• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.17 no.2
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• pp.93-97
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• 2014

Purpose: Gastroesophageal reflux in infant is a physiological process. However, surgery is performed in high risk infants with severe gastroesophageal reflux disease (GERD) when medical management fails. This study focuses on efficacy and safety of Nissen fundoplication for GERD in infants under age 12 months. Methods: This study was a retrospective case analysis of 11 neonates and infants under 12 months of age who underwent Nissen fundoplication following a failure of medical treatment between June 2010 and June 2013 at Pusan National University Children's Hospital. The records were reviewed to determine the effect of fundoplication on symptoms and post-operative complications. Results: A total of 11 infants consist of four males and seven females. Mean birth weight was $2,305.5{\pm}558.6g$ (1,390-3,130 g). They had some underlying disease, which are not related with GERD such as congenital heart disease (54.5%), prematurity (45.5%), neurologic disease (18.2%), respiratory disease (18.2%), and other gastrointestinal disease. Mean body weight at surgery was $3,803.6{\pm}1,864.9g$ (1,938.7-5,668.5 g). Mean age at operation was $99.9{\pm}107.6days$ (17-276 days). Duration from operation to full enteral feeding was 10.9 days. Symptoms related GERD disappeared in all patients including one who got reoperation. One infant died of congenital heart disease unrelated to surgery. There were no complications related to fundoplication. Conclusion: Fundoplication is effective and safe treatment in the neonates and infants with severe GERD.

• Korean Journal of Bronchoesophagology
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• v.2 no.1
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• pp.88-96
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• 1996

In recently the gastroesophageal reflux disease(GERD) has been known to induce the otolaryngologic manifestations. Pharyngeal neurosis is a disease which we could have not found the cause frequently. So we have studied the relation between the pharyngeal neurosis and the GERD among 50 patients who were diagnosed as pharyngeal neurosis after esophagogram and laryngoscopic examination. We performed esophageal manometry and 24hour double-probe pH-metry and then compared with normal control group(n=30). The results are as follows 1 Among 50 patients, 12(24%) patients were diagnosed as GERD by DeMeester scoring. 2. In esophageal manometry, the upper and lower esophageal sphincter between the patients and the control group have no significant difference(p>0.05) and 9 among 50 pateints showed abnormal peristaltic movement in esophageal body contraction. 3. In 24hour double-probe pH-metry, the esophageal probe showed that in GERD group(n= 12) the number of reflux episode, episodes greater than 5 minutes and the percentage of time

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.4
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• pp.341-349
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• 2019

Background: A self-assessment questionnaire, the GERD-Questionnaire (GERD-Q) was used to determine the prevalence of GERD in adolescents, describe the related factors, and determine the impact on quality of life (QoL). Methods: The incidence of GERD was evaluated using the GERD-Q in adolescents aged 12-18 years. The Pediatric Gastroesophageal Reflux Disease Symptom Questionnaire and Quality of Life Questionnaire (PGSQ-A) for adolescents were additionally administered. Some factors considered related to GERD were also evaluated. Results: The 520 adolescents were included. The prevalence of suspected GERD, according to a GERD-Q cutoff score of ${\geq}7$ was 32.9%, and those drinking soda were 1.7 times more likely to have GERD (95% confidence interval, 1.3-2.2; p<0.001). However, soda consumption was not a risk factor for development of GERD symptoms. Applying a cutoff score of ${\geq}8$, only 10.9% of the participants had a positive GERD score, but the association with soda consumption persisted. The median PGSQ-A score in subjects suspected of GERD was 8 (range 0-37) on weekends and 1 (range 0-17) during weekdays (p<0.001) compared to those not suspected of GERD, with a median of 2 (range 0-27) during weekends and 0 (range 0-10) during weekdays. Heartburn, regurgitation, and extraesophageal symptoms correlated significantly with QoL (p<0.001). Conclusion: The prevalence of suspected GERD in adolescents was 32.9% or 10.9%, depending on the cutoff score used. There was a statistically significant difference in PGSQ-A scores between the subjects suspected or not of GERD, indicating an impaired QoL.

