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Sutep Gonlachanvit - One of the best experts on this subject based on the ideXlab platform.
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Original Article The Therapeutic and Diagnostic Value of 2-week High Dose Proton Pump Inhibitor Treatment in Overlapping Non-erosive Gastroesophageal Reflux Disease and Functional Dyspepsia Patients
2013Co-Authors: Chatchai Kriengkirakul, Tanisa Patcharatrakul, Sutep GonlachanvitAbstract:To evaluate the value of a 2-week high dose proton pump inhibitor (PPI) treatment on patients with overlapping non-erosive gastroesophageal reflux disease (NERD) and functional dyspepsia (FD). Methods Sixty overlapping NERD and FD patients with symptom onset> 3 months prior underwent 24-hour esophageal pH monitoring studies. All patients received rabeprazole 20 mg b.i.d. for 2 weeks. The reflux and dyspeptic symptoms were evaluated using a symptom questionnaire with 4-point Likert scales before and at the end of treatment. A positive PPI test was defined as score improvement in ≥ 50 % from the baseline in the typical reflux symptoms. Results The prevalence of each reflux and dyspeptic symptom did not differ significantly between patients with positive and negative pH tests. After the PPI treatment, epigastric burning, acid Regurgitation, heartburn, nausea, vomiting and chest discomfort scores were significantly improved compared to pretreatment values (P < 0.05), whereas postprandial abdominal fullness, early satiation, belching and Food Regurgitation were not. The proportion of patients who responded to the PPI treatment did not differ significantly between patients with positive and negative pH tests. The sensitivity, specificity, PPV, NPV and accuracy of 2-week high dose rabeprazole treatment for diagnosing gastroesophageal reflux disease were 47%, 38%, 50%, 35 % and 43%, respectively
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The Therapeutic and Diagnostic Value of 2-week High Dose Proton Pump Inhibitor Treatment in Overlapping Non-erosive Gastroesophageal Reflux Disease and Functional Dyspepsia Patients.
Journal of neurogastroenterology and motility, 2012Co-Authors: Chatchai Kriengkirakul, Tanisa Patcharatrakul, Sutep GonlachanvitAbstract:BACKGROUND/AIMS To evaluate the value of a 2-week high dose proton pump inhibitor (PPI) treatment on patients with overlapping non-erosive gastroesophageal reflux disease (NERD) and functional dyspepsia (FD). METHODS Sixty overlapping NERD and FD patients with symptom onset > 3 months prior underwent 24-hour esophageal pH monitoring studies. All patients received rabeprazole 20 mg b.i.d. for 2 weeks. The reflux and dyspeptic symptoms were evaluated using a symptom questionnaire with 4-point Likert scales before and at the end of treatment. A positive PPI test was defined as score improvement in ≥ 50% from the baseline in the typical reflux symptoms. RESULTS The prevalence of each reflux and dyspeptic symptom did not differ significantly between patients with positive and negative pH tests. After the PPI treatment, epigastric burning, acid Regurgitation, heartburn, nausea, vomiting and chest discomfort scores were significantly improved compared to pretreatment values (P < 0.05), whereas postprandial abdominal fullness, early satiation, belching and Food Regurgitation were not. The proportion of patients who responded to the PPI treatment did not differ significantly between patients with positive and negative pH tests. The sensitivity, specificity, PPV, NPV and accuracy of 2-week high dose rabeprazole treatment for diagnosing gastroesophageal reflux disease were 47%, 38%, 50%, 35% and 43%, respectively. CONCLUSIONS The two-week high dose PPI treatment was not effective for early satiation, postprandial abdominal fullness, Regurgitation or belching symptoms in patients with overlapping NERD and FD. Acid exposure in the distal esophagus could not predict the response of symptoms to PPI. In addition, the 2-week PPI test provided limited value for gastroesophageal reflux disease diagnosis in patients with overlapping NERD and FD.
