Background: pH monitoring 24h is used to diagnose atypical gastroesophageal reflux disease or can be applied to consider surgery for cases poorly respond with medical treatment. Objective: To study clinical signs, gastroscopic and oesophageal histopathologic features, pH monitoring 24h in the patients with gastroesophageal reflux disease (GERD). Subjects and method: The descriptive, cross-sectional study was conducted in patients with gastroesophageal reflux disease treated at Bach Mai Hospital from November 2005 to October 2006. 73 patients with GERD diagnosed according to Romell criteria were underwent gastroscopy and biopsy. 15 patients having extraesophageal manifestations of gastroesophageal reflux disease were underwent gastroesophageal reflux monitoring pH. Results: 31 (42.4%) patients had oesophagitis in which 67.7% grade A, 6.5% grade D and C, 2.7% Barret, and 53.4% having gastritis associated. 61 % oesophagitis and 13.9% Barret were seen on the biopsy. 40% (6/15) patients had abnormal pH monitoring but there was no statistically significant difference in pH monitoring between the group having oesophagitis from those without oesophagitis (p > 0.05). Conclusions: Among 15 patients underwent Ph monitoring, the rate of patients with abnormal pH monitoring was 40%. There was no statistically significant difference of pH monitoring result between patients with or without esophagus lesion.
Gastroesophageal Reflux/pathology ; etiology

Gastroesophageal reflux (GER) and cow's milk allergy (CMA) are common disorders in infants. In recent years, more and more research has investigated the relationship between these two diseases. Some studies reported that about half of the cases of GER in infants younger than 1 year may be an association with CMA. Therefore, overall understanding the role of CMA on the pathogenesis of GER has a great importance on improving clinical level of diagnosis and therapy. This review article tried to elaborate advances in research on the relationship between CMA and GER in infants, including epidemiology, pathogenesis, clinical manifestations, diagnosis and treatment.
Gastroesophageal Reflux ; diagnosis ; etiology ; Humans ; Infant ; Milk Hypersensitivity ; complications

The manifestations of pediatric gastroesohageal reflux (GER) are varied and complex. Extra-oesophageal symptoms, including GER-related respiratory diseases, ear, nose and throat diseases, oral diseases and neuropsychiatric symptoms, are thought to be major manifestations of pediatric GER, but the causal relationship between GER and these extra-oesophageal symptoms is still unclear. Therefore, we describe the progress of research on the relationship between GER and asthma, chronic cough, laryngitis, pharyngitis, laryngeal papilloma, sinusitis, otitis media, dental erosion, apparent life-threatening event, and the crying baby syndrome in this review. It provides new strategies for the diagnosis and treatment of GER-related diseases in children.
Asthma ; etiology ; Cough ; etiology ; Gastroesophageal Reflux ; complications ; Humans ; Laryngitis ; etiology ; Sinusitis ; etiology ; Tooth Erosion ; etiology

The effects of different grades of running on esophageal motility and gastroesophageal reflux in the fed state were evaluated. We studied healthy volunteers (male: 12, age: 27+/-5 yr) using ambulatory esophageal manometry, pH catheter and portable digital data recorder. Each exercise was performed 30 min after meal, with 20 min of rest between exercises. Subjects exercised on a treadmill at 40% and 70% maximal heart rate. The number of gastroesophageal reflux episodes, the duration of esophageal acid exposure and percent time pH below 4 were significantly (p<0.01) increased during exercise at 70% maximal heart rate. The frequency of contraction (contraction/min) (p<0.05), frequency of repetition (p<0.01), percent of simultaneous contraction (p<0.01), percent of above 100 mmHg amplitude (p<0.05), and frequency of 2-peak contraction (p<0.01) were significantly increased during exercise at 70% maximal heart rate. However, median amplitude and median duration showed no significant changes between each exercise session. Postprandial running exercises induce gastroesophageal reflux, which correlates with exercise intensity. These effects are mediated by disorganized esophageal motility.
Adult ; *Eating ; Esophageal Motility Disorders/etiology/*physiopathology ; Gastroesophageal Reflux/etiology/*physiopathology ; Human ; Male ; Postprandial Period ; *Running

