Non-surgical, non-pharmacological treatments for gastroesophageal reflux disease compared
Regular magnetic resonance imaging (MRI) evaluations show that only about half of patients with multiple sclerosis achieve and sustain a response to treatment with interferon beta over three years, according to a study posted online today that will appear in the January 2009 print issue of Archives of Neurology. Before they develop symptoms of a
Full Post: Interferon beta treatment success for multiple sclerosis shown with MRI
Two non-surgical, non-pharmacological treatments for gastroesophageal reflux disease (GERD) both appear effective in reducing medication use and improving voice and swallowing symptoms, according to a report in the January issue of Archives of Surgery.
One type of therapy also appears effective for reducing heartburn and cough, whereas the other may be associated with a reduction in regurgitation.
GERD - a condition in which acid from the stomach backs up into the esophagus - is typically treated first with medications such as proton pump inhibitors, according to background information in the article. However, it may be difficult for patients to comply with or afford long-term drug therapy, and GERD returns more than 80 percent of the time when medication is discontinued. Surgical options have been available since the 1990s, and more recently, endoluminal therapies that involve entering through the body’s natural passages to repair the underlying causes of GERD have become available.
One endoluminal therapy, full-thickness plication, involves using a long, narrow tool known as an endoscope to tighten the junction between the esophagus and the stomach with sutures. A second, radiofrequency therapy, delivers energy waves to the muscles of the esophagus and stomach, purportedly improving the function of the valve between the esophagus and the stomach. Louis O. Jeansonne IV, M.D., then of Emory University School of Medicine, Atlanta, and now at Ochsner Medical Center, Baton Rouge, La., and colleagues compared the effectiveness of these two therapies in 126 patients treated for GERD between 2002 and 2006.
For the first two years of the study, only radiofrequency was available; for the remainder, treatment decisions were based on patient preference, the surgeon’s judgment and anatomical factors. A total of 68 patients underwent radiofrequency treatment and 58 underwent full-thickness plication. Patients were asked to report their medication use and rate their GERD symptoms before and after the procedure.
After an average of six months, follow-up data was obtained for 51 percent of patients. Among those who underwent radiofrequency treatment, on follow-up the percentage with moderate to severe heartburn decreased from 55 percent to 22 percent; medication use decreased from 84 percent to 50 percent; and decreases were also seen for swallowing difficulties, voice symptoms and cough. In the full-thickness plication group, moderate to severe heartburn decreased from 53 percent to 43 percent of patients; medication use decreased from 95 percent to 43 percent; and decreases were seen for regurgitation, voice symptoms and swallowing difficulties. There were no changes in chest pain or asthma symptoms after treatment in either group.
“Our experience indicates that radiofrequency and full-thickness plication are both effective, providing symptomatic relief and reduction in proton pump inhibitor use,” the authors conclude. “For patients whose chief complaint is regurgitation, full-thickness plication may be the preferred procedure. Further study is needed to determine the long-term effectiveness of endoluminal treatments.”
AstraZeneca has announced the submission of a supplemental New Drug Application (sNDA) to the U.S. Food and Drug Administration (FDA) for NEXIUM(R) (esomeprazole magnesium) to seek approval for the short-term (up to 6 weeks) treatment of gastroesophageal reflux disease (GERD) in pediatric patients ages 0 to 1 year old. GERD is a condition in which
Full Post: AstraZeneca submits sNDA for NEXIUM (esomeprazole magnesium)
Chronic gastrointestinal symptoms are highly prevalent in different geographic populations and cause various gastrointestinal symptoms that greatly inconvenience the lives of those affected. Examples include GERD, uninvestigated dyspepsia, irritable bowel syndrome, and chronic constipation. These problems have an impact on the individual’s quality of life. There is a lack of community-based research evaluating the impact
Full Post: Chronic gastrointestinal symptoms in Korean population
You know the drill: join the family for feasting on a high-fat, carbohydrate-filled meal followed by a generous slice of pumpkin pie. Regret-brought on by the growing storm in your stomach - begins before you even make your way to the couch. While some people sleep off their heartburn, others are roused by alarming symptoms.
Full Post: Reminder, signs of a heart attack can be subtle
Researchers at the University of Pennsylvania School of Medicine have discovered stem cells in the esophagus of mice that were able to grow into tissue-like structures and when placed into immune-deficient mice were able to form parts of an esophagus lining. The investigators report their findings online this month in the Journal of Clinical Investigation.
Full Post: Newly discovered esophagus stem cells grow into transplantable tissue
Lining the upper portion of the small intestine with an impermeable sleeve led to both weight loss and restoration of normal glucose metabolism in an animal model of obesity-induced diabetes. Investigators from the Massachusetts General Hospital (MGH) Weight Center and Gastrointestinal Unit report in the journal Obesity that the procedure reproducing several aspects of gastric
Full Post: A potential new procedure for treating obesity