• Title/Summary/Keyword: Gastric reflux

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GSRS(Gastrointestinal Symptom Rating Scale)-Based Investigation about Gastrointestinal Symptoms and Histories in Patients with Asthmatic Symptoms (GSRS에 근거한 천식증상환자 중의 소화기증상 및 과거력에 대한 조사)

  • 이재성;정승연;이건영;최준용;정희재;이형구;정승기
    • The Journal of Korean Medicine
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    • v.25 no.1
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    • pp.198-204
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    • 2004
  • Backgrounds & Methods : Asthma is considered to be chronic inflammatory disease characterized by airway hyperresponsiveness and pulmonary eosinophilia. Recently, there has been many researches about asthma. IBS(Irritable Bowel Syndrome), PUD(peptic Ulcer disease) and GERD(gastroesophageal reflux disease) are the most common diseases of the gastrointestinal tract. Recent studies suggest that IBS, PUD and GERD are associated with bronchial hyper-responsiveness and bronchial asthma might be more prevalent in IBS and GERD patients than in control subjects. In addition, there are many comments about the interrelationship between the gastrointestinal problem and asthma in the oriental medical books. Actually, many oriental medical doctors don$^{\circ}$Øt consider the gastrointestinal condition when they deal with the asthmatic patients these days. So, we assessed the prevalence of gastrointestinal symptoms and histories in a cohort of patients with asthmatic symptoms. We evaluated 128 outpatients with asthmatic symptoms(60 males and 68 females, aged 13-75). All subjects enrolled completed the GSRS(Gastrointestinal Symptom Rating Scale). GSRS is an interview based rating scale consisting of 15 items for assessment of gastrointestinal symptoms in IBS and PUD developed by Jan Svedlund. Results : The limit of total score of GSRS in asthmatic patients is zero to 30. The number of patients with no GI symptoms is 66(51.5%). The number of patients with GSRS>5 is 62(48.4%), GSRS>10 is 24(18.8%), GSRS>15 is 8(6.25%). The number of patients with history of gastritis is 54(42.2%), gastric ulcer is 13(10.2%), gastroptosis is 8(6.25%), IBS is 6(4.68%), others is 6(4.68%). Conclusions : This study suggests that patients with bronchial asthma have an significant prevalence of gastrointestinal symptoms. Additional studies are needed to find the mechanism of the association between gastrointestinal symptoms and asthma.

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Dumping Syndrome in a Child with Gastrojejunal Tube Feeding (위공장 경관식이(Gastrojejunal Tube Feeding) 환아에서 동반된 덤핑 증후군(Dumping Syndrome) 1례)

  • Lee, Sung Hyuk;Byun, Jun Chul;Choi, Won Joung;Choi, Soon-Ok;Hwang, Jin-Bok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.1
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    • pp.96-101
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    • 2005
  • Dumping syndrome is a known complication of gastric surgery in adults, but a very rare disease in the pediatric population. We report on a case of dumping syndrome in a 19-month-old child, who underwent gastrojejunal feeding tube insertion for the treatment and prevention of gastroesophageal reflux and frequent aspiration pneumonia. At 17 months of age, 2 months after the beginning of gastrojejunal tube feeding, postprandial diaphoresis, palpitation, lethargy, bloating, and diarrhea occurred, and a single episode of convulsion with hypoglycemia were noted. Early and late dumping syndrome was confirmed by an abnormal oral glucose tolerance test with early onset hyperglycemia followed by delayed onset hypoglycemia. Diet therapy including uncooked corn starch then improved the postprandial diaphoresis, abnormal glucose levels, and her nutritional status. We conclude that dumping syndrome may be considered as a complication of gastrojejunal tube feeding in a child.

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Dysphagia Caused by Giant Granuloma Arising from the Oropharyngeal Posterior Wall (연하곤란을 초래하는 구인두 후벽에서 발생한 거대육아종)

  • Jung, Eun Kyung;Shin, Bong-Jin;Kim, Jongmin;Lee, Joon Kyoo
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.32 no.1
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    • pp.39-42
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    • 2021
  • Granuloma is an uncommon benign disease that develops in the process of wound healing. Pharyngeal or laryngeal granuloma can be associated with gastric reflux, mechanical injury or trauma including intubation, voice abuse, or foreign body. 50-year-old female was transferred to our institute with a huge mass occupying the upper aerodigestive tract causing dysphagia. The patient has been suffering from a brain hemorrhage for several months and was kept in bed due to the quadriplegia with stuporous mental status, and was tracheotomized. On examination, the whole oropharynx and hypopharynx was covered by a smooth-surfaced soft big diffuse granular mass, which extended down to the upper trachea through the larynx. The huge granuloma was successfully removed with surgery and was found to have a pedunculating stalk on the oropharyngeal posterior wall with a small mucosal defect, suggestive of the origin of the mass. The defect was closed primarily after the cauterization. The patient is now followed up regularly without any recurrence of the disease.

