• 대한한방내과학회지
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• 제38권4호
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• pp.520-530
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• 2017

Objectives: Gastro-esophageal reflux-induced chronic cough is not easy to diagnose and treat. In this study, three patients diagnosed with this disease were treated with Ojeok-san plus Saengmaek-san. Methods: Three patients with chronic cough, suspected to be gastro-esophageal and reflux-based, were diagnosed according to symptoms and abdominal examinations. They were treated with the herbal medicine, Ojeok-san plus Saengmaek-san. To evaluate the effectiveness of the treatment, a visual analogue scale (VAS) for measuring the severity of a cough and the Korean version of the Leicester Cough Questionnaire (LCQ-K) were used to determine the patients' quality of life. Results: After administration of Ojeok-san plus Saengmaek-san, the severity of the patients' coughing decreased based on VAS scores and quality of life improved based on LCQ-K scores for all patients. Conclusions: Ojeok-san plus Saengmaek-san is a potent therapeutic agent for gastro-esophageal reflux-induced chronic cough.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권2호
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• pp.107-121
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• 2019

The diagnosis and management of gastro-esophageal reflux (GER) and GER disease (GERD) in infants and children remains a challenge. Published guidelines and position papers, along with Embase, MEDLINE, and the Cochrane Database were reviewed and summarized with the intent to propose a practical approach and management of GER and GERD for healthcare providers and to standardize and improve the quality of care for infants and children. For this purpose, 2 algorithms were developed, 1 for infants <12 months of age and the other for older children. None of the signs and symptoms of GER and GERD are specific and there is no gold standard diagnostic test or tool. Nutritional management is recommended as a first-line approach in infants, while in children, a therapeutic trial with antacid medication is advised for early management. The practical recommendations from this review are intended to optimize the management of GER in infants and older children and reduce the number of investigations and inappropriate use of medication.

• 대한기관식도과학회지
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• 제19권1호
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• pp.11-14
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• 2013

Gastro-esophageal reflux disease (GERD) is a recurrent, long-term gastrointestinal condition characterised by the abnormal reflux of stomach contents into the esophagus. Heartburn is the most dominant symptom, which can be life long and can considerably reduce quality of life. The main goals of treatment are to alleviate symptoms and prevent relapses, esophageal stricture and adenocarcinoma. This paper presents a review comparing the effectiveness of omeprazole with Nissen fundoplication surgery for the treatment of GERD. Nissen fundoplication is more effective in controlling heartburn symptoms, healing esophagitis and preventing relapses than omeprazole. Quality of life, in terms of productivity and ability to work, is difficult to assess in the omeprazole group and, as a result, a comparison of this aspect is limited. Although fundoplication is expensive in the short term, it is more cost-effective than omeprazole. Nurses need to be aware of the effectiveness of omeprazole and fundoplication to provide patients with accurate information, which assists patients in decision making regarding treatment options.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제7권1호
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• pp.48-53
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• 2004

