Displaying publications 1 - 20 of 59 in total

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  1. Sugano K, Spechler SJ, El-Omar EM, McColl KEL, Takubo K, Gotoda T, et al.
    Gut, 2022 Aug;71(8):1488-1514.
    PMID: 35725291 DOI: 10.1136/gutjnl-2022-327281
    OBJECTIVE: An international meeting was organised to develop consensus on (1) the landmarks to define the gastro-oesophageal junction (GOJ), (2) the occurrence and pathophysiological significance of the cardiac gland, (3) the definition of the gastro-oesophageal junctional zone (GOJZ) and (4) the causes of inflammation, metaplasia and neoplasia occurring in the GOJZ.

    DESIGN: Clinical questions relevant to the afore-mentioned major issues were drafted for which expert panels formulated relevant statements and textural explanations.A Delphi method using an anonymous system was employed to develop the consensus, the level of which was predefined as ≥80% of agreement. Two rounds of voting and amendments were completed before the meeting at which clinical questions and consensus were finalised.

    RESULTS: Twenty eight clinical questions and statements were finalised after extensive amendments. Critical consensus was achieved: (1) definition for the GOJ, (2) definition of the GOJZ spanning 1 cm proximal and distal to the GOJ as defined by the end of palisade vessels was accepted based on the anatomical distribution of cardiac type gland, (3) chemical and bacterial (Helicobacter pylori) factors as the primary causes of inflammation, metaplasia and neoplasia occurring in the GOJZ, (4) a new definition of Barrett's oesophagus (BO).

    CONCLUSIONS: This international consensus on the new definitions of BO, GOJ and the GOJZ will be instrumental in future studies aiming to resolve many issues on this important anatomic area and hopefully will lead to better classification and management of the diseases surrounding the GOJ.