The Protective Effect of Arecae Semen and Coptidis Rhizoma in a Chronic Reflux Esophagitis Rat Model (만성 역류성 식도염 모델에서 빈랑(檳榔)와 황련(黃連) 복합물의 보호 효과)

  • Lee, Se Hui;Lee, Jin A;Shin, Mi-Rae;Lee, Ji Hye;Roh, Seong-Soo
    • The Journal of Internal Korean Medicine
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    • v.42 no.1
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    • pp.11-24
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    • 2021
  • Objective: Chronic reflux esophagitis (CRE), characterized by esophageal mucosa ulcer, is caused by continuous backflow of gastric acid and consequent inflammation due to unstable gastroesophageal sphincter. The aim of the present study was to clarify the effect of an Arecae Semen and Coptidis Rhizoma mixture (AC-mix) on CRE. Methods: CRE was surgically induced in SD rats with three experimental groups used: normal; CRE control; and CRE treatment (200 mg/kg AC-mix). Blood and esophageal tissue were collected after two weeks of drug administration. The anti-oxidant activity of the AC-mix was measured by total polyphenol and total flavonoid contents as well as by radical scavenging activity with protein levels evaluated using western blotting. Results: CRE damage to the esophageal mucosa was significantly reduced in the AC-mix group as compared with the controls, and administration of the AC-mix was seen to inhibit NF-κBp65 activity. Consequently, the inactivation of NF-κBp65 significantly inhibited inflammatory mediators such as COX-2 and iNOS. Moreover, the anti-oxidant enzyme HO-1 significantly increased through activation of the Nrf2-Keap1 pathway. Matrix metalloproteinase-2 (MMP-2), which can break down collagen from the basement membrane and extracellular matrix, was decreased following AC-mix treatment, and elevated levels of MMP-2 were regulated by its tissue inhibitor. Conclusions: These results show that AC-mix can alleviate esophageal mucosa ulcer though inhibition of the NF-κBp65 inflammatory pathway and enhancement of the anti-oxidant Nrf2-Keap1 pathway.

Short-Term Outcomes of Laparoscopic Proximal Gastrectomy With Double-Tract Reconstruction Versus Laparoscopic Total Gastrectomy for Upper Early Gastric Cancer: A KLASS 05 Randomized Clinical Trial

  • Hwang, Sun-Hwi;Park, Do Joong;Kim, Hyung-Ho;Hyung, Woo Jin;Hur, Hoon;Yang, Han-Kwang;Lee, Hyuk-Joon;Kim, Hyoung-Il;Kong, Seong-Ho;Kim, Young Woo;Lee, Han Hong;Kim, Beom Su;Park, Young-Kyu;Lee, Young-Joon;Ahn, Sang-Hoon;Lee, In-Seob;Suh, Yun-Suhk;Park, Ji-Ho;Ahn, Soyeon;Han, Sang-Uk
    • Journal of Gastric Cancer
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    • v.22 no.2
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    • pp.94-106
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    • 2022
  • Purpose: Laparoscopic proximal gastrectomy with double-tract reconstruction (LPG-DTR) is a function-preserving procedure performed for treating upper early gastric cancer (EGC). However, few studies have compared the outcomes of LPG-DTR with those of laparoscopic total gastrectomy (LTG). This study aimed at comparing the short-term outcomes of LPG-DTR between LTG and upper EGC. Materials and Methods: For upper-third EGC, a multicenter, prospective, randomized trial was performed to compare those who underwent LPG-DTR with those who underwent LTG. Short-term outcomes, including clinicopathologic results, morbidity, mortality, and postoperative courses, were evaluated using a full analysis set based on the intention-to-treat principle and the per-protocol set. Results: Of the patients, 138 who fulfilled the criteria were randomized to each group. One patient in the LPG-DTR group withdrew consent. Sixty-eight patients underwent LPG-DTR and 69 underwent LTG. The operative time (LPG-DTR=219.4 minutes; LTG=201.8 minutes; P=0.085), estimated blood loss (LPG-DTR=76.0 mL; LTG=66.1 mL; P=0.413), and the morbidity rate (LPG-DTR=23.5%; LTG=17.4%; P=0.373) between the groups were not significantly different. No mortality occurred in either of the study groups. Two weeks post operation, the Visick scores for postprandial symptoms, including reflux symptoms, were not significantly different between the groups (P=0.749). Laboratory findings on postoperative day 5 were not significantly different between the groups. Conclusions: The short-term outcomes of LPG-DTR for upper EGC were comparable to those of LTG.