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T1893 Effects of Red Chili, a Natural Capsaicin Receptor Agonist, on Gastroesophageal Reflux (GER) Symptoms and Transient Lower Esophageal Sphincter Relaxations (TLESRs) in Healthy Humans
Gastroenterology, 2010Co-Authors: Chatchai Kriengkirakul, Sutep GonlachanvitAbstract:Capsaicin or TRPV1 receptors have been reported to be increased in the esophagus of patients with non-erosive reflux disease. The effects of red chili, a natural capsaicin agonist, on TLESRs have not been reported. Aim: To investigate the effects of red chili on gastroesophageal reflux symptoms and TLESRs in healthy humans. Methods: After an overnight fast, 8 healthy volunteers (5 males, mean age 31±3 years) underwent high resolution esophageal manometry with ingestion of 2 gm red chili (capsaicin = 1.46 mg) or placebo in capsules, in a randomized double blind cross-over fashion with a one-week washout period. Lower esophageal sphincter pressure monitoring began at 15 minutes before chili or placebo ingestion. All subjects ingested standard liquid meals (250 ml of Ensure®) at 15 minutes after the ingestion of chili or placebo capsules. Lower esophageal sphincter monitoring was continued for 2 hours after the meal ingestion. The TLESRs were defined as the relaxations which fulfilled the 4 following criteria: 1) absent of swallowing between 4 seconds before and 2 seconds after the onset of LES relaxations, 2) relaxation rate of >1 mmHg/second, 3) time from onset to complete relaxation of 10 seconds and fulfilled the last 3 criteria. The number of TLESRs and other esophageal manometry parameters were compared between after placebo and chili ingestion. GER and dyspeptic symptoms were evaluated using 10 cm long visual analog scales. Results: (data were expressed as mean±SEM or median and interquartile range) All subjects completed the studies. After ingestion of red chili, heartburn, acid Regurgitation, Food Regurgitation and abdominal burning symptom scores were significantly increased compared to placebo (2.5±0.9, 1.6±0.4, 2.1±0.4, and 5.9±0.7 vs 0.3±0.3, 0.9±0.2, 0.9±0.2, and 0.5±0.2, respectively, p 0.05). The resting LES pressure (19.8±0.9 vs 19.8±0.7 mmHg) was not significantly different between after chili and placebo ingestions (p>0.05). There was no significant correlation between the number of TLESRs and heartburn, acid Regurgitation, or Food Regurgitation scores (p>0.05). Conclusions: Ingestion of red chili increases GER symptoms and epigastrium burning symptoms in healthy volunteers. However, red chili has no significant effect on TLESRs. This suggests that, in healthy volunteers, red chili modulates GER symptoms by its effect on esophageal sensation rather than on the TLESRs.
Chatchai Kriengkirakul - One of the best experts on this subject based on the ideXlab platform.
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Original Article The Therapeutic and Diagnostic Value of 2-week High Dose Proton Pump Inhibitor Treatment in Overlapping Non-erosive Gastroesophageal Reflux Disease and Functional Dyspepsia Patients
2013Co-Authors: Chatchai Kriengkirakul, Tanisa Patcharatrakul, Sutep GonlachanvitAbstract:To evaluate the value of a 2-week high dose proton pump inhibitor (PPI) treatment on patients with overlapping non-erosive gastroesophageal reflux disease (NERD) and functional dyspepsia (FD). Methods Sixty overlapping NERD and FD patients with symptom onset> 3 months prior underwent 24-hour esophageal pH monitoring studies. All patients received rabeprazole 20 mg b.i.d. for 2 weeks. The reflux and dyspeptic symptoms were evaluated using a symptom questionnaire with 4-point Likert scales before and at the end of treatment. A positive PPI test was defined as score improvement in ≥ 50 % from the baseline in the typical reflux symptoms. Results The prevalence of each reflux and dyspeptic symptom did not differ significantly between patients with positive and negative pH tests. After the PPI treatment, epigastric burning, acid Regurgitation, heartburn, nausea, vomiting and chest discomfort scores were significantly improved compared to pretreatment values (P < 0.05), whereas postprandial abdominal fullness, early satiation, belching and Food Regurgitation were not. The proportion of patients who responded to the PPI treatment did not differ significantly between patients with positive and negative pH tests. The sensitivity, specificity, PPV, NPV and accuracy of 2-week high dose rabeprazole treatment for diagnosing gastroesophageal reflux disease were 47%, 38%, 50%, 35 % and 43%, respectively
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The Therapeutic and Diagnostic Value of 2-week High Dose Proton Pump Inhibitor Treatment in Overlapping Non-erosive Gastroesophageal Reflux Disease and Functional Dyspepsia Patients.
