A Murky Relationship Between GERD and Interstitial Lung Disease
Gastroenterology Summary and Comment
Previous studies document a high prevalence of GERD in patients with idiopathic pulmonary fibrosis but provide no evidence of causality.
By David A. Johnson, MD
February 3, 2012
Covering:
Hershcovici T et al., Aliment Pharmacol Ther 2011 Dec; 34:1295
PPIs Don't Ease Asthma Symptoms in Children with Severe Asthma and Asymptomatic GERD
General Medicine Summary and Comment
In addition, lansoprazole raised the incidence of adverse events.
By David J. Amrol, MD
February 2, 2012
Covering:
Holbrook JT et al., JAMA 2012 Jan 25; 307:373
Martinez FD., JAMA 2012 Jan 25; 307:406
PPIs and CAP, Revisited
Infectious Diseases Summary and Comment
In a retrospective, nested case-control study, the risk for community-acquired pneumonia was 29% higher with current use of a proton-pump inhibitor than with past use.
By Neil M. Ampel, MD
January 18, 2012
Covering:
Hermos JA et al., Clin Infect Dis 2012 Jan 1; 54:33
A New Four-Drug Regimen for H. pylori Infection?
Gastroenterology Summary and Comment
Eradication was better than with standard triple therapy.
Sequential Therapy Bests Triple Therapy for H. pylori Infection
Gastroenterology Summary and Comment
Eradication rates were higher; adverse events were similar.
Diagnosing Gastroenterological Causes of Noncardiac Chest Pain
Gastroenterology Summary and Comment
Free
Endoscopy and pH tests should be used to confirm GERD status to guide decisions on treatment with PPIs and the need for further diagnostic testing.
A New Way to Assess Risk in Upper Gastrointestinal Bleeding?
Gastroenterology Summary and Comment
An assessment of five readily available measures in emergency settings could improve patient triage and outcomes.
Gastrointestinal Bleeding with Low-Dose Aspirin
Gastroenterology Summary and Comment
A meta-analysis supports evidence of increased risk for GI bleeding from low-dose aspirin alone and in combination with clopidogrel or anticoagulants.
Can Celecoxib or Helicobacter pylori Eradication Reduce Gastric Lesions?
Gastroenterology Summary and Comment
Regression of precancerous lesions was better with either treatment than with placebo.
Predictors of Rebleeding After Endoscopic Therapy for Peptic Ulcers
Gastroenterology Summary and Comment
Risk factors were hemodynamic instability, a low hemoglobin value, active bleeding, large ulcer size, and an ulcer in the posterior duodenum or high on the lesser gastric curve.
Radiofrequency Ablation for Dysplastic Barrett Esophagus: Do Results Last?
Gastroenterology Summary and Comment
An ongoing trial suggests long-term effectiveness of the procedure, although further evidence might be needed for treatment of low-grade dysplasia.
By David A. Johnson, MD
November 4, 2011
Covering:
Shaheen NJ et al., Gastroenterology 2011 Aug; 141:460
Estrogen Might Protect Against Duodenal Ulcers
Gastroenterology Summary and Comment
Results of a large population-based study support the hypothesis that estrogen promotes duodenal bicarbonate secretion, which lowers the risk for ulcers.
Screening and Surveillance of Barrett Esophagus Might Not Be Justifiable
Gastroenterology Summary and Comment
Free
A large, population-based study adds to a growing body of evidence that the incidence of cancer or dysplasia in patients with BE is lower than previously suggested.
By David A. Johnson, MD
October 21, 2011
Covering:
Hvid-Jensen F et al., N Engl J Med 2011 Oct 13; 365:1375
Kahrilas PJ., N Engl J Med 2011 Oct 13; 365:1437
Upper GI Bleeding: Still a Substantial Cause of Death in the U.K.
Gastroenterology Summary and Comment
The in-hospital mortality rate was 10% overall; Rockall score was highly predictive of mortality.
No "Weekend Effect" for Upper GI Bleeding in the U.K.
Gastroenterology Summary and Comment
Outcomes were similar whether patients presented to hospitals on weekends or during the week.
End-Stage Renal Disease Increases Risk for Gastrointestinal Rebleeding
Gastroenterology Summary and Comment
A study of Taiwanese hospitalizations is the first to evaluate long-term risks for peptic ulcer rebleeding in patients with ESRD.
How Often Does Barrett Esophagus Progress to Cancer?
Gastroenterology Summary and Comment
A low cancer incidence documented in the U.K. suggests the need to review current surveillance standards for BE, particularly among patients without specialized columnar metaplasia.
By David A. Johnson, MD
August 19, 2011
Covering:
Bhat S et al., J Natl Cancer Inst 2011 Jul 6; 103:1049
Ulcers Heal While Patients Continue Aspirin Therapy
Gastroenterology Summary and Comment
Efficacy of rabeprazole in treating ulcers was high with either aspirin or clopidogrel.
Eosinophilic Esophagitis Should Not Be Diagnosed by Histology Alone
Gastroenterology Summary and Comment
Response to high-dose proton-pump inhibitors suggests diagnoses other than EoE.
By David A. Johnson, MD
August 12, 2011
Covering:
Molina-Infante J et al., Clin Gastroenterol Hepatol 2011 Feb; 9:110
PPIs Are the Most Effective Drugs to Reduce Risk for Upper GI Bleeding
Gastroenterology Summary and Comment
Proton-pump inhibitors bested histamine-2–receptor antagonists and nitrates in patients taking gastrotoxic drugs and in the general population.
Helicobacter pylori Therapy in Latin America: Triple-Drug Regimen Still Best
Gastroenterology Summary and Comment
Standard 14-day triple-drug therapy — despite its suboptimal eradication rate — was more effective than shorter-duration concomitant or sequential four-drug regimens.
Which Scoring System Best Predicts Outcomes of Upper Gastrointestinal Bleeding?
Gastroenterology Summary and Comment
Glasgow-Blatchford and Rockall scores were similarly effective, but comparing systems is less important than using some method to identify which patients need early and vigorous therapy.
Nonadherence to Gastroprotective Therapy Among NSAID Users
Gastroenterology Summary and Comment
Low adherence increased risk for upper gastrointestinal bleeding.
PPI Cotherapy Is Cost-Effective in Patients Taking Aspirin
Gastroenterology Summary and Comment
Cotherapy with a proton-pump inhibitor and aspirin produced better gastrointestinal and cardiovascular outcomes than aspirin alone and was cost-effective in all age groups.
New Asia-Specific Guidelines for Nonvariceal Upper Gastrointestinal Bleeding
Gastroenterology Summary and Comment
Recommendations take into account varying healthcare resources and the epidemiology of gastrointestinal disease in Asian and Pacific countries.
