No abstract available.
Alginates/*therapeutic use ; Aluminum Hydroxide/*therapeutic use ; Antacids/*therapeutic use ; Female ; Gastroesophageal Reflux/*drug therapy ; Humans ; Male ; Silicic Acid/*therapeutic use ; Sodium Bicarbonate/*therapeutic use

No abstract available.
Alcohol Drinking ; Antacids/therapeutic use ; Endoscopy, Gastrointestinal ; Esophagitis, Peptic/complications/*diagnosis ; Gastroesophageal Reflux/complications/*diagnosis ; Humans ; Risk Factors ; Sex Factors

Gastroesophageal reflux disease (GERD) is defined as a condition that develops when the reflux of stomach contents causes troublesome symptoms and/or complications. In the last decade, GERD has been increasing in Korea. Seventeen consensus statements for the treatment of GERD were developed using the modified Delphi approach. Acid suppression treatments, such as proton pump inhibitors (PPIs), histmine-2 receptor antagonists and antacids are effective in the control of GERD-related symptoms. Among them, PPIs are the most effective medication. Standard dose PPI is recommended as the initial treatment of erosive esophagitis (for 8 weeks) and non-erosive reflux disease (at least for 4 weeks). Long-term continuous PPI or on-demand therapy is required for the majority of GERD patients after the initial treatment. Anti-reflux surgery can be considered in well selected patients. Prokinetic agents and mucosal protective drugs have limited roles. Twice daily PPI therapy can be tried to control extra-esophageal symptoms of GERD. For symptomatic patients with Barrett's esophagus, long-term treatment with PPI is required. Further studies are strongly needed to develop better treatment strategies for Korean patients with GERD.
Antacids/therapeutic use ; Antidepressive Agents/therapeutic use ; Drug Therapy, Combination ; Gastroesophageal Reflux/surgery/*therapy ; Histamine Antagonists/therapeutic use ; Humans ; Muscle Relaxants, Central/therapeutic use ; Proton Pump Inhibitors/therapeutic use

BACKGROUNDThe controversy on the treatment strategy for severe acute pancreatitis (SAP) has never stopped for the past century. Even now surgical procedures play a decisive role in the treatment of SAP, especially in managing the related complications, but the rational indications, timing, and approaches of surgical intervention for SAP are still inconclusive.

METHODSClinical data of 308 SAP patients recruited during January 2000-January 2013, including 96 conservatively treated cases plus 212 surgically intervened cases, were comparatively analyzed. Based on the initial surgical intervention time, the surgical intervention group was split into two: early intervention group (within 2 weeks) 103 cases, and late intervention group (after 2 weeks) 109 cases.

RESULTSIn the conservative treatment group, the cure rate was 82.29% (79/96), the death rate was 13.54% (13/96), and 4 cases self-discharged, while in the surgical intervention group, the cure rate was 84.43% (179/212) and the death rate was 10.85% (23/212) with 10 cases self-discharged. The difference was of no statistical significance between these two groups (P > 0.05). In surgical intervention group, the death rate 15.53% (16/103) in the early surgical intervention group was higher than that of late surgical intervention group 6.42% (7/109), and the difference was statistically significant (P < 0.05).

CONCLUSIONSBoth conservative treatment and surgical intervention play important roles in the treatment of SAP, and the indication, timing, and procedure should be strictly followed. Surgery earlier than 2 weeks after onset of the disease is not recommended in patients with necrotizing pancreatitis only when there are specific indications, such as multiple organ failure, which does not improve despite active treatment, and in those who develop abdominal compartment syndrome.

Adult ; Aged ; Antacids ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Pancreatectomy ; Pancreatitis, Acute Necrotizing ; drug therapy ; surgery ; therapy ; Retrospective Studies ; Somatostatin ; therapeutic use

OBJECTIVETo explore the diagnostic values of 24-hour pH monitoring in patients with laryngopharyngeal reflux disease (LPRD).

METHODSFifty patients with suspected laryngopharyngeal reflux were enrolled into this study. Twenty five patients had 24-hour pH monitoring, antacid treatment with omeprazole was given in study group with pathologic reflux. The remaining 25 patients as control group only had the same antacid treatment. All the patients had 3 months follow up, and treatment effect was evaluated according to clinical manifestation improvement. After 3 month treatment followed up, it was defined as inefficacy treatment if the clinical manifestation score decrease was equal or less than 4, defined as efficacy if the score decrease was more than 4.

