A new laparoscopic therapy for reflux has been recently approved for the treat of reflux. The procedure requires laparoscopic surgery (small incisions in the abdomen) in order to place this new device at the level of the lower esophageal sphincter. Certain limitations will occur as the result of this procedure as will be discussed.
Anthony A. Starpoli, MD | www.starpoli.com
Reflux, hiatal hernia, TIF, LINX, GERD, atypical reflux, heartburn, EsophyX, Barrett's Esophagus
Several news agencies recently reported concerns of the FDA over the increased risk of Clostridium difficle diarrheal illness in patients using acid lowering antireflux drugs in the treatment of gastroesophageal reflux disease (GERD).
Anthony A. Starpoli, MD | www.starpoli.com
A six-month follow up of 12 people with GERD and six others who were not suffering from the condition showed that those with acid reflux had much worse tooth wear and erosion.
Tooth erosion may naturally occur due to chewing but about half of GERD patients had tooth wear and erosion several times higher than the healthy counterparts, says the report inJournal of the American Dental Association.
The acid from the stomach is strong enough “to dissolve the tooth surface directly, or soften the tooth surface, which is later worn down layer by layer,” said lead author Dr. Daranee Tantbirojn of the University of Tennessee.
“The damage from acid reflux looks like tooth wear -- the tooth is flattened, thin, sharp or has a crater or cupping.”
Saliva acts as a defense mechanism because its buffering capacity helps protecting teeth in neutralizing acid, but it cannot fully protect teeth against all acid condition in mouth formed after eating and drinking or due to acid reflux from stomach.
Researchers suggested people with acid reflux to follow some measures to lower their teeth damage. They, for instance, should avoid brushing their teeth immediately after an acid reflux episode and use a fluoride rinse instead.
Using Xylitol chewing gum and taking baking soda or antacids after acid reflux episodes can also protect teeth against erosion.
Anthony A. Starpoli, MD | www.starpoli.com
On September 7th and October 13th, 2011, the first two combined laparoscopic and transoral antireflux procedures were performed at the New York Univerisity Langone Medical Center in New York City.
Anthony A. Starpoli, MD | www.starpoli.com
Reflux, hiatal hernia, TIF, fundoplication, GERD, LPR, atypical reflux, heartburn, EsophyX, Barrett's Esophagus
In a retrospective study from Japan, the chronic use of proton pump inhibitors (PPIs), often used in the treatment of GERD, was found to be associated with a greater than 3-fold increased risk of developing Clostridium difficile–associated diarrhea (CDAD), Takatoshi Kitazawa, MD, assistant professor at Teikyo University in Tokyo, Japan, reported during a poster session at the 51st Interscience Conference on Antimicrobial Agents and Chemotherapy.
Anthony A. Starpoli, MD | www.starpoli.com
Doctor Radio is a groundbreaking 24/7 national radio channel featuring live,
call-in shows hosted by leading NYU Langone Medical Center doctors from a vast
array of fields including: child psychology and psychiatry; sexual health;
plastic surgery; emergency room medicine; cancer; heart health; women's health;
dermatology; pediatrics; men's health; diet and nutrition; sports medicine;
psychiatry; and more.
SIRIUSXM and NYU have built a state-of-the-art broadcasting studio
in the lobby of the Manhattan-based NYU Langone Medical Center, bringing
listeners right into the middle of the medical world.
Anthony A. Starpoli, MD | www.starpoli.com
TIF, doctor radio, GERD, atypical reflux, heartburn, EsophyX, Barrett's Esophagus
A report was published in the May 18 issue ofA report was published in the May 18 issue of Journal of the American Medical Association. In, what is referred to as the LOTUS (Long-Term Usage of Esomeprazole vs Surgery for Treatment of Chronic GERD) study, remission rates at five years were 92% (95% CI 89 to 96) for patients on esomeprazole and 85% (95% CI 81 to 90, P=0.048) for those who had laparoscopic antireflux surgery, according to Jean-Paul Galmiche, MD, of Nantes University in France, and colleagues.
Anthony A. Starpoli, MD | www.starpoli.com
Heartburn is a signature symptom of gastroesophageal reflux disease (GERD), which is a cluster of symptoms and signs associated with regurgitation of stomach acid up to the pharynx and mouth. Patient-based studies of GERD have shown high prevalence and chronicity, particularly in Western societies. GERD is associated with significant health-care utilization and diminished quality of life. Heartburn, coupled with acid regurgitation and painful swallowing are considered to be highly specific for GERD. Very few epidemiological studies have been performed with regard to heartburn, and only one has been population-based. The natural history of GERD or heartburn has received little attention. The pathophysiology of GERD and heartburn is basically unknown.
A research article to be published on February 7, 2011 in the World Journal of Gastroenterology addresses this question. The authors evaluated the natural history of heartburn in the Icelandic population prospectively over a 10-year period, as well as to evaluate different factors which are affected by heartburn both physically and sociodemographically.
The study showed heartburn is a common condition in the population of Iceland. The prevalence is slightly higher than reported elsewhere. Heartburn is a chronic condition, affecting every fifth person every week. Heartburn subjects with a body mass index lower or higher than normal weight were more likely to experience heartburn than subjects of normal weight. Heartburn did not seem to result in less food and beverage consumption, but one out of five heartburn subjects did avoid a specific food or alcohol because of the heartburn. Heartburn had a great impact on daily activities and quality of life. Half of the heartburn subjects experienced sleep disturbances because of this condition.
This study creates a database for future studies and hopefully stimulates studies in other countries. Secular prevalence trends and international comparison can contribute towards understanding of the pathophysiology of the disease.
Anthony A. Starpoli, MD | www.starpoli.com
I came upon this post on the endonurse.com web site. For those who will be having colon cancer screening with colonoscopy, this application may be of value. If the colon is not cleaned well, the risk of poor visualization is high and, therefore,abnormalities such as polyps or cancerous growth can be missed.
Anthony A. Starpoli, MD | www.starpoli.com
I came upon this article in healthday news, on January 11, 2011, that drives home the financial impact of obesity in our country and Canada. The total economic cost of overweight and obesity in the United States is $270 billion per year while the cost in Canada is about $30 billion a year, a new study shows.
Anthony A. Starpoli, MD | www.starpoli.com