    Matched MeSH terms: Gastroesophageal Reflux*
  2. Gwee KA, Lee YY, Suzuki H, Ghoshal UC, Holtmann G, Bai T, et al.
    J Gastroenterol Hepatol, 2023 Feb;38(2):197-209.
    PMID: 36321167 DOI: 10.1111/jgh.16046
    Contemporary systems for the diagnosis and management gastrointestinal symptoms not attributable to organic diseases (Functional GI Disorders, FGID, now renamed Disorders of Gut-Brain Interaction, DGBI) seek to categorize patients into narrowly defined symptom-based sub-classes to enable targeted treatment of patient cohorts with similar underlying putative pathophysiology. However, an overlap of symptom categories frequently occurs and has a negative impact on treatment outcomes. There is a lack of guidance on their management. An Asian Pacific Association of Gastroenterology (APAGE) working group was set up to develop clinical practice guidelines for management of patients with functional dyspepsia (FD) who have an overlap with another functional gastrointestinal disorder: FD with gastroesophageal reflux (FD-GERD), epigastric pain syndrome with irritable bowel syndrome (EPS-IBS), postprandial distress syndrome with IBS (PDS-IBS), and FD-Constipation. We identified putative pathophysiology to provide a basis for treatment recommendations. A management algorithm is presented to guide primary and secondary care clinicians.
    Matched MeSH terms: Gastroesophageal Reflux*
  3. Lee LH, Gao X, Sun G
    Front Cell Infect Microbiol, 2023;13:1339579.
    PMID: 38094747 DOI: 10.3389/fcimb.2023.1339579
    Matched MeSH terms: Gastroesophageal Reflux*
  4. Goh KL, Chang CS, Fock KM, Ke M, Park HJ, Lam SK
    J Gastroenterol Hepatol, 2000 Mar;15(3):230-8.
    PMID: 10764021
    Gastro-oesophageal reflux disease (GORD) occurs more frequently in Europe and North America than in Asia but its prevalence is now increasing in many Asian countries. Many reasons have been given for the lower prevalence of GORD in Asia. Low dietary fat and genetically determined factors, such as body mass index and maximal acid output, may be important. Other dietary factors appear to be less relevant. Increased intake of carbonated drinks or aggravating medicines may influence the increasing rates of GORD in some Asian countries but no strong evidence links other factors, such as the age of the population, smoking or alcohol consumption, to GORD. The management of GORD in Asia is similar to that in Europe and North America but the lower incidence of severe oesophagitis in Asia may alter the approach slightly. Also, because Asians tend to develop stomach cancer at an earlier age, endoscopy is used routinely at an earlier stage of investigation. Gastro-oesophageal reflux disease is essentially a motility disorder, so short-term management of the disease can usually be achieved using prokinetic agents (or histamine (H2)-receptor antagonists). More severe and recurrent GORD may require proton pump inhibitors (PPI) or a combination of prokinetic agents and PPI. The choice of long-term treatment may be influenced by the relative costs of prokinetic agents and PPI.
    Matched MeSH terms: Gastroesophageal Reflux/epidemiology*
  5. Norzila MZ, Azizi BH, Deng CT, Zulfikar A, Devadass P, Tai A
    Med J Malaysia, 1996 Mar;51(1):93-8.
    PMID: 10967986
    Respiratory symptoms in children may be associated with underlying gastro-oesophageal reflux (GOR). We reviewed the case notes of 20 children who presented to us from June 1993 to June 1994 with respiratory symptoms and GOR. The patients consisted of 16 Malays, two Chinese and two Indians with equal number of males and females. Their age at diagnosis was less than one year in 17 patients. The earliest age at presentation was at the third day of life. All patients had major respiratory manifestations i.e. recurrent wheezing, recurrent cough and pneumonia. In addition, three patients had stridor and six patients had apparent life threatening episodes (ALTE). Fourteen patients required ventilation because of respiratory failure. Diagnosis of GOR was based on clinical grounds supported by barium oesophagogram in seven patients and ultrasound examination in 11 patients. Eight patients were fundoplicated because of ALTE and recurrent severe bronchospasm. On follow up, 14 patients had hyperactive airways requiring inhaled bronchodilator and steroid therapy.
    Matched MeSH terms: Gastroesophageal Reflux/complications*; Gastroesophageal Reflux/diagnosis; Gastroesophageal Reflux/surgery
  6. Siti Mazliah K, Norzila MZ, Deng CT, Zulfiqar A, Azizi BHO
    Med J Malaysia, 2000 Jun;55(2):180-7.
    PMID: 19839146
    Objectives: This was a cross sectional study conducted in the Paediatric Institute among infants and children with chronic respiratory symptoms with the following objectives: i) to determine the prevalence of gastro-oesophageal reflux in children with persistent respiratory symptoms, ii) to identify the clinical predictors of GOR (Gastro-oesophageal reflux) in children with persistent respiratory symptoms and iii) assess the validity of abdominal ultrasound, barium oesophagogram and chest radiograph in diagnosing GOR in these patients.
    Materials and Methods: Forty-four patients were recruited over a period of six months. All the presenting symptoms were identified. The patients were subjected to chest radiograph, abdominal ultrasound, barium oesophagogram and 24-hour pH oesophageal monitoring.