• Journal of Neurogastroenterology and Motility
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• v.24 no.4
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• pp.559-569
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• 2018

Background/Aims Gastroesophageal reflux disease (GERD) is a common disease globally with increasing prevalence and consequently greater burden on the Healthcare system. Traditionally, GERD has been considered a disease of middle-aged and older people. Since risk factors for GERD affect a growing number of the adult population, concerns have been raised that increasingly younger people may develop GERD. We aim to determine if the proportion of younger patients has increased among the GERD population. Methods The incidence of GERD as well as several variables were evaluated during an 11-year period. Explorys was used to evaluate datasets at a "Universal" and Healthcare system in northern Ohio to determine if trends at a local level reflected those at a universal level. GERD patients were classified into 7 age groups (15-19, 20-29, 30-39, 40-49, 50-59, 60-69, and ${\geq}70$ years). Results The proportion of patients with GERD increased in all age groups, except for those who were ${\geq}70$ years in the universal dataset (P < 0.001) and those who were ${\geq}60$ years in the Healthcare system (P < 0.001). The greatest rise was seen in 30-39 years in both datasets (P < 0.001). Similarly, the proportion of GERD patients who were using proton pump inhibitors increased in all age groups except for those who were ${\geq}70$ years in both datasets (P < 0.001), with the greatest increase being the group 30-39 years (P < 0.001). Conclusion Over the last decade, there has been a significant increase in the proportion of younger patients with GERD, especially those within the age range of 30-39 years.

• Journal of Digestive Cancer Research
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• v.10 no.2
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• pp.49-55
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• 2022

Helicobacter pylori (H. pylori) infection is associated with gastroduodenal diseases such as gastritis, peptic ulcer diseases, gastric adenocarcinoma, and mucosa-associated lymphoid tissue lymphoma. Furthermore, various extragastroduodenal diseases have been suggested to be related with H. pylori infection. Although no single factor has been considered the cause of gastroesophageal reflux disease (GERD), a negative association was found between the prevalence of H. pylori and GERD severity. Additionally, the role of eradication therapy of H. pylori in reflux esophagitis is controversial, and a significant correlation was found between successful H. pylori eradication rate and reflux esophagitis development. H. pylori infection remains an inconclusive and important issue in GERD. Thus, more experimental studies are necessary to elucidate the potential mechanisms.

• The Journal of Internal Korean Medicine
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• v.41 no.3
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• pp.362-413
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• 2020

Objectives: The purpose of this research is to examine the recent clinical research trends on the efficiency of traditional herb medicine (THM) on gastroesophageal reflux disease (GERD), and to provide clinical evidence of herbal medicine, Banhasasin-tang or Banxiexin decoction by using a systemic review and meta-analysis of randomized trials (RCTs). Methods: In this study, randomized controlled trials (RCTs) were included that verified effects of traditional herbal medicine (THM), including a Banxia-xiexin-tang decoction, as a treatment for GERD. A study of the literature in Chinese and Korean databases was performed for papers published from January 1, 2010, to January 1, 2020. The selected literature was assessed by Cochrane's risk of bias (RoB). Results: A total of 90 RCTs met the inclusion criteria. Except for four RCT studies, all studies identified the effect of a Banxia-xiexin-tang decoction in the treatment of GERD. The effectiveness of treatment was significantly higher in the intervention group than in the control group, as shown through various evaluation indicators, including the reflux disease diagnostic questionnaire (RDQ). Adverse effects were reported in 22 articles (24.44%). Conclusions: Treatment with Banhasasin-tang, or a Banxia-xiexin-tang decoction, was found to be effective in treating GERD. However, due to the low quality of available studies, the significance of this conclusion is somewhat limited. This study could serve as a foundation for further clinical studies on the development of diagnosis and treatment methods for GERD based on Korean medicine.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.25 no.2
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• pp.109-120
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• 2022

