Treating GERD Successfully: Beyond Heartburn Relief
Gastroenterology Summary and Comment
Free
A short questionnaire helps identify whether patients on therapy for GERD are experiencing sleep disturbance and might benefit from an adjustment in therapy.
By David A. Johnson, MD
May 17, 2013
Covering:
Moayyedi P et al., Aliment Pharmacol Ther 2013 Apr; 37:730
Fundoplication vs. Optimal Medical Management for Chronic GERD
General Medicine Summary and Comment
In the long run, patients with gastroesophageal reflux disease experienced greater improvements with surgery.
Labeling Symptoms as GERD Increases Parents' Desire for Medication
Labeling regurgitation and irritability as gastroesophageal reflux disease promotes overmedication.
Bleeding Ulcers in Helicobacter pylori –Infected Aspirin Users
General Medicine Summary and Comment
After <$EMPH_O>H. pylori<$EMPH_C> eradication, recurrent ulcer bleeding is uncommon, despite ongoing aspirin use.
By Allan S. Brett, MD
March 28, 2013
Covering:
Chan FKL et al., Gastroenterology 2013 Mar; 144:528
New Guidelines on GERD
Gastroenterology Clinical Practice Guideline Watch
Free
The latest update on best practices from the American College of Gastroenterology
By David A. Johnson, MD
March 15, 2013
Covering:
Katz PO et al., Am J Gastroenterol 2013 Mar; 108:308
Does H. pylori Affect Ulcer Bleeding in Aspirin Users?
Gastroenterology Summary and Comment
Incidence of peptic ulcer rebleeding is low after <$EMPH_O>Helicobacter pylori<$EMPH_C> eradication, but high in patients with no history of infection.
A Magnetic Sphincter Device Shows Promise for GERD
Gastroenterology Summary and Comment
Esophageal acid exposure was significantly reduced in 64% of patients who had the device surgically implanted.
By David A. Johnson, MD
February 20, 2013
Covering:
Ganz RA et al., N Engl J Med 2013 Feb 21; 368:719
Which Transfusion Strategy Is Best for Acute Upper Gastrointestinal Bleeding?
Hospital Medicine Summary and Comment
A restrictive transfusion approach led to superior clinical outcomes, including a better survival rate.
By Aaron J. Calderon, MD, FACP
February 15, 2013
Covering:
Villanueva C et al., N Engl J Med 2013 Jan 3; 368:11
Laine L., N Engl J Med 2013 Jan 3; 368:75
Citalopram Reduces GERD Symptoms in Hypersensitive Esophagus
Gastroenterology Summary and Comment
This selective serotonin reuptake inhibitor showed promise in a small clinical trial of patients who did not respond to acid suppressants.
By David A. Johnson, MD
January 18, 2013
Covering:
Viazis N et al., Am J Gastroenterol 2012 Nov; 107:1662
Discontinue Aspirin After Hospitalization For Bleeding Peptic Ulcer?
Gastroenterology Summary and Comment
Not in patients with cardiovascular comorbidities, who are at elevated short-term risk for death and acute cardiovascular events.
Use of Screening Upper Endoscopy in Gastroesophageal Reflux Disease: Best Practices
Gastroenterology Clinical Practice Guideline Watch
New guidance from the American College of Physicians aims to prevent unnecessary procedures and their associated complications and costs.
By David A. Johnson, MD
December 7, 2012
Covering:
Shaheen NJ et al., Ann Intern Med 2012 Dec 4; 157:808
Allen JI., Ann Intern Med 2012 Dec 4; 157:827
Ablative Therapy for Barrett Esophagus: Caveat Emptor
Gastroenterology Summary and Comment
Free
Cancer can still occur after successful eradication of dysplasia with radiofrequency ablation.
By David A. Johnson, MD
November 16, 2012
Covering:
Titi M et al., Gastroenterology 2012 Sep; 143:564
Radiofrequency Ablation Is Cost-Effective for High-Grade Dysplasia in Barrett Esophagus
Gastroenterology Summary and Comment
However, it is most likely prohibitively expensive for low-grade dysplasia, especially if costs of anesthesia are included in the analysis.
By David A. Johnson, MD
November 16, 2012
Covering:
Hur C et al., Gastroenterology 2012 Sep; 143:567
No Evidence of Cancer Risk from Long-Term PPI Therapy
Gastroenterology Summary and Comment
Hormonal and histologic changes observed with long-term use of proton-pump inhibitors do not seem to translate into an elevated risk for mucosal gland atrophy or cancer.
Proton-Pump Inhibitors Often Are Prescribed Inappropriately at U.S. Teaching Hospitals
Hospital Medicine Summary and Comment
Free
Most prescriptions for PPIs lacked a valid indication.
Is Helicobacter pylori Eradication Sufficient for Bleeding Ulcers?
Gastroenterology Summary and Comment
A prospective study suggests that peptic ulcer rebleeding is very unusual after <$EMPH_O>H. pylori<$EMPH_C> eradication and that maintenance antiulcer therapy may not be needed.
Shifting Causes of Peptic Ulcer Disease
Gastroenterology Summary and Comment
An observational study supports prior findings of less PUD attributed to H. pylori infection and more attributed to use of NSAIDs, particularly aspirin.
Must We Stop Prophylactic Aspirin in Patients Who Develop Peptic Ulcers?
General Medicine Summary and Comment
Proton-pump inhibitors usually heal aspirin-associated ulcers, even if aspirin is continued.
By Allan S. Brett, MD
July 26, 2012
Covering:
Liu C-P et al., Am J Gastroenterol 2012 Jul; 107:1022
Proton-Pump Inhibitors Reduce NSAID-Associated Ulcers in Japan
Gastroenterology Summary and Comment
In a double-blind, placebo-controlled trial, esomeprazole was effective in preventing NSAID-associated ulcers in Japanese patients with a history of peptic ulcers.
Bleeding Peptic Ulcers in Patients With vs. Without Cirrhosis
Gastroenterology Summary and Comment
A small study supports previous observations of distinctive etiologies but similar responses to treatment.
H. pylori Infection and Ulcer Risk: Genetic Strain Matters
Gastroenterology Summary and Comment
Free
In a 5-year longitudinal study, only <$EMPH_O>H. pylori<$EMPH_C> infection positive for cytotoxin-associated gene A increased the risk for gastric and duodenal ulcers.
Combined Ibuprofen/Famotidine Tablet Might Reduce Ulcers
Gastroenterology Summary and Comment
Patients receiving the combination tablet developed fewer upper gastrointestinal ulcers than those receiving ibuprofen alone.
Low-Dose or High-Dose PPI Therapy After Endoscopic Hemostasis?
Gastroenterology Summary and Comment
A small study conducted in Taiwan suggests that after successful endoscopic hemostasis in patients with bleeding peptic ulcers, low- and high-dose pantoprazole are equally effective.
Mortality from Peptic Ulcer Bleeding for Patients Admitted on Holidays
Gastroenterology Summary and Comment
A large study conducted in Hong Kong suggests that Sunday or holiday admission does not worsen outcomes if therapeutic endoscopy is performed promptly.
Treating Suspected EoE: Do Not Use pH Monitoring as a Guide
Gastroenterology Summary and Comment
In a prospective study of patients with confirmed eosinophilic esophagitis, pH was a poor predictor of response to treatment.
By David A. Johnson, MD
March 30, 2012
Covering:
Francis DL et al., Aliment Pharmacol Ther 2012 Jan; 35:300