목 적: 기계적 환기 요법 시 삽입된 비위관으로 인한 식도 운동 기능의 저하와 가해진 양압이 위식도 압력차를 감소시켜 미숙아에서 위식도 역류가 증가한다고 알려져 있으나, 아직 국내에서는 보고된 바가 없기에 본 연구에서는 미숙아에서 기계적 환기 요법이 위식도 역류에 미치는 영향과 유발 요인을 조사하였다. 방 법: 2000년부터 2004년까지 부산대학교병원 신생아 집중치료실에 입원하여 신생아 호흡 곤란 증후군, 신생아 가사 등의 원인으로 기계적 환기 요법을 받은 11명을 대상으로 하였다. 24시간 식도 산도 측정은 DIGITRAPPER MK III (Synectics Medical AB, Stockholm, Sweden)를 이용하였고, 탐촉자로는 antimony electrode를 사용하였다. 역류의 정도를 알아보는 지표들로는 역류 지수, 역류 횟수, 5분 이상 지속되는 역류 횟수, 가장 긴 역류의 지속 시간, 총 역류 횟수 중 5분 이상 지속된 역류 횟수의 비 등 5개의 지표 중 2개 이상이 기준에 합당할 경우 의미있는 위식도 역류로 정의하였다. 결 과: 전체 환아의 평균 재태 기간은 30.9주, 출생시의 평균 체중은 1,568 g, 검사 당시의 평균 나이는 2.8일이었다. 미숙아 중 4명(남아 3명, 여아 1명)에서 의미있는 위식도 역류가 있었다. 역류가 없었던 군이 재태 기간이 짧았고, 평균 체중이 작았으며, 검사 당시의 평균 나이가 많은 경향은 보였지만 대상 수가 적어 통계학적인 의미를 두기 어려웠다. 의미있는 위식도 역류가 동반된 군과 역류가 없었던 군 사이에 호흡기 설정에서는 의미있는 차이가 없었다. 결 론: 본 연구에서 위식도 역류를 증가시키는 요인을 발견할 수는 없었으며, 기계적 환기 요법시 위식도 역류의 빈도가 이전 연구들과 비슷한 결과를 보여 기계적 환기 요법이 미숙아의 위식도 역류에 큰 위험 요인은 아닌 것으로 판단된다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제26권4호
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• pp.173-180
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• 2023

Purpose: Gastro esophageal reflux disease (GERD) is a burdensome disease affecting many children. A clinical examination is reported to be unreliable to diagnose GERD in children. This study aimed to investigate the relationship between the Pediatric Gastroesophageal Reflux Disease Symptom and Quality of Life Questionnaire (PGSQ) and endoscopic and histopathological findings in children with symptoms suggesting GERD. Changes in the PGSQ score in children with esophagitis as response to one month therapy were recorded as secondary outcome. Methods: This is a prospective cohort study in the pediatric outpatient clinic in an Indonesian tertiary hospital. Children aged 2-17 years old with clinical symptoms suspected of GERD are included in the study. Blinded endoscopic and histopathological examination was performed in all patients before one month proton pump inhibitors (PPI) therapy. The PGSQ information was collected at inclusion and after one month PPI treatment. Results: Fifty-eight subjects were included. Esophagitis was found in 60.9% of subjects according to endoscopy and 58.6% according to histology. There was no significant relationship between the PGSQ score and endoscopic (p=0.781) nor biopsy (p=0.740) examinations. The PGSQ showed a low diagnostic value compared to endoscopy and biopsy (area under the curve [AUC] 0.477, p=0.477, 95% confidence interval [CI] 0.326-0.629 and AUC 0.474, p=0.740 (95% CI 0.321-0.627 respectively). The PGSQ improved significantly post one month of PPI treatment. Conclusion: The PGSQ cannot be used to diagnose esophagitis in children with clinical symptoms suggesting GERD. However, the PGSQ can be used to monitor the treatment response in children with esophagitis.

• 사상체질의학회지
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• 제24권3호
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• pp.93-103
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• 2012

Objectives Rate of gastroesophageal reflux disease accompanied by irritable bowel syndrome is on the increase. This case study reports significant improvement of patients with gastroesophageal reflux disease and irritable bowel syndrome who had suffered from chest pain, globus pharyngis and diarrhea after taking Sasang constitutional treatment. Methods This patient was diagnosed as Large Yin type Esophagus Cold pattern(Taeeumin Wiwanhanjeung). Herb medicine(Jowiseungcheong-tang) was taken by the patient, three or two times per day during treatment periods. We assessed the changes of the main symptoms such as chest pain, globus pharyngis, defecation discomfort, insomnia et al. using visual analogue scale(VAS). Results The symptoms of chest pain, globus pharyngis, defecation discomfort, insomnia decreased from VAS 7~8 to VAS 0~1 for about three months. Conclusions This case shows that Sasang constitutional medicine treatment can be effective treatment method for gastroesophageal reflux disease accompanied by irritable bowel syndrome.

