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Displaying publications 21 - 26 of 26 in total

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Fulltext The effect of dietary carbohydrate on gastroesophageal reflux disease

Wu KL, Kuo CM, Yao CC, Tai WC, Chuah SK, Lim CS, et al.

J Formos Med Assoc, 2018 Nov;117(11):973-978.
PMID: 29339035 DOI: 10.1016/j.jfma.2017.11.001

BACKGROUND: Acid changes in gastroesophageal reflux with vary component in the food have less been studied, especially carbohydrate. We plan to clarify the effect of different carbohydrate density on low esophageal acid and reflux symptoms of patients with gastroesophgeal reflux disease.
METHODS: Twelve patients (52 ± 12 years old; five female) with gastroesophageal reflux disease were recruited for the prospective crossover study. Each patient was invited for panendoscope, manometry and 24 h pH monitor. The two formulated liquid meal, test meal A: 500 ml liquid meal (containing 84.8 g carbohydrate) and B: same volume liquid meal (but 178.8 g carbohydrate) were randomized supplied as lunch or dinner. Reflux symptoms were recorded.
RESULTS: There are significant statistic differences in more Johnson-DeMeester score (p = 0.019), total reflux time (%) (p = 0.028), number of reflux periods (p = 0.026) and longest reflux (p = 0.015) after high carbohydrate diet than low carbohydrate. Total reflux time and number of long reflux periods more than 5 min are significant more after high carbohydrate diet.
CONCLUSION: More acid reflux symptoms are found after high carbohydrate diet. High carbohydrate diet could induce more acid reflux in low esophagus and more reflux symptoms in patients with gastroesophageal reflux disease.

Matched MeSH terms: Manometry
High-resolution oesophageal manometry and 24-hour impedance-pH study in systemic sclerosis patients: association with clinical features, symptoms and severity

Raja J, Ng CT, Sujau I, Chin KF, Sockalingam S

Clin Exp Rheumatol, 2016 Sep-Oct;34 Suppl 100(5):115-121.
PMID: 26843456

OBJECTIVES: To evaluate the associations between objectively measured gastroesophageal involvement using high-resolution manometry and 24- hour impedance-pH study, and clinical presentations in systemic sclerosis (SSc) patients.
METHODS: This cross-sectional study was conducted in University of Malaya Medical Centre (UMMC) with 31 consecutive SSc patients recruited into this study. Clinical symptoms of gastroesophageal involvement, high-resolution impedance-manometry and 24-hour impedance-pH monitoring were assessed. Their associations with serological features and other organ involvement were evaluated.
RESULTS: Twenty-five (80.6%) patients had gastroesophageal reflux disease (GORD) symptoms, mainly heartburn (45.1%), regurgitation (32.2%) and dysphagia (29%). Using manometry, oesophageal dysmotility was detected in 24 (88.9%) patients, while hypotensive lower oesophageal sphincter (LOS) was observed in 17 (63%) patients. 21 (84%) patients had GORD based on pH study. Hypotensive LOS was significantly associated with presence of digital ulcers. The main gastroesophageal symptoms were absent in majority of the SSc patients including in those with severe gastroesophageal manifestations demonstrating failed peristalsis >75%, hypotensive LOS, Demeester score >200 and acid reflux >200 per day. Demeester score >200 is associated with severity of GORD symptoms. Demeester score >200 was also associated with restrictive lung pattern (p=0.001). Significant association between GORD severity (daily number of acid reflux episodes >200) and pulmonary fibrosis was seen (p=0.030).
CONCLUSIONS: The presence and severity of gastroesophageal symptoms may not accurately reflect the seriousness of oesophageal involvement. GORD severity is associated with presence of restrictive lung pattern and pulmonary fibrosis. Oesophageal manometry and 24-hour pH study should be considered more frequently in the assessment of SSc patients.

Matched MeSH terms: Manometry
Craniofacial morphology, head posture, and nasal respiratory resistance in obstructive sleep apnoea: an inter-ethnic comparison

