Dr. Starpoli's Blog

Silent Acid Reflux

Posted by Anthony A. Starpoli, MD on Feb 20, 2014 8:00:00 AM

Silent acid reflux, also known as Laryngopharngeal Reflux or LPR, is a condition that you could be suffering from without even knowing it, and can have many negative impacts on health. Similar in many ways to Gastroesophageal Reflux Disease (better known as GERD), there are a few critical differences that can make silent reflux very difficult to treat, and even harder to diagnose. 

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Anthony A. Starpoli, MD | www.starpoli.com

Reflux

New Surgical Therapy for GERD: The LINX Magnetic Bracelet

Posted by Anthony Starpoli on Apr 23, 2012 9:27:00 AM

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.

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Anthony A. Starpoli, MD | www.starpoli.com

Reflux, hiatal hernia, TIF, LINX, GERD, atypical reflux, heartburn, EsophyX, Barrett's Esophagus

Dental Detriments of GERD

Posted by Anthony Starpoli on Mar 13, 2012 2:35:00 AM

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. 

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Anthony A. Starpoli, MD | www.starpoli.com

Reflux, GERD, atypical reflux, nonacid reflux

Acid Reflux on the Rise- Obesity Increase Likely to Blame

Posted by Rachel Jones on Jan 3, 2012 9:54:00 AM

Study: Acid Reflux on the Rise

Obesity Increase Likely to Blame, Researchers Say

By Salynn Boyles

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Anthony A. Starpoli, MD | www.starpoli.com

Reflux, GERD, dietary suggestions, obesity surgery

"Anti-Reflux Drugs, Antibiotics May Raise C. diff Risk" - Anthony A. Starpoli, M.D. on WebMD

Posted by Rachel Jones on Dec 7, 2011 2:36:00 PM

Dr. Starpoli recently lent his expertise to WebMD on the subject of PPI drugs. Read on:

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Anthony A. Starpoli, MD | www.starpoli.com

Reflux, PPI, c. difficile, starpoli

Hybrid GERD Surgery Performed at NYU Langone Medical Center

Posted by Anthony Starpoli on Oct 14, 2011 11:40:00 AM

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.

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Anthony A. Starpoli, MD | www.starpoli.com

Reflux, hiatal hernia, TIF, fundoplication, GERD, LPR, atypical reflux, heartburn, EsophyX, Barrett's Esophagus

Much Greater Risk for Clostridium difficle with Reflux Therapy

Posted by Anthony Starpoli on Oct 7, 2011 6:47:00 PM

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.

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Anthony A. Starpoli, MD | www.starpoli.com

Reflux, diarrhea, TIF, GERD, nonacid reflux, EsophyX

Antireflux Surgery and GERD Drug Therapy Achieve Similar Results

Posted by Anthony Starpoli on Jun 4, 2011 11:43:00 AM


 
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. 

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Anthony A. Starpoli, MD | www.starpoli.com

Reflux, TIF, fundoplication, GERD, nonacid reflux, EsophyX

Which wines are better choices if I have acid reflux or GERD?

Posted by Anthony A. Starpoli, MD on Feb 23, 2011 11:35:00 AM
If you have been diagnosed with GERD, you probably have many questions about your diet moving forward. Patients often wonder if they can still eat and drink the foods they enjoy, or if this diagnosis will greatly impact their quality of life. One question that often comes up is if a patient can still drink wine after being diagnosed with reflux. While the answer is basically patient specific, we came across this article which addresses that very question. We hope that you find it helpful.

Which wines are better choices if I have acid reflux?

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Anthony A. Starpoli, MD | www.starpoli.com

Reflux, wine, GERD, heartburn

Natural History of Heartburn in an Icelandic Population

Posted by Anthony Starpoli on Feb 8, 2011 1:46:00 AM

Heartburn is a signature symptom of (GERD), which is a cluster of symptoms and signs associated with regurgitation of 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 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 , affecting every fifth person every week. Heartburn subjects with a 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 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.

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Anthony A. Starpoli, MD | www.starpoli.com

Reflux, sleep disturbance, GERD, heartburn