• Journal of Chest Surgery
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• 제53권4호
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• pp.217-221
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• 2020

Gastroesophageal reflux is a common problem after gastroesophageal resection and reconstruction, despite the routine prescription of proton pump inhibitors (PPIs). Resection of the lower esophageal sphincter and excision of the vagus nerve are generally thought to be the main factors that interfere with gastric motor function. However, physiological studies of reflux symptoms after esophagectomy are still lacking. Gastroesophageal reflux occurs frequently after esophagectomy, but there is no known effective method to prevent it. Therefore, in order to manage gastroesophageal reflux after esophagectomy, strict lifestyle modifications and gastric acid suppression treatment such as PPIs are needed, and further clinical studies are required.

• 셀메드
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• 제13권4호
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• pp.15.1-15.6
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• 2023

Objective: A case report on improving the symptoms of patients with reflux esophagitis by Ortho-Cellular Nutrition Therapy (OCNT). Methods: A 61-year-old Korean male who has been taking proton-pump inhibitors in the hospital for a long time due to the symptoms of reflux esophagitis. Results: The practice of Ortho-Cellular Nutrition Therapy (OCNT) restored the patient's mucosal cells of the esophageal sphincter, which led to the judgment that he was cured of reflux esophagitis. Conclusion: Ortho-Cellular Nutrition Therapy (OCNT) can be effective in relieving the symptoms of patients with reflux esophagitis.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제4권2호
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• pp.133-141
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• 2001

위식도역류는 영아들에 있어서 흔하게 있다고 알려져 있고 특히 미숙아들에게 더 흔히 있다고 알려져 있지만 아직 이에 대한 연구는 부족하다. 목적: 건강하게 자라고 있는 미숙아들에게 위식도역류의 진단에 가장 예민하다고 알려져 있는 24시간 식도 pH 검사를 통하여 그 빈도 및 연관 인자를 찾고자 하였다. 방법: 특이 증상 없이 건강하게 자라고 있는 미숙아 21명(평균 재태기간: $30+{\pm}2+0$주, 출생시의 평균 체중은 $1,468{\pm}329$ g, 검사 당시의 평균 나이는 $29{\pm}8$일, 수태 후 나이(Postconceptional age: 재태기간+출생 후 나이)는 $34+6{\pm}1+4$주, 체중은 $1,750{\pm}329$ g, 남아 : 여아=15:6)을 대상으로 휴대용 레코더가 연결되어 있는 실리콘 재질의 마이크로 소식자를 Stobel의 공식($0.252{\times}$키+5 (cm))에 따라 코로 넣어 그 거리만큼 식도내강에 위치시킨 후 거리를 교정하여 24시간 동안 식도 pH 검사를 시행하였다. 결과: 네 가지 파라미터(number of acid reflux, number of long acid reflux (5 min), longest acid reflux minutes, RI)를 제시하였고 전체 대상환아의 57%에서 유의한 위식도역류가 있음을 보였다. 위식도역류와 number of acid reflux, RI의 두 파라미터가 통계적으로 의미있는 상관관계를 보였으며 이 두 파라미터와 Reflux index of the postprandial 120 min간에도 의미있는 상관관계가 있음을 알 수 있었다. 위식도역류가 있는 환아들을 출생체중, 재태기간, 검사 당시의 나이, 수태 후 나이, 체중, 성별 및 테오필린(theophylline) 투약 여부에 따라 각각 구분하여 그 차이를 살펴보았고 모두 통계학적으로 큰 차이는 없었다. 소식자의 거리는 Stobel의 공식에 의한 거리와 실제길이 사이에 차이가 있어 우리의 미숙아의 경우에는 $0.252{\times}$키+3.7 (cm)로 적용시킬 수 있었다. 결론: 위와 같은 결과로 미숙아들에게 있어서 무증상적, 유의한 위식도역류가 57%의 높은 빈도로 나타났고, 위식도역류증의 진단에 가장 중요한 파라미터는 number of acid reflux, RI와 Reflux index of the postprandial 120 min로 나타났다. 출생체중, 재태기간, 검사 당시의 나이, 수태 후 나이, 체중 및 성별, 테오필린 투약여부 등과 위식도역류와는 통계적으로 유의성이 없었다. 또한 1세 이하의 영아에게 소식자의 위치를 정하는데 사용되는 Strobel의 공식을 본 연구대상 미숙아들에게 적용해본 결과 소식자의 위치가 $0.252{\times}$키+3.7(cm)로 나타났다.