    The predictive validity of clinical symptoms, chest radiograph, abdominal ultrasound and barium oesophagogram were assessed. Twenty-four hours oesophageal pH was the gold standard to diagnose GOR.
    Results: The mean age of patients was 9.1 months (1-58 months). Thirty-one patients (70.5%) were confirmed to have GOR by pH study. Respiratory symptoms alone were not useful to predict GOR. Cough had the highest sensitivity of 51.6%. stridor, wheeze and choking each had a specificity of 76%. Wheeze, vomiting, choking and stridor were identified to have high specificity (90-100%) in diagnosing GOR when any two symptoms were taken in combination.
    Collapse/consolidation was the commonest radiological abnormality but had low sensitivity (35.5%) and specificity (53.8%). However hyperinflation on chest radiograph had a specificity of 92.3% with positive predictive value at 80% in diagnosing GOR. Barium oesophagogram has low sensitivity (37.9%) and moderate specificity (75%) in diagnosing GOR in children with respiratory symptoms.
    Abdominal ultrasound was a valid mode of diagnosing GOR when there were three or more reflux episodes demonstrated during the screening period with a specificity of 90.9%. However the sensitivity was low ie 20-25%. The specificity increased to 90-100% when two positive tests were taken in combination (abdominal ultrasound and barium oesophagogram). However the sensitivity remained low (10-20%). Chest radiograph did not improve the predictive value when considered with the above tests. Combination of clinical symptoms were useful as clinical predictors of GOR. In the absence of a pH oesophageal monitoring, a combination of barium oesophagogram and ultrasound may be helpful in diagnosing GOR.
    Matched MeSH terms: Gastroesophageal Reflux/diagnosis*; Gastroesophageal Reflux/ethnology; Gastroesophageal Reflux/epidemiology*; Gastroesophageal Reflux/ultrasonography
  7. Lee YY, Wu JCY
    Gastroenterology, 2018 06;154(8):2018-2021.e1.
    PMID: 29730025 DOI: 10.1053/j.gastro.2018.04.030
    Matched MeSH terms: Gastroesophageal Reflux/classification; Gastroesophageal Reflux/complications; Gastroesophageal Reflux/diagnosis; Gastroesophageal Reflux/therapy*
  8. Chong VH, Chand PB, Gautam HR, Jalihal A
    Med J Malaysia, 2013 Jun;68(3):234-8.
    PMID: 23749013
    Gastro-oesophageal reflux disorders (GORD) are common in Western countries and has been reported to be increasing in the East. This study assessed the prevalence of GORD among the Nepalese residing in the Brunei Darussalam.
    Matched MeSH terms: Gastroesophageal Reflux*
  9. Goh KL
    J Gastroenterol Hepatol, 2004 Sep;19 Suppl 3:S22-5.
    PMID: 15324378
    Gastroesophageal reflux disease (GERD) is a common disease in the West, which now appears to be also increasing in prevalence in the Asian Pacific region. The reasons for this changing epidemiology are two-fold: an increased awareness among doctors and patients, and/or a true increase in the prevalence of the disease. Prevalence rates of reflux esophagitis (RE) of up to 16% and prevalence of GERD symptoms of up to 9% have been reported in the Asian population. However, the frequency of strictures and Barrett's esophagus remain very low. Non-erosive reflux disease (NERD) appears to be the most common form of GERD among Asian patients accounting for 50-70% of cases with GERD. Among Asian patients differences can also be discerned among different ethnic groups. For example, in Malaysia where a multiracial society exists, RE is significantly more common among Indians compared to Chinese and Malays whereas NERD is more frequently seen in the Indian and Malays compared to the Chinese. The reasons for these differences are not known but may indicate both genetic factors and environmental factors peculiar to the particular racial group. GERD has also been increasing in the region demonstrating a time-lag phenomenon compared to the West. Differing predisposition to GERD among different ethnic groups would mean that such an increase would be more prominent among certain racial groups.
    Matched MeSH terms: Gastroesophageal Reflux/epidemiology*
  10. Siow SL, Mahendran HA, Hardin M
    Asian J Surg, 2017 Jul;40(4):324-328.
    PMID: 25779884 DOI: 10.1016/j.asjsur.2015.01.007
    Surgery for Killian-Jamieson diverticulum of the esophagus is scarcely reported in the literature owing to the rarity of this entity. This is a case report of such a diverticulum and a description of the transcervical diverticulectomy that we performed on a 49-year-old lady. The patient was investigated for symptoms of gastroesophageal reflux disease and was diagnosed with a left-sided Killian-Jamieson diverticulum.
    Matched MeSH terms: Gastroesophageal Reflux/etiology*
  11. Ma ZF, Deraman MA, Coyle C, Lee YY
    Aliment Pharmacol Ther, 2020 07;52(2):398-399.
    PMID: 32592257 DOI: 10.1111/apt.15835
    Matched MeSH terms: Gastroesophageal Reflux*
  12. Lee WS, Beattie RM, Meadows N, Walker-Smith JA
    J Paediatr Child Health, 1999 Dec;35(6):568-71.
    PMID: 10634985
    OBJECTIVES: To assess the clinical features, investigations and outcome of 69 children (40 males, 29 females) with gastro-oesophageal reflux (GOER) referred to a tertiary referral centre in paediatric gastroenterology.

