000-00017
更新日期:1992-03-01 00:00:00
abstract::Immunohistochemical staining using a specific monoclonal antibody against sulfatide was performed to examine cellular localization of sulfatides in normal human gastric mucosa and in various types of gastric carcinoma. In normal gastric mucosa without Helicobacter pylori infection, both epithelial and glandular cells ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199700001-00023
更新日期:1997-01-01 00:00:00
abstract:GOALS:To review the published experience with acute pancreatitis in childhood. STUDY:Computerized search of the English medical literature since 1965 using MEDLINE. RESULTS:Details of 589 patients were reviewed. Mean age was 9.2 +/- 2.4 years (range: 1 week to 21 years). Male to female ratio was 1.2. Etiologies inclu...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-200308000-00015
更新日期:2003-08-01 00:00:00
abstract:BACKGROUND AND AIMS:There is no study verifying the predictive value of model for end-stage liver disease and sodium (MELD-Na) for rebleeding and its associated mortality in cirrhotic patients after cessation of acute esophageal variceal hemorrhage (AVH) by endoscopic therapy. This study aimed to determine the predicti...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000000043
更新日期:2014-11-01 00:00:00
abstract::Hepatic iron deposition is common in patients with chronic hepatitis C (HCV) and may play a role in progression of liver disease. This pilot study examines the relationship between hepatic iron concentration (HIC) and histologic progression over time in patients with HCV. HIC was retrospectively measured in 14 patient...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200311000-00012
更新日期:2003-11-01 00:00:00
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journal_title:Journal of clinical gastroenterology
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更新日期:1982-02-01 00:00:00
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199203000-00010
更新日期:1992-03-01 00:00:00
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journal_title:Journal of clinical gastroenterology
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更新日期:2020-07-10 00:00:00
abstract::The tissue distribution of a previously identified M(r) 40 K epithelial autoantigen in ulcerative colitis was examined in situ in the fetal tissue by immunocytochemical method, using an immunoglobulin M (IgM) monoclonal antibody (7E12H12). Fetal-autopsy tissue from 9 to 19 weeks of development (11-21 gestational weeks...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199212000-00009
更新日期:1992-12-01 00:00:00
abstract::Here we reported the first case in Taiwan of human intestinal myiasis caused by larvae of Telmatoscopus albipunctatus. The 21-year-old male patient experienced gastroenteritis and anal itching. During the patient's first hospital visit the doctor suspected Enterobius infection. After treatment with anthelmintic mebend...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/01.mcg.0000212615.66713.ba
更新日期:2007-04-01 00:00:00
abstract:GOALS:Follicular lymphoma (FL) is a common nodal lymphoma. Primary gastrointestinal follicular lymphoma (GIFL) is rare and most commonly occurs in the elder women with indolent clinical course, mainly in the duodenum and terminal ileum. We conducted this study to characterize GIFL in Taiwan. STUDY:A total of 13 cases ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e3180f62b12
更新日期:2008-10-01 00:00:00
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000000729
更新日期:2018-05-01 00:00:00
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/01.mcg.0000139034.38568.51
更新日期:2004-10-01 00:00:00
abstract::Although relatively frequent. diabetic involvement of digestive tract motility has not been investigated extensively in different organs. The authors studied esophageal, gastric, and gallbladder motor function in 35 type 2 (noninsulin-dependent) diabetic patients to determine the extent of gut involvement. Of these pa...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199909000-00014
更新日期:1999-09-01 00:00:00
abstract::A 54-year-old man with chronic hepatitis C virus (HCV) developed quadrihemianopsia caused by lacunar brain infarction. Extensive evaluation revealed high titers of anticardiolipin antibodies (ACA). Following interferon treatment (6 x 10(6), three times a week for 2 months and 3 x 10(6) for another 7 months), liver tra...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199701000-00009
更新日期:1997-01-01 00:00:00
abstract::Chronic hepatitis B virus (HBV) infection due to mother-to-child transmission during the perinatal period remains an important global health problem. Despite standard passive-active immunoprophylaxis with hepatitis B immunoglobulin and hepatitis B vaccine in neonates, up to 8.5% of newborns still acquire HBV infection...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
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更新日期:2017-01-01 00:00:00
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MCG.0b013e318299f181
更新日期:2014-01-01 00:00:00
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e3181d96aad
更新日期:2010-09-01 00:00:00
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199812000-00007
更新日期:1998-12-01 00:00:00
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000000676
更新日期:2018-01-01 00:00:00
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e318282a1d7
更新日期:2013-08-01 00:00:00
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e3181354294
更新日期:2009-02-01 00:00:00
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e3182a4711d
更新日期:2014-02-01 00:00:00
abstract::In 236 resection specimens of Crohn's disease (127 first excisions and 109 reexcisions) there were 60 specimens with fistulas (excluding anal fistulas): 44 in first excisions and 16 in reexcisions. In primary excisions, 36 fistulas arose in the ileum, three in the colon and five in the ileocecal valve. The majority we...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198904000-00015
更新日期:1989-04-01 00:00:00
abstract::Barrett's esophagus is a common premalignant condition that predisposes to the development of adenocarcinoma of the esophagus through a process of transformation from metaplasia to dysplasia and then carcinoma. Periodic endoscopic surveillance with multiple biopsies is adopted by most physicians to detect dysplasia or...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199810000-00019
更新日期:1998-10-01 00:00:00