• 대한한의학회지
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• 제39권2호
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• pp.92-105
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• 2018

Objectives: This aim of this study is to compare the reflux esophagitis improvement effects of Sepiae Os, Arcae Concha, Ostreae Concha, and Proton Pump Inhibitor(esomeprazole) through rat experiments. Methods: NO production inhibitory effect was measured by NO production amount and iNOS mRNA expression level in cell lines. iNOS, $TNF-{\alpha}$ and $p-I{\kappa}B$, and serotonin were compared using immunohistochemistry at the rat reflux esophagitis. Reflux esophagitis connection external form, lower esophageal sphincter, and gap were observed and an esophageal inflammatory indicator, IL-6 activity was also evaluated by immunohistochemistry. Results: NO production and iNOS mRNA expression was showed concentration dependent decrease in cell lines treated with Sepiae OS, Arcae Concha, and Ostreae Concha at the experiments of cell lines. In the suppression of iNOS and $p-I{\kappa}B$ at the rat reflux esophagitis, Sepiae Os treat group(SOT) and Ostreae Concha treat group(OCT) were more effective. In the increase of serotonin at the rat reflux esophagitis, ACT, MT and OCT were more effective. Damage of lower esophageal sphincter, and gap between esophageal keratin and mucosa were observed less at the SOT, ACT, OCT. In the suppression of IL-6 at the rat reflux esophagitis, SOT and OCT were more effective than GE and, SOT was more effective than MT significantly. Conclusions: The anti-inflammatory effect was the best in the SOT and lower esophageal sphincter muscle contraction was the best in the ACT at the rat reflux esophagitis. Sepiae OS was more effective than esomeprazole in the suppression of iNOS, $TNF-{\alpha}$, and IL-6.

• Journal of Gastric Cancer
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• 제20권3호
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• pp.337-343
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• 2020

Distal gastrectomy with Billroth I or II reconstruction may cause duodenogastroesophageal reflux (DGER), thereby resulting in digestive or respiratory symptoms. The mainstay of treatment is medication with proton pump inhibitors. However, these drugs may have limited effects in DGER. Laparoscopic fundoplication has been proven to be highly effective in treating gastroesophageal reflux disease (GERD), but it cannot be performed optimally for GERD that develops after gastrectomy. We report the case of a 72-year-old man with a history of distal gastrectomy and Billroth I anastomosis due to early gastric cancer. GERD due to bile reflux occurred after surgery and was refractory to medical therapy. The patient underwent Roux-en-Y conversion from Billroth I gastroduodenostomy and hiatal hernia repair with only cruroplasty. Fundoplication was not performed. His symptoms improved significantly after the surgery. Therefore, laparoscopic hiatal hernia repair and Roux-en-Y conversion can be an effective surgical procedure to treat medically refractory DGER after Billroth I gastrectomy.

• 대한후두음성언어의학회지
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• 제27권2호
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• pp.78-83
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• 2016

Laryngopharyngeal reflux (LPR) disease is an extraoesophageal variant of gastro-esophageal reflux disease that can affect the larynx and pharynx. LPR is associated with symptoms of laryngeal irritation such as throat clearing, coughing, and hoarseness. The main diagnostic methods currently used are laryngoscopy and pH monitoring. The most common laryngoscopic signs are redness and swelling of the throat. However, these findings are not specific of LPR and may be related to other causes or can even be found in healthy individuals. Furthermore, the role of pH monitoring in the diagnosis of LPR is controversial. A therapeutic trial with proton pump inhibitors (PPIs) has been suggested to be cost-effective and useful for the diagnosis of LPR. However, the recommendations of PPI therapy for patients with a suspicion of LPR are based on the results of uncontrolled studies, and high placebo response rates suggest a much more complex and multifactorial pathophysiology of LPR than simple acid reflux. Laryngoscopy and pH monitoring have failed as reliable tests for the diagnosis of LPR. Empirical therapy with PPIs is widely accepted as a diagnostic test and for the treatment of LPR. However, further research is needed to develop a definitive diagnostic test for LPR.