• Restorative Dentistry and Endodontics
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• 제43권1호
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• pp.13.1-13.7
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• 2018

Dental erosion is frequently overlooked in clinical practice. The management of erosion-induced damage to the dentition is often delayed, such that extensive occlusal rehabilitation is required. These cases can be diagnosed by a careful clinical examination and a thorough review of the patient's medical history and/or lifestyle habits. This case report presents the diagnosis, categorization, and management of a case of gastro-esophageal reflux disease-induced palatal erosion of the maxillary teeth. The early management of such cases is of utmost importance to delay or prevent the progression of damage both to the dentition and to occlusal stability. Non-invasive adhesively bonded restorations aid in achieving this goal.

• 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.

• 대한한방내과학회지
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• 제37권6호
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• pp.1030-1041
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• 2016

Objectives: This study investigated the administration of Jeungmiyijin-tang (JYT) to rats with reflux esophagitis (RE) induced by pylorus and forestomach ligation operations. Methods: Twenty laboratory rats were divided into three groups with 5~7 rats in each group. The control group consisted of rats with no inflammation (CON). The RE group had rats with gastroesophageal reflux elicited by pylorus and forestomach ligation operations. The JYT group had rats that were orally administered Jeungmiyijin-tang (1.5 ml/day/300 g) once a day for 14 days before reflux esophagitis was induced by the pylorus and forestomach ligation operations. Six hours after the operations, the rats were sacrificed, morphological changes were observed, and histological examinations were done in the stomach and esophagus lesion areas. If apoptosis was observed, the apoptotic cells in the esophagus lesion areas were counted. Results: The morphological and histochemical changes consisted of various injuries from hemorrhagic erosion in the RE group, while there were significantly fewer in the JYT group. The RE group marked increases of gastric mucosa erosion and infiltration of inflammatory cells in the submucosa, as well as cell division in the epithelial layer, the proliferation and degranulation of mast cells, and increases in the IL-$1{\beta}$, TNF-${\alpha}$, and MMP-9 expressions in the esophagus of the rats. The JYT group was inhibited above expression compared with the RE group. Apoptosis was statistically significantly decreased in the JYT group compared with the RE group. Conclusions: According to the above results, it appears that Jeungmiyijin-tang inhibits the expression of pro-inflammatory cytokines (TNF-${\alpha}$, IL-$1{\beta}$, and MMP-9) and apoptosis in the esophagus mucosa, thereby preventing esophageal mucosal damage from esophageal reflux.

• 사상체질의학회지
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• 제23권1호
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• pp.132-138
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• 2011

1. Objectives: This case study reports a Taeumin patient with Gastro-esophageal reflux disease who had suffered from chest pain, heartburn, acid regurgitation and dyspepsia who improved after Yeoldahanso-tang(Reduohanshao-tang) medication. 2. Methods: This patient had started treatment with Yeoldahanso-tang(Reduohanshao-tang), three times per day for three months and assessed the changes of the main symptoms such as chest pain, heartburn and acid regurgitation from baseline to post-treatment using a questionnaire with visual analogue scale(VAS). Electrogastrography(EGG) was also performed for assessment of gastric function from baseline to post-treatment. 3. Results: After the treatment, symptoms of GERD such as chest pain, heartburn, and acid regurgitation are almost disappeared. The patient don't need to take the proton pump inhibitor therapy. There was significant increase of % bradygastria parameters in fed EEG after treatment with Yeoldahansotang(Reduohanshao-tang). And significant increase of the power ratio after treatment was shown (20.5), compared with initial EGG(0.0). 4. Conclusions: This results show Yeoldahanso-tang(Reduohanshao-tang) can be used to treat GERD with Dry-heat symptom of Taeumin. This results suggest that Sasang Constitutional treatment for GERD patients who has a chronic condition with highly recurrence rate, might be a candidate for a therapeutic agent. Also effects of Yeoldahanso-tang(Reduohanshaotang) on GERD need further studies such as clinical trials.