erosive esophagitis Dotaz Zobrazit nápovědu
OBJECTIVE: To investigate whether gastroesophageal reflux disease (GERD) with mild to moderate erosive esophagitis (ERD) is a more severe disease regarding the amount of acid reflux, motor abnormalities, and the presence/absence of hiatus hernia than non-erosive reflux disease (NERD). MATERIAL AND METHODS: The study comprised a retrospective analysis of prospectively collected data on 313 consecutive subjects referred for endoscopy, pH-metry, and esophageal manometry. The patients were divided into four groups: Group I (n=92), subjects without GERD with normal pH-metry, without esophagitis and without reflux symptoms; Group II (n=111), patients with NERD (no esophagitis, abnormal pH-metry); Group III (n=77), patients with mild to moderate ERD (LA A, B; abnormal pH-metry); Group IV (n=33), patients with severe or complicated esophagitis (LA C, D; Barrett's esophagus). All data are expressed as medians with 5th-95th percentiles. RESULTS: No difference was found in the amount of acid reflux between patients with mild to moderate ERD and those with NERD. The DeMeester score was 34.5 (17-105) in NERD patients and 31.6 (15-102) in ERD patients. No significant differences were found between NERD and ERD patients regarding lower esophageal sphincter (LES) basal pressure (11.6 mmHg; 3-25 in NERD versus 10.7 mmHg; 3-22 in ERD). Similar proportions of patients with NERD and ERD had low LES basal pressure (20.7% in NERD versus 24.7% in ERD; NS) and hiatus hernia (44% and 56%; NS). A relatively high proportion of patients without GERD (Group I) had ineffective esophageal motility (39%) and hiatus hernia (30%). CONCLUSIONS: No difference was found between NERD and mild to moderate ERD in terms of acid exposure time and esophageal motor abnormalities. To a certain extent, ERD is a "more complicated" form of the disease. Host factors related to a particular patient (e.g. mucosal defense, genetics, acid clearance) might be responsible for the development of esophagitis.
- MeSH
- dospělí MeSH
- ezofágus patologie patofyziologie MeSH
- gastroezofageální reflux komplikace patologie patofyziologie MeSH
- gastrointestinální endoskopie MeSH
- lidé středního věku MeSH
- lidé MeSH
- peptická ezofagitida komplikace patologie MeSH
- poruchy motility jícnu komplikace MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
BACKGROUND: Helicobacter pylori may be found during upper gastrointestinal endoscopy (UGE) performed to diagnose celiac disease (CeD), inflammatory bowel disease (IBD), and eosinophilic esophagitis (EoE). We aimed to describe the frequency of H. pylori in children undergoing UGE for CeD, IBD, and EoE and the number of children receiving eradication treatment. MATERIALS AND METHODS: A retrospective multicenter study from 14 countries included pediatric patients diagnosed with CeD, IBD, and EoE between January 2019 and December 2021. DATA COLLECTED: age, gender, hematologic parameters, endoscopic, histologic, and H. pylori culture results, and information on eradication treatment. RESULTS: H. pylori was identified in 349/3890 (9%) children [167 (48%) male, median 12 years (interquartile range 8.1-14.6)]. H. pylori was present in 10% (173/1733) CeD, 8.5% (110/1292) IBD and 7.6% (66/865) EoE patients (p = NS). The prevalence differed significantly between Europe (Eastern 5.2% (28/536), Southern 3.8% (78/2032), Western 5.6% (28/513)) and the Middle East 26.6% (215/809) [odds ratio (OR) 7.96 95% confidence interval (CI) (6.31-10.1) p < 0.0001]. Eradication treatment was prescribed in 131/349 (37.5%) patients, 34.6% CeD, 35.8% IBD, and 56.1% EoE. Predictors for recommending treatment included erosions/ulcers [OR 6.45 95% CI 3.62-11.47, p < 0.0001] and nodular gastritis [OR 2.25 95% CI 1.33-3.81, p 0.003]. Treatment rates were higher in centers with a low H. pylori prevalence (<20%) [OR 3.36 95% CI 1.47-7.66 p 0.004]. CONCLUSIONS: Identifying H. pylori incidentally during UGE performed for the most common gastrointestinal diseases varies significantly among regions but not among diseases. The indications for recommending treatment are not well defined, and less than 40% of children received treatment.