Journal of neurogastroenterology and motility, 2012Co-Authors: Chatchai Kriengkirakul, Tanisa Patcharatrakul, Sutep GonlachanvitAbstract:BACKGROUND/AIMS To evaluate the value of a 2-week high dose proton pump inhibitor (PPI) treatment on patients with overlapping non-erosive gastroesophageal reflux disease (NERD) and functional dyspepsia (FD). METHODS Sixty overlapping NERD and FD patients with symptom onset > 3 months prior underwent 24-hour esophageal pH monitoring studies. All patients received rabeprazole 20 mg b.i.d. for 2 weeks. The reflux and dyspeptic symptoms were evaluated using a symptom questionnaire with 4-point Likert scales before and at the end of treatment. A positive PPI test was defined as score improvement in ≥ 50% from the baseline in the typical reflux symptoms. RESULTS The prevalence of each reflux and dyspeptic symptom did not differ significantly between patients with positive and negative pH tests. After the PPI treatment, epigastric burning, acid Regurgitation, heartburn, nausea, vomiting and chest discomfort scores were significantly improved compared to pretreatment values (P < 0.05), whereas postprandial abdominal fullness, early satiation, belching and Food Regurgitation were not. The proportion of patients who responded to the PPI treatment did not differ significantly between patients with positive and negative pH tests. The sensitivity, specificity, PPV, NPV and accuracy of 2-week high dose rabeprazole treatment for diagnosing gastroesophageal reflux disease were 47%, 38%, 50%, 35% and 43%, respectively. CONCLUSIONS The two-week high dose PPI treatment was not effective for early satiation, postprandial abdominal fullness, Regurgitation or belching symptoms in patients with overlapping NERD and FD. Acid exposure in the distal esophagus could not predict the response of symptoms to PPI. In addition, the 2-week PPI test provided limited value for gastroesophageal reflux disease diagnosis in patients with overlapping NERD and FD.
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T1893 Effects of Red Chili, a Natural Capsaicin Receptor Agonist, on Gastroesophageal Reflux (GER) Symptoms and Transient Lower Esophageal Sphincter Relaxations (TLESRs) in Healthy Humans
Gastroenterology, 2010Co-Authors: Chatchai Kriengkirakul, Sutep GonlachanvitAbstract:Capsaicin or TRPV1 receptors have been reported to be increased in the esophagus of patients with non-erosive reflux disease. The effects of red chili, a natural capsaicin agonist, on TLESRs have not been reported. Aim: To investigate the effects of red chili on gastroesophageal reflux symptoms and TLESRs in healthy humans. Methods: After an overnight fast, 8 healthy volunteers (5 males, mean age 31±3 years) underwent high resolution esophageal manometry with ingestion of 2 gm red chili (capsaicin = 1.46 mg) or placebo in capsules, in a randomized double blind cross-over fashion with a one-week washout period. Lower esophageal sphincter pressure monitoring began at 15 minutes before chili or placebo ingestion. All subjects ingested standard liquid meals (250 ml of Ensure®) at 15 minutes after the ingestion of chili or placebo capsules. Lower esophageal sphincter monitoring was continued for 2 hours after the meal ingestion. The TLESRs were defined as the relaxations which fulfilled the 4 following criteria: 1) absent of swallowing between 4 seconds before and 2 seconds after the onset of LES relaxations, 2) relaxation rate of >1 mmHg/second, 3) time from onset to complete relaxation of 10 seconds and fulfilled the last 3 criteria. The number of TLESRs and other esophageal manometry parameters were compared between after placebo and chili ingestion. GER and dyspeptic symptoms were evaluated using 10 cm long visual analog scales. Results: (data were expressed as mean±SEM or median and interquartile range) All subjects completed the studies. After ingestion of red chili, heartburn, acid Regurgitation, Food Regurgitation and abdominal burning symptom scores were significantly increased compared to placebo (2.5±0.9, 1.6±0.4, 2.1±0.4, and 5.9±0.7 vs 0.3±0.3, 0.9±0.2, 0.9±0.2, and 0.5±0.2, respectively, p 0.05). The resting LES pressure (19.8±0.9 vs 19.8±0.7 mmHg) was not significantly different between after chili and placebo ingestions (p>0.05). There was no significant correlation between the number of TLESRs and heartburn, acid Regurgitation, or Food Regurgitation scores (p>0.05). Conclusions: Ingestion of red chili increases GER symptoms and epigastrium burning symptoms in healthy volunteers. However, red chili has no significant effect on TLESRs. This suggests that, in healthy volunteers, red chili modulates GER symptoms by its effect on esophageal sensation rather than on the TLESRs.