RESULTSSeventeen of 25 patients had pathologic reflux, positive rate was 68.0%. The mean times of total acid reflux was 35.71 +/- 41.70 (x +/- s), the mean total reflux time was (35.71 +/- 33.19) min, the mean total reflux index (reflux times per hour) was (1.53 +/- 1.73)/h, the mean reflux time was (1.12 +/- 0.91) min. Before antacid treatment, the mean clinical manifestation score was 14. 88 +/- 4.11 in study group and 13.00 +/- 4.17 in control group. There was no significant difference between the two groups (t = 1.444, P > 0.05). The validity of study group was 82.4% (14/17), Among the control group, two cases were out of followed, and the validity of remained patients was 52. 2% (12/23). The mean decreased score of clinical manifestation in study group was 7.47 +/- 3.18 and 3.96 +/- 4.25 in control group. There was significant difference between the two groups (t = 2. 864, P = 0.007).

CONCLUSIONSThe dual-probe 24-hour pH monitoring is considered the gold standard for diagnosis of LPRD and it is essential in patients who have laryngopharyngeal complaints and is capable to improve the effect of antacid treatment significantly. It's worthy of clinical application.

Adult ; Aged ; Antacids ; therapeutic use ; Esophageal pH Monitoring ; Female ; Humans ; Laryngopharyngeal Reflux ; diagnosis ; drug therapy ; physiopathology ; Male ; Middle Aged ; Omeprazole ; therapeutic use ; Pharynx ; physiopathology ; Young Adult

Over the past century, since the introduction of non steroidal anti-inflammatory drugs (NSAID), antacid, histamine H2-receptor antagonists (H2RA), proton pump inhibitors (PPI), and discovery of Helicobacter pylori infection, the paradigm of peptic ulcer disease has changed with marked decrease in morbidity and mortality. However, peptic ulcer disease still occupies a position as a major health problem with increase of aged population and NSAIDs usage. In daily general practice, the management of peptic ulcer disease is directed according to the presence of bleeding or not. For non-bleeding peptic ulcer disease, proper acid suppression and the correction of underlying causes such as Helicobacter pylori infection and NSAID use is the main stay of treatment. Though a complete understanding of pathophysiology and a perfect treatment strategy are still a challenge, this guideline aims to provide practical recommendations based on evidences or consensus of experts through in-depth literature review and expert meeting.
Antacids/toxicity ; Anti-Inflammatory Agents, Non-Steroidal/toxicity ; Anti-Ulcer Agents/therapeutic use ; Bismuth/therapeutic use ; Helicobacter Infections/diagnosis/drug therapy ; Helicobacter pylori ; Histamine Antagonists/therapeutic use ; Humans ; Peptic Ulcer/*drug therapy ; Proton Pump Inhibitors/therapeutic use

Eleven years has passed since the guideline of the Korean College of Helicobacter and Upper Gastrointestinal Research group for H. pyori infection was produced in 1998. During this period the research for H. pyori has much progressed that H. pyori is now regarded as the major cause of gastric cancer. The seroprevalence of H. pyori in Korea was found to be decreased especially below the age of 40's and in the area of Seoul.Gyeonggi province, and annual reinfection rate of H. pyori has decreased up to 2.94%. In the aspect of diagnostic tests of H. pyori the biopsy is recommended in the body instead of antrum in the subjects with atrophic gastritis and/or intestinal metaplasia for the modified Giemsa staining or Warthin Starry silver staining. The urea breath test is the test of choice to confirm eradication when follow-up endoscopy is not necessary. Definite indication for H. pyori eradication is early gastric cancer in addition to the previous indications of peptic ulcer including scar and Marginal zone B cell lymphoma (MALT type). Treatment is also recommended for the relatives of gastric cancer patient, unexplained iron deficiency anemia, and chronic idiopathic thrombocytopenic purpura. One or two week treatment of proton pump inhibitor (PPI) based triple therapy consisting of one PPI and two antibiotics, clarithromycin and amoxicillin, is recommended as the first line treatment regimen. In the case of treatment failure, one or two weeks of quadruple therapy (PPI+metronidazole+tetracycline+bismuth) is recommended. Herein, Korean College of Helicobactor and Upper Gastrointestinal Research proposes a diagnostic and treatment guideline based on currently available evidence.
Amoxicillin/therapeutic use ; Antacids/therapeutic use ; Anti-Infective Agents/therapeutic use ; Bismuth/therapeutic use ; Breath Tests ; Clarithromycin/therapeutic use ; Enzyme-Linked Immunosorbent Assay ; Gastroscopy ; Helicobacter Infections/*diagnosis/*drug therapy ; *Helicobacter pylori ; Humans ; Metronidazole/therapeutic use ; Peptic Ulcer/diagnosis ; Proton Pump Inhibitors/therapeutic use ; Stomach Neoplasms/diagnosis ; Tetracycline/therapeutic use

BACKGROUNDLeukokeratosis of the vocal cords is a clinical descriptive diagnosis, which includes a group of squamous intraepithelial lesions of the vocal cord mucosa. We investigated the clinical classification and treatment efficacy of leukokeratosis of the vocal cords.

