Empirical Esomeprazole vs. Endoscopy-Guided Treatment for GERD
General Medicine Summary and Comment
Empirical treatment of GERD without alarm symptoms was as effective as and less expensive than endoscopy-guided treatment.
Acid Pockets Might Contribute to GERD
Gastroenterology Summary and Comment
Postprandial gastroesophageal reflux might be exacerbated by acid pockets — small areas of unbuffered acid in the gastric cardia.
Proton-Pump Inhibitors to Prevent NSAID Complications
General Medicine Summary and Comment
Risk for upper GI events was higher when NSAIDs or coxibs were prescribed without PPIs.
By Allan S. Brett, MD
February 21, 2008
Covering:
Abraham NS et al., Am J Gastroenterol 2008 Feb; 103:323
Does Sleep Deprivation Worsen GERD Symptoms?
Gastroenterology Summary and Comment
Sleep deprivation might cause hyperalgesia in patients with GERD via enhanced perception of intraesophageal acid.
By David A. Johnson, MD
February 8, 2008
Covering:
Schey R et al., Gastroenterology 2007 Dec; 133:1787
Idiopathic Duodenal Ulcers and Duodenal H. pylori Infection
Gastroenterology Summary and Comment
Duodenal <$EMPH_O>H. pylori<$EMPH_C> infection may account for a substantial number of duodenal ulcers that previously were classified as idiopathic.
GERD and Aging
Gastroenterology Summary and Comment
Age-related degradation of the gastroesophageal junction and progressive impairment of esophageal clearance result in more-severe GERD.
By David A. Johnson, MD
January 25, 2008
Covering:
Lee J et al., Clin Gastroenterol Hepatol 2007 Dec; 5:1392
Acupuncture vs. Higher PPI Doses for GERD Patients
Gastroenterology Summary and Comment
Can this alternative technique reduce persistent GERD symptoms in patients with incomplete responses to PPIs?
By David A. Johnson, MD
January 4, 2008
Covering:
Dickman R et al., Aliment Pharmacol Ther 2007 Nov 15; 26:1333
How Are GER and Metabolic Syndrome Related?
Gastroenterology Summary and Comment
Univariate analysis shows that the prevalence of GER rises with increases in BMI, blood pressure, triglyceride levels, and fasting blood glucose levels.
By David A. Johnson, MD
November 2, 2007
Covering:
Moki F et al., Aliment Pharmacol Ther 2007 Oct 1; 26:1069
Gastroprotective Cotherapy or Coxibs to Prevent Ulcer Hospitalizations in NSAID Users?
Gastroenterology Summary and Comment
Findings show that PPIs are as effective as coxibs in preventing NSAID-related gastropathy.
Endoscopic Dilation with Medical Therapy for Benign Gastric-Outlet Obstruction
Gastroenterology Summary and Comment
Most patients in this small study underwent multiple dilations and received long-term acid-suppression therapy.
GERD During Pregnancy and Beyond
Gastroenterology Summary and Comment
Does heartburn during pregnancy predispose women to subsequent GERD?
By David A. Johnson, MD
October 19, 2007
Covering:
Bor S et al., Clin Gastroenterol Hepatol 2007 Sep; 5:1035
Acid Reduction After Endoscopic Mucosal Dissection
Gastroenterology Summary and Comment
PPIs worked better than H2 RAs for lowering bleeding risk among patients who underwent endoscopic removal of early gastric cancers.
Grading Esophagitis
Gastroenterology Summary and Comment
Adding NBI images to conventional photographs obtained during endoscopy significantly improved readers’ ability to distinguish mild esophagitis.
By David A. Johnson, MD
September 28, 2007
Covering:
Lee Y-C et al., Gastrointest Endosc 2007 Aug; 66:230
GI Safety of COX-2 Inhibitors: Cochrane Collaboration Systematic Review
Gastroenterology Summary and Comment
Free
Adverse GI events are less common with COX-2 inhibitors than with NSAIDs, but we still have to weigh overall harms and benefits before prescribing these agents.