The Management of Systemic Voice Disorders (전신질환과 관련된 음성장애의 치료)

  • Woo, Joo Hyun
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.27 no.1
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    • pp.5-10
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    • 2016
  • Variable systemic diseases affect larynx and vocal fold and result in voice change. Asthma and chronic obstructive pulmonary disease make increase of intra-abdomimal pressure followed by reflux of gastric acid, which stimulate vagal-bronchopulomary reflex aggravating cough and respiratory disturbance. Fungal laryngitis in the general population is extremely rare, but can occur in immunocompromised AIDS patients. Although, initially, empirical antifungal therapy for candidiasis is often given without biopsy, diagnostic direct laryngoscopy and biopsy is imperative if a substantial clinical response is not rapidly achieved. In the highly active anti-retroviral therapy era, HIV-positive patients are living longer and are at higher risk for developing non-AIDS-defining malignancies. The incidence of head and neck cancer (HNC) which is related with human papilloma virus infection has increased. The survival is significantly lower among the AIDS-HNC patients with CD4 counts ${\leq}200cells/{\mu}L$. Rheumatoid arthritis (RA) cause voice disturbance by developing cricoarytenoid joints fixation or nodule on vocal fold. Post-menopausal voice disorder (PMVD) is caused by decreased secretion of estrogen-progesterone resulting in decrease of fundamental frequency (F0). Hormonal replacement therapy is helpful to reduce F0 decrease. RA and PMVD result in slight voice change, but it could crucial in professional voice user.

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Analysis of Frequently Diagnosed Gastrointestinal Disorders and Therapeutic Regimens in the Outpatients (외래환자의 위장관계 다빈도 질환과 처방 분석)

  • Kim, Min Jeong;Choi, Kyung Eob
    • Korean Journal of Clinical Pharmacy
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    • v.7 no.1
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    • pp.22-32
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    • 1997
  • The gastrointestinal disorders (GI disorders) is one of the most common diseases in Korea. The community pharmacists are often faced with the complaints of symptoms due to the GI disorders. However the drugs used to treat the GI disorders are frequently abused by the patients themselves because these drugs are easily available and have high placebo effects. Therefore, we have reviewed the digestive diseases statistics of 1996 to find out the frequencies of the GI disorders in the outpatients of Samsung Medical Center. Using these statistic data, we figured out the frequently diagnosed GI disorders and analysed commonly used prescriptions from February 1st to 28th of 1997. In addition, we also evaluated the commonly used drugs in these prescriptions. About twenty thousands of patients visited the hopital because of their GI symptoms in 1996. It was found that dyspepsia, viral hepatitis, and gastric and duodenal ulcer disease are frequently diagnosed in these patients. In a point of view on other GI disorders, gastritis and duodenitis, irritable bowel syndrome, gastroesophageal reflux disease, constipation and diarrhea were commonly detected. And a number of drugs were prescribed to treat the GI disorders, which included the prokinetics, Histamine-2 receptor antagonists, proton pump inhibitor, antacids, tranquillizers, antidepressants, antispasmodics, laxatives and so on. Interestingly, there were many prescriptions composing of the antibiotic regimens to eradicate H. pylori which has been proven to cause peptic ulcers.