METHODSWe conducted a retrospective analysis of the medical history, laryngoscopic examinations, morphological features under a surgical microscope, and pathology results of 360 cases of leukokeratosis of the vocal cords to examine correlations among treatment modalities, therapeutic effects, and clinical features.

RESULTSAll cases were divided into four types based on symptoms, examination results, and treatment efficacies as follows: 21 patients had type I inflammatory leukoplakia and their vocal cord morphology and voice quality recovered after conservative therapies; 76 patients had type II frictional polyps and received CO2 laser submucosal cordectomy; 68 patients had type III sulcus vocalis and received mucosal slicing with dredging; and 195 cases had type IV simple leukokeratosis and received partial subligamental cordectomy with CO2 lasers or transmuscular cordectomy. Our treatment achieved a surgical cure rate of 90.9% (308/339), with a recurrence rate of 9.1% (31/339) and malignant transformation rate of 6.5% (22/339). All cancerous transformations occurred in type IV patients.

CONCLUSIONChoosing conservative or CO2 laser surgery based on the morphological characteristics of squamous epithelial lesions of keratinized vocal cord mucosa can maximally protect voice quality, reduce complications, and improve the cure rate.

Antacids ; therapeutic use ; Anti-Inflammatory Agents ; therapeutic use ; Budesonide ; therapeutic use ; Female ; Humans ; Laser Therapy ; Leukoplakia ; classification ; diagnosis ; drug therapy ; surgery ; Male ; Neoplasm Recurrence, Local ; classification ; diagnosis ; drug therapy ; surgery ; Retrospective Studies ; Vocal Cords

Functional dyspepsia (FD) is defined as the presence of symptoms thought to originate in the gastroduodenal area, in the absence of any organic, systemic, or metabolic disease that is likely to explain the symptoms. Based on the available evidence and consensus opinion, thirteen consensus statements for the treatment of FD were developed using the modified Delphi approach. Proton pump inhibitor, prokinetics, and histamine 2 receptor antagonists are effective for the treatment of FD. Mucosal protecting agents, fundus relaxant, and drugs for visceral hypersensitivity can improve symptoms in FD. Antacids and antidepressants may help improving symptoms in FD. Comparing endoscopy with 'test and treat' of Helicobacter pylori, endoscopy may be more effective initial strategy for managing patients with FD in Korea given high incidence of gastric cancer and low cost of endoscopy. Helicobacter pylori eradication can be one of the therapeutic options for patients with FD. Psychotherapy is effective for those who have severe symptoms and refractoriness. Further studies are strongly needed to develop better treatment strategies for Korean patients with FD.
Antacids/therapeutic use ; Anti-Ulcer Agents/therapeutic use ; Antidepressive Agents/therapeutic use ; Dyspepsia/diet therapy/*therapy ; Gastroscopy ; Helicobacter Infections/drug therapy ; Helicobacter pylori ; Histamine H2 Antagonists/therapeutic use ; Humans ; Proton Pump Inhibitors/therapeutic use ; Psychotherapy ; Serotonin 5-HT3 Receptor Antagonists/therapeutic use ; Vasoconstrictor Agents/therapeutic use

In 2010, a Korean guideline for the management of gastroesophageal reflux disease (GERD) was made by the Korean Society of Neurogastroenterology and Motility, in which the definition and diagnosis of GERD were not included. The aim of this guideline was to update the clinical approach to the diagnosis and management of GERD in adult patients. This guideline was developed by the adaptation process of the ADAPTE framework. Twelve guidelines were retrieved from initial queries through the Appraisal of Guidelines for Research & Evaluation II process. Twenty-seven statements were made as a draft and revised by modified Delphi method. Finally, 24 consensus statements for the definition (n=4), diagnosis (n=7) and management (n=13) of GERD were developed. Multidisciplinary experts participated in the development of the guideline, and the external review of the guideline was conducted at the finalization phase.
Antacids/therapeutic use ; Anti-Ulcer Agents/therapeutic use ; Antidepressive Agents/therapeutic use ; Barrett Esophagus/complications/diagnosis ; Databases, Factual ; Diet ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Drug Therapy, Combination ; Endoscopy, Digestive System ; Esophageal pH Monitoring ; Gastroesophageal Reflux/complications/*diagnosis/drug therapy ; Histamine Antagonists/therapeutic use ; Humans ; Peptic Ulcer/complications/diagnosis ; Proton Pump Inhibitors/therapeutic use ; Stomach Neoplasms/complications/diagnosis