Can Lumiracoxib Lower Risk for Ulcer Complications in High-Risk Patients?
Gastroenterology Summary and Comment
Free
Depending on the risk group, NNTs to prevent ulcer complications with lumiracoxib versus nonselective NSAIDs ranged from 47 to 135.
Abdominal Circumference and BE
Gastroenterology Summary and Comment
In a case-control study, larger abdominal circumference (adjusted for BMI) was associated modestly with greater risk for Barrett esophagus.
By David A. Johnson, MD
August 30, 2007
Covering:
Corley DA et al., Gastroenterology 2007 Jul; 133:34-41
EoE Prevalence in Asymptomatic Adults
Gastroenterology Summary and Comment
Eosinophilic infiltration of the esophagus was noted in about 5% of a largely asymptomatic population-based Swedish cohort.
Coxibs plus PPIs for Patients with High Risk for Bleeding
Gastroenterology Summary and Comment
Free
In patients at high risk for NSAID-related bleeding, PPIs plus coxibs resulted in less bleeding than coxibs alone.
By David J. Bjorkman, MD, MSPH (HSA), SM (Epid.)
July 13, 2007
Covering:
Chan FKL et al., Lancet 2007 May 12; 369:1621-6
Screening for BE: Capsule vs. Standard Endoscopy
Gastroenterology Summary and Comment
Free
The latest comparison between capsule and conventional endoscopy suggests that capsules aren’t quite ready for ruling out Barrett esophagus in patients with GERD.
By David A. Johnson, MD
July 6, 2007
Covering:
Lin OS et al., Gastrointest Endosc 2007 Apr; 65:577-83
Recent PPI Use and CAP
Gastroenterology Summary and Comment
In a large case-control study, recent PPI use was associated with higher risk for community-acquired pneumonia, but this isn’t a definitive analysis.
By David A. Johnson, MD
July 6, 2007
Covering:
Gulmez SE et al., Arch Intern Med 2007 May 14; 167:950-5
H. pylori Infection and Gastric Cancer
Gastroenterology Summary and Comment
Prospective data from Taiwan support a link between <$EMPH_O>H. pylori<$EMPH_C> infection and increased risk for gastric cancer.
By David J. Bjorkman, MD, MSPH (HSA), SM (Epid.)
June 22, 2007
Covering:
Hsu PI et al., Am J Gastroenterol 2007 Apr; 102:725-30
Does H. pylori Eradication Reduce Excess Risk for Gastric Cancer?
Gastroenterology Summary and Comment
Results from a retrospective study in Japan are suggestive but not conclusive.
By David J. Bjorkman, MD, MSPH (HSA), SM (Epid.)
June 22, 2007
Covering:
Takenaka R et al., Aliment Pharmacol Ther 2007 Apr 1; 25:805-12
Endoscopic Plication for Treatment of GERD
Gastroenterology Summary and Comment
Despite availability of 3-year follow-up results from an initial study of endoscopic plication, the durability of this procedure remains unclear.
By David A. Johnson, MD
June 15, 2007
Covering:
Pleskow D et al., Surg Endosc 2007 Mar; 21:439-44
Sequential Therapy for H. pylori Eradication
Gastroenterology Summary and Comment
Free
In this study, sequential therapy was more efficacious than simultaneous therapy, but the mechanism underlying its success remains unexplained.
By David J. Bjorkman, MD, MSPH (HSA), SM (Epid.)
June 15, 2007
Covering:
Vaira D et al., Ann Intern Med 2007 Apr 17; 146:556-63
PPIs and Risk for Community-Acquired Pneumonia
General Medicine Summary and Comment
Current PPI use — especially recently initiated use — was associated with higher risk.
By Jamaluddin Moloo, MD, MPH
May 31, 2007
Covering:
Gulmez SE et al., Arch Intern Med 2007 May 14; 167:950-5