• Childhood Kidney Diseases
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• 제7권1호
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• pp.106-111
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• 2003

저자들은 발열과 급성 음낭증으로 내원한 4개월 남아에서 요로감염과 급성 부고환염을 진단한 뒤 시행한 배뇨중 방광요도 조영술상, 요도의 폐쇄가 없이도 방광요관 역류와 요도정낭 역류가 함께 존재하는 증례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. 또한 영아에서 급성 부고환염이 의심될 때 요로계 영상검사를 반드시 실시하여 신손상이나 불임으로 진행할 수 있는 조건들이 있는 지 살펴 볼 것을 제안하는 바이다.

• The Korean Journal of Physiology and Pharmacology
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• 제16권6호
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• pp.455-462
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• 2012

This study was designed to determine the protective effect of Rumex Aquaticus Herba extracts containing quercetin-3-${\beta}$ -D-glucuronopyranoside (ECQ) on experimental reflux esophagitis. Reflux esophagitis was induced by surgical procedure. The rats were divided into seven groups, namely normal group, control group, ECQ (1, 3, 10, 30 mg/kg) group and omeprazole (30 mg/kg) group. ECQ and omeprazole groups received intraduodenal administration. The Rats were starved for 24 hours before the experiments, but were freely allowed to drink water. ECQ group attenuated the gross esophagitis significantly compared to that treated with omeprazole in a dose-dependent manner. ECQ decreased the volume of gastric juice and increased the gastric pH, which are similar to those of omeprazole group. In addition, ECQ inhibited the acid output effectively in reflux esophagitis. Significantly increased amounts of malondialdehyde (MDA), myeloperoxidase (MPO) activity and the mucosal depletion of reduced glutathione (GSH) were observed in the reflux esophagitis. ECQ administration attenuated the decrement of the GSH levels and affected the MDA levels and MPO activity. These results suggest that the ECQ has a protective effect which may be attributed to its multiple effects including anti-secretory, anti-oxidative and anti-inflammatory actions on reflux esophagitis in rats.

• 대한후두음성언어의학회지
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• 제32권2호
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• pp.56-63
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• 2021

Laryngopharyngeal reflux disease (LPRD) is an inflammatory condition of the upper aerodigestive tract mucosa induced by reflux content from stomach. Some of vocal cord diseases are associated with laryngopharyngeal reflux. Because of the pathophysiological features, proton pump inhibitor shows therapeutic effect on some vocal cord diseases. As like that, the gastric reflux contents can make macroscopic or microscopic morphological changes in the upper aerodigestive tract mucosa. Although the pathophysiology of LPRD is relatively clear, clinical diagnosis is still difficult. The diagnosis of LPRD includes objective tests such as 24-hours multichannel intraluminal impedance-pH metry and subjective tests such as questionnaire method. However, the objective verification of reflux is difficult due to invasiveness of the method, and the questionnaire methods have limitations because many symptoms are not specific for LPRD. Moreover, most methods are not fully standardized until now. Despite these limitations, many researchers are struggling to standardize diagnosis and treatment of LPRD, and there are several new achievements recently. Therefore, the purpose of this article is to review the recent literature on the clinical presentation, diagnosis, and treatment of LPRD, and to systematize our knowledge.

• 대한한방내과학회지
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• 제43권6호
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• pp.1239-1246
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• 2022

Objectives: The purpose of this study was to report the effectiveness of Korean medicine in the treatment of reflux esophagitis. Methods: A 62-year-old male patient had reflux esophagitis that occurred one year after a proximal gastrectomy for gastric ulcer in 2020. The patient underwent drug treatment in 2021 and inpatient treatment in 2022 at Mokpo Hankook Hospital, but he did not improve. We treated him with Korean medical treatments, including herbal medicines (Pyungjingunbi-tang-gami), acupuncture, and moxibustion. His symptom severity was assessed with a daily visual analog scale (VAS) for heartburn, upper abdomen pain, and acid reflux. Results: After treatment, the patient's symptoms were improved. The severity of heartburn and acid reflux was reduced from VAS 7 to VAS 1, and his upper abdomen pain was improved from VAS 6 to VAS 1. The symptom frequency was also reduced. Conclusion: Korean medicine treatment could be an effective and quick treatment for reflux esophagitis.