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Cervical Esophageal Cancer (경부식도암)

  • 노영수;김진환
    • Korean Journal of Bronchoesophagology
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    • v.9 no.1
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    • pp.30-38
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    • 2003
  • Cancers of the cervical esophagus occur uncommonly, but treatment is remaining a challenging problem and surgery demands special knowledge of abdominal, thoracic, and neck surgery. The primary risk factor is chronic heartburn, leading to a sequence of esophagitis, Barrett's esophagus, reflux esophagitis and etc. Among the various treatment modalities, Surgery is still a mainstay of treatment. The main aim of surgery is not only oncologically adequate resection but also preservation or restoration of physiologic functions, such as deglutition and phonation. Surgical treatment of cervical esophageal cancer is influenced by special problems arising from tumor factors, patient factors and surgeon factors. Complete clearance of loco-regional disease and prevention of postoperative complications are of particular importance for the improvement of long-term survival in patients with these cancers. So the cervical and thoracic extension of these tumors usually required an extensive lymphadenectomy with primary resection. Radical resection of the primary site almostly include sacrifice of the larynx, but the voice could be rehabilitated with various methods, such as tracheoesophageal prosthesis or tracheoesophageal shunts, etc. Restoration of the esophageal conduit can be performed using gastric or colon interposition, radial forearm free flap or jejunum free flap, etc. Recently, the advances of radiation therapy and chemotherapy will enable less extended resections with greater rates of laryngeal preservation. At initial presentation, up to 50% to 70% of patients will have advanced locoregional or distant disease with virtually no chance for cure. Patients with advanced but potentially resectable esophageal cancer are generally treated by surgery with some form of neoadjuvant chemotherapy, radiotherapy, or both, with 5-year survivals in the 20% to 30% range. So the significant adverse factors affecting survival should be taken into account to select the candidates for surgery.

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Large Mesenteric Pedunculated Lipoma in a Horse

  • Seokho Son;Seyoung Lee;Eun-bee Lee;Kyung-won Park;Ji-Youl Jung;Jae-Hoon Kim;Hyohoon Jeong;Jong-pil Seo
    • Journal of Veterinary Clinics
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    • v.41 no.2
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    • pp.123-126
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    • 2024
  • A seven-month pregnant 15-year-old Thoroughbred mare presented with acute abdominal pain to Jeju National University Equine Hospital. At presentation, a nasogastric intubation revealed 10 L of gastric reflux; rectal palpation and ultrasound revealed dilated loops and thickening of the walls of the small intestine. An exploratory laparotomy revealed strangulation of the small intestine due to a large abdominal mass. The mass was double-ligated and resected blindly due to the short pedicle. An enterectomy was not performed as intestinal motility was detected following the mass removal. Histopathological examination confirmed that the mass was a lipoma, measuring 24 cm × 16 cm × 16 cm in size. On day 8 post-surgery, the mare was discharged without complications. This case report describes the diagnosis and treatment of strangulation of the small intestine by a pedunculated lipoma, thus providing useful information on lipoma in horses.

HyungSang Medical Approach to Phlegm-Fire (담화(痰火)에 대한 형상의학적(刑象醫學的) 고찰)

  • Kim, Jong-Won;Jun, Soo-Hyung;Ji, Gyu-Yong;Kim, Kyung-Chul;Lee, In-Sun;Lee, Tae-Sik;Kim, Kyu-Kon;Lee, Yong-Tae
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.1
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    • pp.1-6
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    • 2009
  • Many of our contemporaries suffer from the symptoms of phlegm-fire, which is caused by stress, processed food, heavy diet, and unseasonal fruits and vegetables. With consultations from 'Euihaklpmoon', 'DongeuiBogham', and 'Ji-San's clinical lectures' this research, which is mainly focused on phlegm-fire, concluded as following. Phlegm-fire is caused by congestion of seven emotions, congestion of qi, complication of phlegm on fire, depletion of body fluids after long periods of disease, heavy diet, or congenital unbalance of yin-yang and qi-hyul. Concentration of phlegm-fire on the head causes headache, dizziness, frontal headache, tinnitus, and auditory dysfunction. The patient usually complains breaking pain. Dhamhwabang of Yijin-tang, Chunghoonhwadham-tang, and Yijin-tang variation for right headache can be used. Concentration of phlegm-fire on the thorax causes insomnia, palpitation, and insanity. Samhoohndham-tang variation, Chungsimgondhanhwan can be used. Concentration of phlegm-fire on the gastric region causes reflux of gastric acid, eructation, vomiting, abdominal discomfort, dysmenorrhea, and fluor gentalis. Yijin-tang variation for abdominal discomfort, Yanghyulsamul-tang, Hwadhamchunghwa-tang can be used. Shin type or Gi type, female with prevalence of qi and tendency of fire, female with dark facial color, female with raised eye tails and large noses, female with pointed noses, and male or female with large noses and mouths are likely to possess phlegm-fire. Abdominal discomfort of male with thick eyebrow and headache of Gi type female is usually caused by phlegm-fire.