Chronic cough is one of the most common reasons for referral to a respiratory physician. Although fatal complications are rare, it may cause considerable distress in the patient's daily life. Western and local data shows that in patients with a normal chest radiograph, the most common causes are postnasal drip syndrome, postinfectious cough, gastro-oesophageal reflux disease and cough variant asthma. Less common causes are the use of angiotensin-converting enzyme inhibitors, smoker's cough and nonasthmatic eosinophilic bronchitis. A detailed history-taking and physical examination will provide a diagnosis in most patients, even at the primary care level. Some cases may need further investigations or specialist referral for diagnosis.
Asthma ; complications ; diagnosis ; Chronic Disease ; Cough ; diagnosis ; etiology ; Diagnosis, Differential ; Gastroesophageal Reflux ; complications ; diagnosis ; Humans

OBJECTIVEAn unhealthy food consumption habit attributes to one of the etiology of gastro-esophageal reflux. The purpose of this article was to study the influence of food intake before going to bed on the nighttime gastro-esophageal reflux.

METHODSThirty-eight children with upper gastrointestinal symptoms were divided into two groups on the basis of taking (Group A, n=16) or not taking (Group B, n=22) food (non-stimulating) within 2 hrs before going to bed. All of them underwent 24 hr esophageal pH monitoring. The times of reflux episode, the longest duration of reflux, the times of reflux duration > 5 min, and the percentage of time of pH < 4 were compared between the two groups.

RESULTSThere were no significant differences in the parameters of pH monitoring between Groups A and B, with the times of reflux episode of 32 (21.5-43.5) vs 24 (15-37.3) , the longest duration of reflux of 6.6 (2.4-29.8) min vs 4.5 (2.5-13.2) min, the times of reflux episode longer than 5 min of 1.5 (0-3) vs 0 (0-3), and the percentage of time of pH < 4 of 4.3 (2.1-15.0)% vs 4.1 (2.0-7.2)% .

CONCLUSIONSNon-stimulating food intake before going to bed did not adversely affect the nighttime gastro-esophageal reflux.

Adolescent ; Child ; Esophageal pH Monitoring ; Feeding Behavior ; Female ; Gastroesophageal Reflux ; etiology ; Humans ; Male ; Time Factors

OBJECTIVETo study the relationship between obstructive sleep apnea and nocturnal gastroesophageal reflux (GER).

METHODSSeventy-six patients with obstructive sleep apnea hypopnea syndrome (OSAHS) underwent polysomnography (PSG) and nocturnal distal esophageal pH monitoring, to assess the prevalence of GER in OSAHS patients. Among these patients, thirty-two OSAHS patients with GER disease had been operated on. Surgical treatment included uvulopalatopharyngoplasty (UPPP), inferior turbinate reduction, nasal septoplasty et al. After 6 months of surgical treatment, the PSG and pH probe testing were rechecked. The pre and post operative apnea-hypopnea index (AHI), micro-arousal index (MAI), lowest artery oxygen saturation (LSaO2), acidified index of distal esophagus (pHI) and percentage of acid contact time of esophagus were compared. The correlation analysis was also employed.

RESULTSThe AHI of 76 OSAHS patients was (38.6 +/- 29.5)/h (average +/- s), GER was present in 48 patients (63.2 %). The pre and post operative AHI, MAI, LSaO2, pHI and percentage of ACT in 32 OSAHS patients associated with GER were (51.2 +/- 23.1)/h and (17.3 +/- 10.3)/h, (38.3 +/- 21.4 )/h and (14.5 +/- 10.0)/h, 0.698 +/- 0.107 and 0.858 +/- 0.076, (12.5 +/- 6.6)/h and (6.3 +/- 4.2)/h, (10.3 +/- 5.2)% and (4.5 +/- 2.9)%. The differences were statistically significant by matching t test (t were 10.95, 7.82, 15.97, 6.12, 7.62 respectively, P < 0.001). There were positive relationships between the reductions of AHI, MAI and the reductions of pHI (r were 0.775, 0.764, P < 0.001). The improved levels of AHI and MAI were correlated with the reduction of the percentage of ACT (r were 0.607, 0.730, P < 0.001).

CONCLUSIONSGER is prevalent in OSAHS patients. Surgical treatment of OSAHS has significant reduction in AHI, MAI as well as marked improvement in the GER, which suggests that nocturnal gastroesophageal reflux is correlated with the disorder of sleep respiration and the sleep disturbances.

Adult ; Aged ; Female ; Gastroesophageal Reflux ; etiology ; Humans ; Male ; Middle Aged ; Polysomnography ; Sleep Apnea, Obstructive ; complications

OBJECTIVE: To analyze the differences in reflux patterns in 24-hour esophageal pH-impedance monitoring in patients with non-erosive reflux disease (NERD), reflux hypersensitivity (RH) and functional heartburn (FH) and explore the possible mechanism of symptoms in patients with heartburn and negative endoscopic findings. METHODS: Seventy-nine patients with heartburn as the main symptoms but negative endoscopic findings, including 35 with NERD, 16 with RH and 28 with FH, were enrolled in this study.All the patients underwent 24-h esophageal pH-impedance monitoring and esophagogastroscopy, and the results were compared among the 3 groups. RESULTS: Acid reflux episode was significantly increased and weakly alkaline reflux episode was significantly decreased in NERD group in comparison with RH group and FH group ( CONCLUSIONS Patients with NERD, RH and FH had different reflux patterns.Acid reflux is predominant in the NERD, while weakly alkaline reflux is significantly increased RH and FH.In patients with normal esophageal acid exposure but without symptoms or without recorded symptoms during esophageal pH-impedance monitoring, analysis of the total reflux episode, mixed reflux episode, proximal acid reflux episode and percentage can help in the differential diagnosis between RH and FH.
Electric Impedance ; Esophageal pH Monitoring ; Gastroesophageal Reflux/diagnosis* ; Heartburn/etiology* ; Humans ; Hydrogen-Ion Concentration

To determine the relationship between Barrett's esophagus (BE) and features of gastroesophageal acid reflux, 24 h esophageal pH monitoring was performed in 90 patients. The patients were divided into 3 groups: 31 subjects with BE, 21 with mild esophagitis and 38 with severe esophagitis. The following parameters were evaluated: the percentage time of pH < 4; the number of reflux episodes over 5 min; the duration of longest episodes and DeMeester score over total period and the auterior three parameters in erect and supine position. All these parameters in BE were significantly different from those with mild esophagitis (P < 0.01) and not significantly different from those with severe esophagitis (P > 0.05). During supine position all the above parameters in BE were significantly different from those with reflux esophagitis (P < 0.05). It is concluded that the quantity of acid reflux is not an important factor in development of BE in gastroesophageal reflux (GER), and the acid reflux in supine position might be important in development of BE in GER.
Barrett Esophagus/etiology ; Barrett Esophagus/*physiopathology ; Esophagitis, Peptic/etiology ; Gastroesophageal Reflux/*complications ; Hydrogen-Ion Concentration ; Supine Position

OBJECTIVE: To explore the clinical features and treatments of contact granuloma of larynx. METHOD: To find the best treatments by analyzing the clinical features, related causes and the treatments of the 13 contact granuloma of larynx cases, which have complete data, of our department from Jan 2005 to Dec 2012, also by comparing the effect of conservative treatment and operation treatment. RESULT: Contact granuloma of larynx is more common in men (84.6%). The main causes are gastro esophageal reflux, chronic cough, habitual hawk and endotracheal intubation disease. However, a big part (38.4%) gets the disease without any other disease history. The main clinical feature of the disease includes: sensation of foreign matter in throat, easy to get exhausted when talking and voice hoarse, but also 30.7% without any feature in throat. Among the 13 cases, 6 were treated by operation and the first recurrence was 66.6%. The cure rate was 50% after one or two operations. The other 7 were treated in conservative way, including anti- Gastro esophageal reflux, avoiding excessive talking, reducing habitual hawk ,or without any medical treatment. The cure rate was 57.1%. The total cure rate was 53.8%. However, it is nonsense to comparing the two different treatments (Chi2 = 0.066, P > 0.05). CONCLUSION There is still no standard treatment for contact granuloma of larynx and the effect is not good enough. The treatment should be depending on individual case. Conservative treatment is the first choice. However, operation should be considered if the patient has obviously hoarse and his granuloma is too large to breathe well.
Chronic Disease ; Female ; Gastroesophageal Reflux ; complications ; Granuloma, Laryngeal ; etiology ; therapy ; Hoarseness ; etiology ; Humans ; Intubation, Intratracheal ; Male ; Recurrence