Transoral endoscopic fundoplication in the treatment of gastroesophageal reflux disease: the anatomic and physiologic basis for reconstruction of the esophagogastric junction using a novel device

OBJECTIVE: To determine the safety, mechanism of action, immediate postprocedural anatomic impact on the esophagogastric junction, and short-term efficacy of the first entirely endolumenal antireflux procedure. BACKGROUND: A safe and effective endoscopic antireflux procedure remains elusive. Transoral endolumenal surgery has enormous potential for the treatment of gastroesophageal reflux disease (GERD) and other esophagogastric diseases. A… Read more »

Do Acid-Lowering Agents Affect Vitamin B12 Status in Older Adults?

OBJECTIVE: To examine the relationship between serum vitamin B12 levels in older adults on histamine(2) receptor antagonists (H2 blockers) or proton-pump inhibitors (PPI) over 6 years. Participants: A cross-sectional sample of 659 adults, 60 to 102 years, from long-term care facilities and community ambulatory care (C) in the Bronx. MEASUREMENTS: Patient demographics, serum B12 levels,… Read more »

Endoluminal fundoplication by a transoral device for the treatment of GERD: a feasibility study

BACKGROUND: A new endoluminal fundoplication (ELF) technique performed transorally using the EsophyXtrade mark device was evaluated for the treatment of gastroesophageal reflux disease (GERD) in a prospective, feasibility clinical trial. METHODS: Nineteen patients were enrolled into the study. Inclusion criteria were chronic and symptomatic GERD, proton pump inhibitor (PPI) dependence, and the absence of esophageal… Read more »

Use of acid-suppressing drugs and the risk of bacterial gastroenteritis

BACKGROUND & AIMS: Gastric acid is a defense mechanism against gastrointestinal infections caused by ingested bacteria. Studies have suggested that the use of acid-suppressing drugs may increase the risk of gastroenteritis (GE). METHODS: Patients aged 20-74 years with an episode of acute bacterial GE (n = 6414) were identified. A control group from the same… Read more »

The development of the GERD-HRQL symptom severity instrument

Abstract The Gastroesophageal Reflux Disease-Health Related Quality of Life (GERD-HRQL) instrument was introduced approximately 10 years ago to provide a quantitative method of measuring symptom severity in gastroesophageal reflux disease (GERD). Since that time the instrument has been used to assess treatment response to medication, endoscopic procedures, and surgery for GERD. However, the development of… Read more »

Acid has antiproliferative effects in nonneoplastic Barrett’s epithelial cells

OBJECTIVES: For patients with Barrett’s esophagus, physicians commonly prescribe antisecretory medications in dosages above those required to heal reflux esophagitis because acid has been shown to have proproliferative and antiapoptotic effects on Barrett’s cancer cells and on Barrett’s mucosal explants. For a number of reasons, these model systems may not be ideal for determining the… Read more »

Long-term proton pump inhibitor therapy and risk of hip fracture

CONTEXT: Proton pump inhibitors (PPIs) may interfere with calcium absorption through induction of hypochlorhydria but they also may reduce bone resorption through inhibition of osteoclastic vacuolar proton pumps. OBJECTIVE: To determine the association between PPI therapy and risk of hip fracture. DESIGN, SETTING, AND PATIENTS: A nested case-control study was conducted using the General Practice… Read more »

Increased risk of fundic gland polyps during long-term proton pump inhibitor therapy

BACKGROUND: It is controversial whether proton pump inhibitor use leads to fundic gland polyp development. AIM: To determine whether fundic gland polyp development is due to proton pump inhibitor use and to investigate mechanisms involved. METHODS: Proton pump inhibitor use and the presence of fundic gland polyps were assessed in consecutive patients undergoing oesophagogastroduodenoscopy. Biopsies… Read more »

Proton pump inhibitors reduce gallbladder function

BACKGROUND: In the authors’ previous study of gallbladder function before and after fundoplication, 58% of the patients demonstrated preoperative gallbladder motor dysfunction, and 86% of those retested after operation and cessation of proton pump inhibitors (PPIs) normalized. Because no study has directly assessed the impact of antisecretory agents on gallbladder function, this study measured gallbladder… Read more »