    METHODS: A study of all patients with significant GOER seen at the Paediatric Gastroenterology Unit, Queen Elizabeth Hospital for Children, Hackney Road, London, between December 1994 and August 1995.

    RESULTS: The median age at referral was 16 months. Presenting symptoms were recurrent vomiting (72%), epigastric and abdominal pain (36%), feeding difficulties (29%), failure to thrive (28%) and irritability (19%). Continuous 24-h lower oesophageal pH studies performed in 57 children showed 20 (35%) had a reflux index of between 10% to 20%, 14 (25%) had a index > 20%, and six (11%) had a postprandial reflux index > 10%. Reflux was shown in 38 (62%) of 62 children who underwent barium studies. None had significant anatomical abnormalities, but in the 22 children who had a negative barium studies, six had severe reflux (reflux index > 20%). Upper gastrointestinal endoscopy performed in 47 children showed reflux oesophagitis in 29 (62%), oesophageal ulceration in three, and Barrett's oesophagus in one. All of the children were treated with standard medical therapy. Sixty-six per cent were able to discontinue medication within 12 months and remained well. Four children (6%) required Nissen's fundoplication for failure to respond to medical therapy.

    CONCLUSIONS: Most infants with GOER have an uncomplicated course. False negative results were noted in both pH monitoring and barium meal. Up to 80% of children, with therapy, will improve within 12 months.

    Matched MeSH terms: Gastroesophageal Reflux/drug therapy*; Gastroesophageal Reflux/physiopathology*; Gastroesophageal Reflux/surgery
  13. Nair AB, Chaturvedi J, Venkatasubbareddy MB, Correa M, Rajan N, Sawkar A
    Malays J Med Sci, 2011 Jul;18(3):75-8.
    PMID: 22135605
    Respiratory fungal infections are usually found in immunocompromised individuals who have received either long-term steroid therapy or broad-spectrum anti-microbial therapy or have a non-resolving underlying chronic disease. These infections are seen as a part of bronchopulmonary fungal infections, and their isolated and primary occurrence as laryngeal diseases is highly uncommon. Laryngeal fungal infections can also mimic various diseases, such as gastroesophageal reflux disease, granulomatous diseases, leukoplakia, and carcinoma, thereby misleading the treating team from correct diagnosis and management. It is therefore important to identify the lesion at the earliest point possible to avoid morbid or life-threatening consequences. We report a case of isolated laryngeal candidiasis in an immunocompetent Indian male with an unusual presentation mimicking laryngeal carcinoma. The clinical and histological features are highlighted with a review of relevant literature to demonstrate the possibility of such an isolated fungal lesion, even in an immunocompetent individual.
    Matched MeSH terms: Gastroesophageal Reflux
  14. Goh KL
    J Gastroenterol Hepatol, 2011 Jan;26 Suppl 1:2-10.
    PMID: 21199509 DOI: 10.1111/j.1440-1746.2010.06534.x
    Gastroesophageal reflux disease (GERD), previously uncommon in Asia, has now become an important disease in the region. Although much variability exists between studies, most endoscopy-based studies show a prevalence of erosive esophagitis of more than 10%. Symptom-based studies also show a prevalence of 6-10%. Two longitudinal follow-up studies on GERD symptoms have shown an increase with time, and several endoscopy-based time trend studies have also shown a significant increase in erosive reflux esophagitis. Studies on Barrett's esophagus have been confounded by the description of short (SSBE) and long segment (LSBE) Barrett's esophagus. Great variation in prevalence rates has been reported. SSBE vary from 0.1% to more than 20% while LSBE vary from 1-2%. Of the putative causative factors, obesity has been the most important. Many studies have linked GERD-esophagitis as well as occurrence of reflux symptoms with an increase in body mass index (BMI), obesity, especially visceral or central obesity, and metabolic syndrome. A decline in Helicobacter pylori infection with growing affluence in Asia has been broadly thought to result in healthier stomachs and a higher gastric acid output resulting in reflux disease. However, variable results have been obtained from association and H. pylori eradication studies.
    Matched MeSH terms: Gastroesophageal Reflux/history*; Gastroesophageal Reflux/epidemiology
  15. Goh KL, Choi MG, Hsu WP, Chun HJ, Mahachai V, Kachintorn U, et al.
    J Gastroenterol Hepatol, 2014 Dec;29(12):1969-75.
    PMID: 24990817 DOI: 10.1111/jgh.12655
    Data on patient satisfaction with proton pump inhibitor (PPI) therapy for gastroesophageal reflux disease (GERD) are scarce in Asia. The perspectives of Asian patients with GERD and their satisfaction with PPI therapy were investigated.
    Matched MeSH terms: Gastroesophageal Reflux/drug therapy*; Gastroesophageal Reflux/psychology*
  16. 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: Gastroesophageal Reflux/diagnosis; Gastroesophageal Reflux/etiology*
  17. Mahadeva S, Raman MC, Ford AC, Follows M, Axon AT, Goh KL, et al.
    Aliment Pharmacol Ther, 2005 Jun 15;21(12):1483-90.
    PMID: 15948816
    There is a paucity of data directly comparing dyspepsia in Western and Eastern populations.
    Matched MeSH terms: Gastroesophageal Reflux/ethnology*; Gastroesophageal Reflux/epidemiology
  18. Osland E, Yunus RM, Khan S, Memon B, Memon MA
    Obes Surg, 2017 May;27(5):1208-1221.
    PMID: 27896647 DOI: 10.1007/s11695-016-2469-5
    PURPOSE: Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic vertical sleeve gastrectomy (LVSG) have been proposed as cost-effective strategies to manage obesity-related chronic disease. The aim of this systematic review was to study the peer review literature regarding postoperative nondiabetic comorbid disease resolution or improvement reported from randomized controlled trials (RCTs) comparing LVSG and LRYGB procedures.