R.d. Handy - One of the best experts on this subject based on the ideXlab platform.
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The influence of high oral doses of mercuric chloride on organ toxicant concentrations and histopathology in rainbow trout, Oncorhynchus mykiss
Comparative Biochemistry and Physiology Part C: Pharmacology Toxicology and Endocrinology, 1993Co-Authors: R.d. Handy, W.s. PenriceAbstract:Abstract 1. Trout were fed a pellet diet for 42 d contaminated with mercuric chloride to provide a mercury concentration of 10 g metal/kg dry weight of Food. 2. Sloughing of the gut epithelium and Food Regurgitation occurred in the last 3 weeks of the study, but no mortalities were observed. 3. The kidney showed increased numbers of melano-macrophages, but gill pathology was notably absent. 4. Mercury accumulated in the gill, liver, kidney, muscle and mucus. The highest toxicant concentrations were recorded in the gill and liver, while contamination in the muscle was lower than most tissues examined. 5. Fish excreted mercury via the body surface mucus, a previously unknown route of mercury clearance. Mucus mercury content correlated positively with whole body burdens, suggesting mucus toxicant levels may be used to identify mercury contamination in live fish.
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The effect of acute exposure to dietary Cd and Cu on organ toxicant concentrations in rainbow trout, Oncorhynchus mykiss
Aquatic Toxicology, 1993Co-Authors: R.d. HandyAbstract:Abstract Trout were fed on a commercial diet containing 10 g of Cd or Cu kg/dry weight of Food for 28 days to determine whether fish could ingest and accumulate toxicants from heavily contaminated Food. Fish initially ingested either diet, but Food Regurgitation eventually occurred. Dietary Cd was more toxic than Cu, causing 14 compared to one mortality. Cadmium deposition in internal organs and impaired copper metabolism contributed to mortalities in the Cd-exposed group. Dietary Cd accumulated in the gills, liver, kidney, and muscle. Oral doses of Cu appeared in the gill, liver, and muscle; but not significantly in the kidney. The highest toxicant concentrations were recorded in the gill and liver, while contamination in the muscle was lower than in other tissues examined. Only limited amounts of Cd and Cu were excreted via the body surface mucus. This study suggests that fish will ingest heavily polluted Food until toxicity occurs. Wild fish may therefore be at risk from contamination via the diet after pollution incidents.
Zeng Ju-lang - One of the best experts on this subject based on the ideXlab platform.
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Incidence of common digestive tract diseases in the shipboard personnel
Journal of Navy Medicine, 2009Co-Authors: Zeng Ju-langAbstract:Objective:To investigate the incidence of common digestive tract diseases in shipboard personnel and in land army and to effectively prevent from high incidence digestive tract diseases in shipboard personnel.Methods: Patients who visited our hospital during from Jan 2004 to Dec 2007 were collected as subject.Common digestive tract diseases were diagnosed in base on history, symptoms and gastroscopy.Among them,gastric ulcer caused by cancer was excepted by pathology check(biopsy) and linitis plastica was excepted in upper gastrointestinal tract barium meal.The patients with reflux esophagitis(RE) whose symptom Sc score was ≥8 were selected as subject,and esophagus straitness,peptic ulcer,gastric or gastric tumors were eliminated by gastroscopy.The judgment was accorded to the gastroesophaheal diagnosis and classification standard which was set down by China reflux esophagitis (conference) in 1999.According to heartburn stomachaches,retrosternal pain,acid reflux,Food Regurgitation,the scores of reflux diagnostic questionnaire(RDQ) were recorded.The patients whose RDQ scores were ≥20 were dignoseed as GERD and those whose RDQ scored were ≤15,not GERD.Subjects whose RDQ scores were among 16-19 were eliminated.Results: (1)In shipboard personnel,incidences of digestive tract were higher than in other crowd,incidences of chronic gastritis were higher than in ordinary people(P0.05).(2)Incidence of duodenal ulcer(DU) in shipboard personnel was signifcantly higher than in department members or grass roots.On the contra,that of RE was also significantly higher than other people(P0.05).(3) The incidence of gastroesophageal reflux in shipboard personnel was 26.81%,9.26% in none shipboard personnel.(4)Among subjects whose gastroscopy Sc scores were ≥8,incedence of RE was 31.55%(59/187)in shipboard personnel and 18.73%(47/251) in land army(P0.05).Conclusion: (1)Medical members must prepare enough leechdom during sealing and have a treating plan for high incidence disease such as duodenal ulcer,reflux gastritis,RE, alimentary tract hemorrhage.(2)We should make prevention well before sealing,such as having physical examination and arranging electronic gastroscopy,or alimentary tract barium meal check for people who have very obvious alimentary tract symptom,ulcer and alimentary tract hemorrhage.High risk patients should be adjusted their work when necessary.