Wong ML, Sandham A, Ang PK, Wong DC, Tan WC, Huggare J

Eur J Orthod, 2005 Feb;27(1):91-7.
PMID: 15743868

The aim of this study was to measure craniofacial morphology and nasal respiratory resistance (NRR) in Malay, Indian and Chinese subjects with obstructive sleep apnoea (OSA). The sample consisted of 34 male subjects, 27-52 years of age (Malay n = 11, which included five mild and six moderate-severe OSA; Indian n = 11, which included six mild and five moderate-severe OSA; and Chinese n = 12, which included six mild and six moderate-severe OSA) diagnosed using overnight polysomnography. After use of a decongestant, NRR was recorded using anterior and posterior rhinomanometry. Standardized lateral cephalometric radiographs were used to record linear and angular dimensions. Malay subjects with moderate-severe OSA had a shorter maxillary (sp-pm) and mandibular (gn-go) length when compared with a mild OSA reference sample (P < 0.05). The hyoid bone was located more caudally in the Chinese moderate-severe subjects (hy-NL, hy-ML)(P < 0.05), and may be a useful diagnostic indicator for severity in this racial group. No pattern of differences for NRR was seen between the moderate-severe and mild OSA subjects. The consistently lower values for nasopharyngeal resistance in all the moderate-severe subjects when compared with the mild group may indicate that some compensation at this level of the airway had taken place. Strong positive correlations between craniocervical angulation (NL/OPT) and total airway resistance and the turbulent component of flow (k(2)) suggest that head posture is sensitive to fluctuations in airway resistance (P < 0.01).

Matched MeSH terms: Manometry/methods
Waist belt and central obesity cause partial hiatus hernia and short-segment acid reflux in asymptomatic volunteers

Lee YY, Wirz AA, Whiting JG, Robertson EV, Smith D, Weir A, et al.

Gut, 2014 Jul;63(7):1053-60.
PMID: 24064007 DOI: 10.1136/gutjnl-2013-305803

OBJECTIVE: There is a high incidence of inflammation and metaplasia at the gastro-oesophageal junction (GOJ) in asymptomatic volunteers. Additionally, the majority of patients with GOJ adenocarcinomas have no history of reflux symptoms. We report the effects of waist belt and increased waist circumference (WC) on the physiology of the GOJ in asymptomatic volunteers.
DESIGN: 12 subjects with normal and 12 with increased WC, matched for age and gender were examined fasted and following a meal and with waist belts on and off. A magnet was clipped to the squamo-columnar junction (SCJ). Combined assembly of magnet-locator probe, 12-channel pH catheter and 36-channel manometer was passed.
RESULTS: The waist belt and increased WC were each associated with proximal displacement of SCJ within the diaphragmatic hiatus (relative to upper border of lower oesophageal sphincter (LOS), peak LOS pressure point and pressure inversion point, and PIP (all p<0.05). The magnitude of proximal migration of SCJ during transient LOS relaxations was reduced by 1.6-2.6 cm with belt on versus off (p=0.01) and in obese versus non-obese (p=0.04), consistent with its resting position being already proximally displaced. The waist belt, but not increased WC, was associated with increased LOS pressure (vs intragastric pressure) and movement of pH transition point closer to SCJ. At 5 cm above upper border LOS, the mean % time pH <4 was <4% in all studied groups. Acid exposure 0.5-1.5 cm above SCJ was increased, with versus without, belt (p=0.02) and was most marked in obese subjects with belt.
CONCLUSIONS: Our findings indicate that in asymptomatic volunteers, waist belt and central obesity cause partial hiatus herniation and short-segment acid reflux. This provides a plausible explanation for the high incidence of inflammation and metaplasia and occurrence of neoplasia at the GOJ in subjects without a history of reflux symptoms.

Matched MeSH terms: Manometry
Modified dynamic gracilis neosphincter for fecal incontinence: an analysis of functional outcome at a single institution

Hassan MZ, Rathnayaka MM, Deen KI

World J Surg, 2010 Jul;34(7):1641-7.
PMID: 20180122 DOI: 10.1007/s00268-010-0489-1

We undertook a prospective longitudinal study of patients with end-stage fecal incontinence who were undergoing transposition of the gracilis muscle as a neo-anal sphincter with external low-frequency electrical stimulation of the nerve to the gracilis combined with biofeedback.

Matched MeSH terms: Manometry
Fulltext Blood pressure variability and arterial elasticity in hyperlipidaemic subjects

Rafidah HM, Azizi A, Noriah MN

Singapore Med J, 2008 Apr;49(4):297-303.
PMID: 18418521

It is debatable whether the assessment of low density lipoprotein or total cholesterol (TC) alone is sufficient to identify an individual's risk of having myocardial infarction. In the Framingham study, the risk of coronary artery disease was better indicated by an increase in the TC to high density lipoprotein cholesterol (TC: HDL) ratio. The aim of this study is to determine the relationship between blood pressure variability (BPV) and arterial compliances in hyperlipidaemics, which was defined as TC:HDL of more than 5.0 as compared to normolipidaemics.

Matched MeSH terms: Manometry