- Klíčová slova
- Helicobacter pylori, children, eradication treatment, incidental diagnosis,
- MeSH
- celiakie * diagnóza epidemiologie MeSH
- dítě MeSH
- eozinofilní ezofagitida * epidemiologie diagnóza MeSH
- gastrointestinální endoskopie MeSH
- Helicobacter pylori * izolace a purifikace MeSH
- idiopatické střevní záněty * epidemiologie diagnóza mikrobiologie MeSH
- infekce vyvolané Helicobacter pylori * diagnóza epidemiologie farmakoterapie MeSH
- lidé MeSH
- mladiství MeSH
- předškolní dítě MeSH
- prevalence MeSH
- retrospektivní studie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- Geografické názvy
- Evropa epidemiologie MeSH
OBJECTIVES: Gastroesophageal reflux (GERD) is a one of the major public health problem that can lead to reflux esophagitis (RE), Barrett's esophagus (BE), and esophageal adenocarcinoma (EAC). The aim of our study was to determine the impact of IL-1 gene polymorphisms on the development of GERD, RE and BE. METHODS: Three hundred and thirty-three Czech patients with gastroesophageal reflux and 165 healthy controls were included in this case-control study. Four polymorphisms in the genes of the IL-1 cluster [IL-1A(-889C/T), IL-1B(-511C/T), IL-1B(+3953C/T), and IL-1RN(VNTR)] were analyzed. RESULTS: Significant differences were found in IL-1RN 1/2 genotype between patients with GERD/RE and controls and in IL-1B+3953 T allele between patients with BE and healthy subjects. In addition, complex analysis revealed differences in IL-1 haplotype frequencies between the groups. Specifically, the haplotype TCCL was significantly more frequent (p = 0.016) in GERD patients than in controls and the haplotype CCCL more frequent (p = 0.008) in RE patients than in controls. However, in patients with BE, frequency of haplotype TCTL was lower (p = 0.05) and haplotypes CTCL and TCCL were higher (p = 0.03 and p = 0.02) in comparison with the controls. CONCLUSIONS: Our results suggest that IL-1 haplotypes may be associated with susceptibility to GERD, RE and BE.
- Klíčová slova
- BE, Barrett’s esophagus, CI, DNA, DU, EAC, EC, EE, GAC, GERD, GIQLI, GU, HWE, Hardy–Weinberg equilibrium, IL-1, LD, LES, NERD, OR, PCR, RE, RFLP, SNP, VNTR, adenocarcinoma of the esophagus, confidence intervals, deoxyribonucleic acid, duodenal ulcer, erosive esophagitis, esophageal cancer, gastric adenocarcinoma, gastric ulcer, gastroesophageal reflux disease, gastrointestinal quality of life index, interleukin-1, linkage disequilibrium, lower esophageal sphincter, non-erosive reflux disease, odds ratio, polymerase chain reaction, reflux esophagitis, restriction fragment length polymorphism, single nucleotide polymorphism, variable number tandem repeat,
- MeSH
- Barrettův syndrom genetika imunologie MeSH
- dospělí MeSH
- frekvence genu MeSH
- gastroezofageální reflux genetika imunologie MeSH
- genetické asociační studie MeSH
- genotyp MeSH
- haplotypy MeSH
- interleukin-1 genetika MeSH
- lidé středního věku MeSH
- lidé MeSH
- multigenová rodina imunologie MeSH
- studie případů a kontrol MeSH
- zvířata MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
- Názvy látek
- interleukin-1 MeSH
Esophageal symptoms can arise from gastroesophageal reflux disease (GERD) as well as other mucosal and motor processes, structural disease, and functional esophageal syndromes. GERD is the most common esophageal disorder, but diagnosis may not be straightforward when symptoms persist despite empiric acid suppressive therapy and when mucosal erosions are not seen on endoscopy (as for nonerosive reflux disease, NERD). Esophageal physiological tests (ambulatory pH or pH-impedance monitoring and manometry) can be of value in defining abnormal reflux burden and reflux-symptom association. NERD diagnosed on the basis of abnormal reflux burden on ambulatory reflux monitoring is associated with similar symptom response from antireflux therapy for erosive esophagitis. Acid suppression is the mainstay of therapy, and antireflux surgery has a definitive role in the management of persisting symptoms attributed to NERD, especially when the esophagogastric junction is compromised. Adjunctive approaches and complementary therapy may be of additional value in management. In this review, we describe the evaluation, diagnosis, differential diagnosis, and management of NERD.