Takayoshi Shimohata - One of the best experts on this subject based on the ideXlab platform.
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Esophageal Involvement in Multiple System Atrophy (P4.307)
Neurology, 2016Co-Authors: Takayoshi Shimohata, Hiroshige Taniguchi, Hideaki Nakayama, Kazuhiro Hori, Makoto Inoue, Masatoyo NishizawaAbstract:Objective: To determine the prevalence of esophageal involvement and its impact on clinical manifestations in patients with multiple system atrophy (MSA). Background: Secondary motor disorders of the esophagus have numerous causes, including cerebrovascular disorders, diabetes, and collagen disease. In addition, it may be secondary to extradigestive disorders and is reportedly a consequence of autonomic nervous system disorders including MSA. However, the prevalence of esophageal involvement and its impact on clinical manifestations in patients with MSA remains unknown. Methods: We recruited 16 consecutive patients with dysphagia associated with MSA (MSA group) and 16 consecutive patients with dysphagia associated with amyotrophic lateral sclerosis (ALS group). We assessed the presence or absence of Food stagnation within the esophagus using videofluorography. Results: Food stagnation within the esophagus was observed in 16 patients (100[percnt]; 7 severe, 9 mild) in the MSA group and in 4 patients (25[percnt]; 4 mild) in the ALS group (P < 0.001). Follow-up videofluorography revealed that Food stagnation in patients with MSA could exacerbate during the disease course. Patients with MSA and severe Food stagnation showed a wide range of intraesophageal stasis by videofluorography. Among the 16 patients in the MSA group, 4 developed aspiration pneumonia and 1 died of suffocation associated with Food Regurgitation during continuous positive airway pressure therapy. Conclusions: Food stagnation within the esophagus occurs more frequently in MSA patients with dysphagia than in ALS patients with dysphagia. Because Food stagnation can cause serious complications such as aspiration pneumonia and suffocation, patients with MSA should be evaluated by videofluorography, especially those with stagnation in the esophageal phase. Disclosure: Dr. Shimohata has nothing to disclose. Dr. Taniguchi has nothing to disclose. Dr. Nakayama has nothing to disclose. Dr. Hori has nothing to disclose. Dr. Inoue has nothing to disclose. Dr. Nishizawa has nothing to disclose.
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Esophageal Involvement in Multiple System Atrophy
Dysphagia, 2015Co-Authors: Hiroshige Taniguchi, Hideaki Nakayama, Kazuhiro Hori, Masatoyo Nishizawa, Makoto Inoue, Takayoshi ShimohataAbstract:The prevalence of esophageal involvement and its impact on clinical manifestations in patients with multiple system atrophy (MSA) remains unknown. We recruited 16 consecutive patients with dysphagia associated with MSA (MSA group) and 16 consecutive patients with dysphagia associated with amyotrophic lateral sclerosis (ALS group). We assessed the presence or absence of Food stagnation within the esophagus using videofluorography. Food stagnation within the esophagus was observed in 16 patients (100 %; 7 severe, 9 mild) in the MSA group and in 4 patients (25 %; 4 mild) in the ALS group (P < 0.001). Follow-up videofluorography revealed that Food stagnation in patients with MSA could exacerbate during the disease course. Patients with MSA and severe Food stagnation showed a wide range of intraesophageal stasis by videofluorography. Among the 16 patients in the MSA group, 4 developed aspiration pneumonia and 1 died of suffocation associated with Food Regurgitation during continuous positive airway pressure therapy. In conclusion, Food stagnation within the esophagus occurs more frequently in MSA patients with dysphagia than in ALS patients with dysphagia. Because Food stagnation can cause serious complications such as aspiration pneumonia and suffocation, patients with MSA should be evaluated by videofluorography, especially those with stagnation in the esophageal phase.