記述言語：日本語   出版者・発行元：日本臨床生理学会  

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記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

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記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

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記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Salivary secretion in patients with proton-pump inhibitor (PPI)-resistant severe reflux esophagitis has not been examined. In this study, saliva secretion and salivary epidermal growth factor (EGF) in patients with PPI-resistant severe reflux esophagitis were investigated. METHODS: We recruited 22 PPI-resistant and 22 PPI-responsive severe reflux esophagitis patients who were not infected with Helicobacter pylori. Saliva secretion testing and esophageal manometry using high-resolution manometry were performed. Saliva secretion was assessed as follows: each patient chewed sugar-free gum for 3 min prior to endoscopy and the amount and pH of saliva as well as the pH of saliva after acid loading as an index of the acid-buffering capacity were measured. The salivary EGF concentration was assessed by ELISA. RESULTS: The amount of saliva secreted was significantly lower in the PPI-resistant group than in the PPI-responsive group, with medians (25th-75th percentile) of 3.7 (2.2-6.8) and 4.9 (4.0-7.8) mL, respectively (p = 0.029). Salivary pH was significantly lower in the PPI-resistant group [6.9 (6.7-7.2)] than in the PPI-responsive group [7.2 (7.1-7.4), p = 0.001]. Salivary pH after acid loading was significantly lower in the PPI-resistant group [5.6 (5.3-5.9)] than in the PPI-responsive group [6.4 (6.1-6.5), p = 0.002]. The salivary EGF concentration was significantly higher in the PPI-resistant group [3211.5 (1865.0-4121.5)] than in the PPI-responsive group [1816.0 (1123.5-2792.3), p = 0.041]. No significant differences were observed in the proportion of esophageal motility abnormalities. CONCLUSION: Stimulated saliva secretion was reduced in PPI-resistant severe reflux esophagitis patients.

DOI： 10.1007/s10388-021-00825-1

PubMed

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記述言語：日本語   出版者・発行元：日本消化器病学会-関東支部  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Background and Aim: Although one of the causes of dyspeptic symptoms in functional dyspepsia patients is gastric hypersensitivity, there is currently no routine endoscopic gastric hypersensitivity test. We developed a new endoscopic method for gastric hypersensitivity testing. The aim of the present study was to investigate whether this method is useful for evaluating gastric hypersensitivity in drug-resistant functional dyspepsia patients who were strongly suspected of having gastric hypersensitivity. Methods: Twenty-seven drug-resistant functional dyspepsia patients and 27 nonfunctional dyspepsia patients were recruited. Gastric pressure was assessed using an external pressure transducer, and the CO2 insufflation volume was measured using an endoscopic CO2-supplied device and flow meter. The following variables were examined: gastric pressure at baseline and gastric pressure, the CO2 insufflation volume, and compliance of the stomach when patients initially felt abdominal tension following CO2 insufflation. Results: No significant differences were observed in baseline gastric pressure or compliance of the stomach between the groups. Drug-resistant functional dyspepsia patients had a significantly smaller CO2 insufflation volume and lower gastric pressure when symptoms developed than nonfunctional dyspepsia patients. Based on a cutoff value of 1.25 L by receiver operating characteristic curves, sensitivity and specificity for gastric pressure were 85.0 and 96.3%, respectively. Similarly, based on a cutoff value of 12.7 mmHg, sensitivity and specificity for the CO2 insufflation volume were 81.5 and 81.5%, respectively. Conclusion: This endoscopic gastric hypersensitivity testing is a useful tool for evaluating the presence of gastric hypersensitivity.

DOI： 10.1002/jgh3.12544

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The relationship between gastroesophageal reflux disease (GERD) and constipation has not yet been examined in Japan. We herein analyzed the use of laxatives by GERD and non-GERD patients to clarify the relationship between GERD and constipation. METHODS: This was a retrospective observational study designed to examine the use of laxatives by GERD and non-GERD patients. A total of 118 patients (mean age 69.7 years, 50 males) with reflux esophagitis (RE) and non-erosive reflux disease (NERD) who received maintenance acid-suppressive therapy for more than 1 year were included in the GERD group (83 RE patients, 35NERD patients). Similarly, 61 patients (mean age 69.4 years, 28 males) who received regular acid-suppressive therapy for reasons other than GERD were included in the non-GERD group. We also investigated demographic factors associated with the onset of GERD, including body mass index (BMI), age, and sex. RESULTS: The frequency of laxative use was significantly higher in the GERD group (38.1%) than in the non-GERD group (21.3%). No significant differences were observed in dose frequencies between the groups. The type of laxative used also did not significantly differ between the groups. Furthermore, no significant differences were noted in sex, age, or BMI between the groups. CONCLUSIONS: The use of laxatives was significantly more common in GERD patients than in non-GERD patients. The present results suggest that a relationship exists between GERD and constipation.

DOI： 10.1007/s10388-020-00770-5

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本消化管学会  

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記述言語：日本語   出版者・発行元：(一社)日本消化管学会  

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記述言語：日本語   出版者・発行元：(一社)日本消化管学会  

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記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

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記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

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記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

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記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

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記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

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記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

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記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

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記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: To examine the clinical characteristics, including complications, of patients older than 75 years of age with proton pump inhibitor-resistant reflux esophagitis. METHODS: Patients who were resistant to standard-dose proton pump inhibitors were enrolled in the present study. Eligible patients (n = 26) were divided into those who were older (n = 11) and younger (n = 15) than 75 years of age. Clinical characteristics including complications (hemorrhage and stricture), body mass index, the severity of reflux esophagitis, Helicobactor pylori infection, gastric mucosal atrophy, hiatal hernia, kyphosis, and the use of antithrombotic agents were examined. The efficacy of 20 mg vonoprazan for proton pump inhibitor-resistant reflux esophagitis was also investigated. RESULTS: The severity of reflux esophagitis was significantly higher in the elderly group than in the non-elderly group. No other significant differences were observed between the groups. The proportion of patients with hemorrhage was significantly larger in the elderly group than in the non-elderly group. Similarly, the proportion of patients with stricture was significantly larger in the elderly group than in the non-elderly group. Nine out of 10 patients in the elderly group and all patients in the non-elderly group achieved healing after the 4-week administration of 20 mg vonoprazan. No significant differences were observed in healing rates between the groups. CONCLUSION: Among patients with proton pump inhibitor-resistant reflux esophagitis, the rates of severe reflux esophagitis and complications (hemorrhage and/or stricture) were significantly higher in elderly patients than in non-elderly patients. Regardless of age, 20 mg vonoprazan was effective for proton pump inhibitor-resistant reflux esophagitis.

DOI： 10.1007/s10388-019-00702-y

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本消化管学会  

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記述言語：日本語   出版者・発行元：(一社)日本消化管学会  

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