- Klíčová slova
- ambulatory reflux monitoring, antireflux surgery, esophageal manometry, nonerosive reflux disease, proton pump inhibitors,
- MeSH
- ezofágoskopie metody MeSH
- gastroezofageální junkce * metabolismus patofyziologie MeSH
- gastroezofageální reflux * diagnóza metabolismus patofyziologie MeSH
- lidé MeSH
- manometrie metody MeSH
- monitorování jícnového pH metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
AIM: To present a complex oral health status including salivary factors, microbial analysis and periodontal and hygiene indices in patients with active gastro-oesophageal reflux disease (GORD). Return of stomach contents is quite common in cases of gastro-oesophageal reflux. Pathological acid movement from the stomach into the oesophagus and oral cavity may lead to a development of dental erosion. Long-lasting untreated GORD may damage hard dental and periodontal tissues and alter the oral microbial environment. The quality and amount of the saliva play an important role in hard and soft oral tissues changes. METHOD: Fifty patients with diagnosed GORD using 24-hour pH manometry underwent dental examination; 24 patients had active GORD and had been waiting for surgical therapy. In this patient group oral health status and salivary analysis were evaluated. RESULTS: Indicated low salivary flow rates and buffering capacity with a low caries risk but a high risk for dental erosion progression.
- MeSH
- DMF Index MeSH
- dospělí MeSH
- eroze zubů etiologie MeSH
- gastroezofageální reflux komplikace MeSH
- koncentrace vodíkových iontů MeSH
- Lactobacillus izolace a purifikace MeSH
- lidé středního věku MeSH
- lidé MeSH
- manometrie MeSH
- orální zdraví MeSH
- parodontální index MeSH
- počet mikrobiálních kolonií MeSH
- pufry MeSH
- rizikové faktory MeSH
- rychlost sekrece MeSH
- sliny chemie metabolismus mikrobiologie MeSH
- Streptococcus mutans izolace a purifikace MeSH
- zubní kaz etiologie mikrobiologie MeSH
- zubní plak mikrobiologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- pufry MeSH
In an open clinical endoscopically controlled study in 30 consecutive patients with rheumatic diseases complicated by the ulcerative and erosive form of gastroduodenopathy induced by non-steroidal antiinflammatory drugs and oesophagitis, after four weeks treatment with oral famotidine (one dose of 40 mg/day) confirmed a significant improvement of the mean oesophageal (0.67 +/- 1.06 vs. 0.03 +/- 0.18, p rrr 0.01) gastric 2.10 +/- 1.49 vs. 0.63 +/- 0.85, p rrr 0.001) and duodenal mucosal score (1.80 +/- 1.52 vs. 0.43 +/- 0.82, p rrr 0.001). After four weeks treatment 71% lesions (5/7) in the oesophagus were cured, 77% gastric lesions (10/13) and 75% duodenal lesions (9/12). Treatment with non-steroid antirheumatics proceeded.