Purpose: While regurgitation is a common and often benign phenomenon in infants and younger children, it can also be a presenting symptom of gastroesophageal reflux disease (GERD). If untreated, GERD can lead to dangerous or lifelong complications. Clinical practice guidelines (CPGs) have been published to inform clinical diagnosis and management of pediatric GERD, but to date there has been no comprehensive review of guideline quality or methodological rigor. Methods: A systematic literature search was performed, and a total of eight CPGs pertaining to pediatric GERD were identified. These CPGs were evaluated using the Appraisal of Guidelines for Research and Evaluation instrument. Results: Three CPGs were found to be "high" quality, with 5 of 6 domains scoring >60%, one "average" quality, with 4 of 6 domains meeting that threshold, and the remaining four "low" quality. Conclusion: Areas of strength among the CPGs included "Scope and Purpose" and "Clarity and Presentation," as they tended to be well-written and easily understood. Areas in need of improvement were "Stakeholder Involvement," "Rigor of Development," and "Applicability," suggesting these CPGs may not be appropriate for all patients or providers. This analysis found that while strong CPGs pertaining to the diagnosis and treatment of pediatric GERD exist, many published guidelines lack methodological rigor and broad applicability.

• Korean Journal of Acupuncture
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• v.32 no.1
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• pp.1-12
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• 2015

Objectives : The purpose of this study was to review the acupuncture and moxibustion therapy for gastroesophageal reflux disease(GERD) in China. Methods : The literatures were searched using the database-China Academic Journals(CAJ)(~2015.1.). Clinical studies of acupuncture and moxibustion therapy for GERD such as randomized controlled trial(RCT), non-randomized controlled trial(NRCT), case series, or case report were included. Results : Thirty studies met our inclusion criteria: 24 RCTs, 4 NRCTs, 1 case series, 1 case report. Various kinds of treatment such as body acupuncture, abdominal acupuncture, acupuncture therapy with finger on back-shu point, electroacupuncture, acupoint injection, auricular acupuncture, and moxibustion were used in the clinical studies. The treatment groups take herbal medicines at the same time in 16 studies, and proton pump inhibitor(PPI) and histamine 2 receptor antagonist were used as a comparative treatment in the most of studies. Acupuncture or moxibustion treatments were done daily or 2~3 times a week for 5 days~18 weeks. All of studies reported higher effective rate in the acupuncture or moxibustion treatment group compared to the western medication control group. Conclusions : The results of this study could be used for the future practice and the clinical research about the acupuncture and moxibustion therapy for GERD.

• Korean Journal of Bronchoesophagology
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• v.16 no.2
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• pp.83-90
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• 2010

The pathophysiology of Gastroesophageal reflux disease (GERD) has been known that it is developed when the offense-primarily the gastric acid-pepsin content of the refluxate-overcomes a 3-tiered esophageal protective defense. consisting of antireflux mechanisms, luminal clearance mechanisms, and tissue resistance. Laryngopharyngeal reflux (LPR), which is known as an extraesophageal variant of GERD, has been considered to be developed by transient lower esophageal sphincter relaxation (TLESR), direct mucosal injury by gastric contents, more sensitive mucosa compared to esophagus, and absence of buffering effect and aggravation of the injury due to pepsin. However, hypothesis of the pathophysiology in both entities are numerous and still lack of understanding for being a theory. There is no conflict that understanding the pathophysiology is necessary for resolving the problems of these diseases and numerous studies and results have been releasing. This review could provide clinicians dealing with GERD and LPR with applicable new information and help for overcoming the clinical obstruction.

• The Journal of Internal Korean Medicine
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• v.27 no.4
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• pp.991-998
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• 2006

Gastroesophageal reflux disorder (GERD) refers to reflux of gastric contents into the esophagus leading to esophagitis, reflux symptoms (e.g. heartburn, regurgitation and non-cardiac chest pain) sufficient to impair quality of life, or long term complications. Non-erosive reflux disease (NERD), a subdivision of GERD, is diagnosed when there were some reflux symptoms without esophagitis and mucosal breaks at endoscopy. We report that severe NERD symptoms and lower quality of life which have not responded to more than 6 months' western medical therapy (acid suppression) were successfully improved with traditional oriental medicine.