    MATERIAL AND METHODS: RCTs comparing postoperative comorbid disease resolution such as hypertension, dyslipidemia, obstructive sleep apnea, joint and musculoskeletal conditions, gastroesophageal reflux disease, and menstrual irregularities following LVSG and LRYGB were included for analysis. The studies were selected from PubMed, Medline, EMBASE, Science Citation Index, Current Contents, and the Cochrane database and reported on at least one comorbidity resolution or improvement. The present work was undertaken according to the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA). The Jadad method for assessment of methodological quality was applied to the included studies.

    RESULTS: Six RCTs performed between 2005 and 2015 involving a total of 695 patients (LVSG n = 347, LRYGB n = 348) reported on the resolution or improvement of comorbid disease following LVSG and LRYGB procedures. Both bariatric procedures provide effective and almost comparable results in improving or resolving these comorbidities.

    CONCLUSIONS: This systematic review of RCTs suggests that both LVSG and LRYGB are effective in resolving or improving preoperative nondiabetic comorbid diseases in obese patients. While results are not conclusive at this time, LRYGB may provide superior results compared to LVSG in mediating the remission and/or improvement in some conditions such as dyslipidemia and arthritis.

    Matched MeSH terms: Gastroesophageal Reflux/complications; Gastroesophageal Reflux/surgery
  19. Rajendra S, Ackroyd R, Robertson IK, Ho JJ, Karim N, Kutty KM
    Helicobacter, 2007 Apr;12(2):177-83.
    PMID: 17309756
    Ethnic differences in gastroesophageal reflux disease (GERD) and its complications as well as racial variations in the prevalence of Helicobacter pylori infection are well documented. Nevertheless, the association between reflux disease, H. pylori, and race has not been adequately explored.
    Matched MeSH terms: Gastroesophageal Reflux/ethnology*; Gastroesophageal Reflux/epidemiology; Gastroesophageal Reflux/pathology
  20. R A A H, Y U C, R N, I R
    J Neonatal Surg, 2015 07 01;4(3):32.
    PMID: 26290814
    Development of infantile hypertrophic pyloric stenosis during postoperative period in EA with TEF is rare. Postoperative vomiting or feeding intolerance in EA is more common which is due to esophageal stricture, gastroesophageal reflux and esophageal dysmotility. A typical case of IHPS also presents with non-bilious projectile vomiting at around 3-4 weeks of life. The diagnosis of infantile hypertrophic pyloric stenosis in this subset is usually delayed because of its rarity. We report a case of IHPS in postoperative EA and emphasize on high index of suspicion to avoid any delay in diagnosis with its metabolic consequences.
    Matched MeSH terms: Gastroesophageal Reflux
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