- MeSH
- antagonisté histaminu H2 terapeutické užití MeSH
- antiflogistika nesteroidní škodlivé účinky MeSH
- ezofagitida chemicky indukované farmakoterapie MeSH
- famotidin terapeutické užití MeSH
- lidé středního věku MeSH
- lidé MeSH
- peptický vřed chemicky indukované farmakoterapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Názvy látek
- antagonisté histaminu H2 MeSH
- antiflogistika nesteroidní MeSH
- famotidin MeSH
Presently, gastroesophageal reflux disease is defined as a disorder where reflux of the stomach content is bothersome and/or brings about complications. The state when macroscopically detectable erosions of mucosa are present is known as erosive reflux disease and the term non-erosive reflux disease is used for the condition with no macroscopic erosions. Reflux oesophagitis is a frequent sign of the disease. A condition, where reflux symptoms persist or new occur and oesophagitis healing fails to take place despite maximum treatment, is classified as refractory gastroesophageal reflux disease. The main symptoms of gastroesophageal reflux disease include heartburn and regurgitation. Gastroesophageal reflux disease may, less frequently, manifest itself with isolated non-oesophageal symptoms, e.g. recurring upper respiratory tract infections or bronchial asthma. Etiopathogenesis involves refluxate, motility disorders, altered anatomic proportions, protective mechanisms disorder and external factors. Diagnosis takes place on the basis of typical symptomatology and endoscopic examination. Complications include bleeding, ulceration, strictures and Barrett's oesophagus. Lifestyle and dietary measures are an important treatment approach as are pharmacological (antisecretion and prokinetic agents) as well as surgical management.
- MeSH
- gastroezofageální reflux diagnóza terapie MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
Epidermolysis bullosa (EB) comprises a group of genetic disorders with the hallmark of fragility of the skin and mucosal surfaces. The severity of different types of EB varies markedly as does the occurrence of extra-cutaneous involvement and complications. A number of emergency situations may occur in the context of EB including obstruction to oral intake from oral or esophageal blisters or scarring, acute airway obstruction, acute urinary retention, sepsis and corneal erosions. Whilst general management principles apply in each of these settings, specific considerations are essential in managing EB to avoid undue trauma or damage to delicate tissues. These recommendations have been developed from a literature review and consensus from experts of the European Network for Rare Skin Disorders (ERN-Skin) to aid decision-making and optimize clinical care by non-EB expert health professionals encountering emergency situations in babies, children and adults with EB.
- Klíčová slova
- Airway obstruction, Blister, Corneal erosion, ERN-skin, Epidermolysis bullosa, Esophageal obstruction, Pain, Sepsis, Urinary retention,
- MeSH
- dítě MeSH
- dospělí MeSH
- epidermolysis bullosa * terapie MeSH
- konsensus MeSH
- kůže MeSH
- lidé MeSH
- sliznice MeSH
- vzácné nemoci MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
INTRODUCTION: A reproducible and simple model is essential for verifying gastric conduit vitality before esophagectomy. Ischemia is a major cause of esophagogastric anastomotic dehiscence and leakage. Ischemic conditioning of the stomach prior to esophageal surgery has been shown to lower the incidence of postoperative complications, including anastomotic leakage. However, the optimal timing and technique of ischemization remain uncertain. METHODS: Male Sprague-Dawley rats (n=24) were randomly divided into four groups: ischemic group - samples collected 1 hour after ischemia (I1H), ischemic group - samples collected 1 day after ischemia (I1D), ischemic group - samples collected 7 days after ischemia (I7D), and control group (C). Ischemia was induced by ligation of the left gastric (LGA) and short gastric arteries (SGA). The samples were verified using histological and macroscopic analysis, and the number and percentage of immunocompetent cells were determined. RESULTS: One hour after ischemization (I1H), ischemic denudation with mucosal erosion was observed, and the total number of eosinophils was significantly higher (p.
- Klíčová slova
- Ischemia, Stomach, esophagogastric anastomosis, histological changes, ischemia, rat, stomach,
- MeSH
- anastomóza chirurgická * MeSH
- ezofagektomie * MeSH
- ezofágus * krevní zásobení chirurgie patologie MeSH
- krysa rodu Rattus MeSH
- netěsnost anastomózy prevence a kontrola etiologie MeSH
- potkani Sprague-Dawley * MeSH
- přivykání k ischémii * metody MeSH
- žaludek * krevní zásobení chirurgie patologie MeSH
- zvířata MeSH
- Check Tag
- krysa rodu Rattus MeSH
- mužské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH