Humans ; Proton Pump Inhibitors/therapeutic use* ; Deprescriptions

The mainstay of treatment of laryngopharyngeal reflux focuses on a concoction involving proton-pump inhibitor and modified beneficial behaviors, sometimes referring to medications like H2-R blocker etc. Therapeutic effect seems to be promising although may at times be challenged by conflict researches. Voice therapy and voice parameters emerge to provide a grand new perspective in treatment and evaluation of this disease.
Humans ; Laryngopharyngeal Reflux ; therapy ; Proton Pump Inhibitors ; therapeutic use

No abstract available.
Asthma/*complications ; Female ; Gastroesophageal Reflux/*drug therapy ; Humans ; Male ; Proton Pump Inhibitors/*therapeutic use

OBJECTIVE: To analyze the therapeutic effect of proton pump inhibitor(PPI) on alleviation of hoarseness symptoms in patients with laryngopharyngeal reflux(LPR). METHOD: The LPR outpatients in ENT department of our hospital(60 cases)complained of hoarseness were enrolled in the study from August of 2013 to October of 2014. All of them were randomly divided into group A and B. The individuals in group A (30 cases) taked golden voice capsule to treat for 3 months, while the individuals in group B (30 cases) taked golden voice capsule and omeprazole to treat for 3 months. The data about reflux symptom index (RSI), reflux finding score (RFS) and voice handicap index (VHI)from the first month to the third month after treatment were recorded and compared group A with group B. RESULT: The scores of RSI and RFS in patients (60 cases) before treatment were significantly correlated with their VHI (r=0. 823, P<0. 01; r=0. 873, P<0. 01). The score changes of RSI and VHI from the first to the third month after treatment in group B were significantly higher than those in group A (P<0. 01). Meanwhile, the score changes of RFS from the third month after treatment in group B were significantly higher than those in group A (t=8. 307, P<. 01), but the differences were not significant for RFS from the first to the second month after treatment between group A and group B(t=1. 128, P>0. 05; t=0. 376, P> 0. 05). CONCLUSION PPI therapy could significantly alleviate the hoarseness symptom in LPR patients.
Hoarseness ; drug therapy ; Humans ; Laryngopharyngeal Reflux ; drug therapy ; Proton Pump Inhibitors ; therapeutic use

Gastric acid suppressants, such as proton pump inhibitors, are one of the most widey used drugs worldwide. There is a very high frequency of abuse of gastric acid suppressants, leading huge waste of medical resources. Moreover, numerous studies have showed that acid suppressants were associated with a variety of adverse events, such as fractures and intestinal infections. Increasing guidelines and consensuses have been made to guide the appropriate use of acid suppressants. Gastrointestinal surgery is one of the fields with the largest prescriptions of acid suppressants. Acid suppressants are widely used for preventing anastomotic bleeding after upper gastrointestinal surgery, treating gastrointestinal bleeding and etc. However, most of these prescriptions are off-label uses lacking adequate evidentiary basis. Thus far, there is no guideline specific for appropriate use of acid suppressants in digestive surgeries. Therefore, Chinese Society of Upper Gastrointestinal Surgeons (CSUGS) and Chinese Gastric Cancer Association (CGCA) developed this clinical practice guideline based on the best research evidence and clinical expertise. The aim is to guide the appropriate use of gastric acid suppressants in gastrointestinal surgery, which in turn, increase the benefits of patients.
Humans ; Digestive System Surgical Procedures ; Gastric Acid ; Gastrointestinal Hemorrhage/prevention & control* ; Proton Pump Inhibitors/therapeutic use*

Objective: To produce the Chinese version of a new reflux symptom score (RSS) of laryngopharyngeal reflux disease (LPRD) and to evaluate its reliability, validity and clinical value. Methods: This was a retrospective study which contained 42 healthy volunteers and 135 possible LPRD patients. RSI,RFS,oropharyngeal pH monitoring (Dx-pH monitoring) and RSS of each patient were performed. RSS was performed again after 1 week. Confirmed LPRD patients were treated with proton pump inhibitor for 8 week. And RSS was performed again after treatment. Reliability and validity of RSS were evaluated. Results: The Cronbach's α coefficient of RSS was 0.77, which indicated good internal reliability of the new score. The results of test-retest found all P values were less than 0.05, which supported good external reliability. Comparing RSS with laryngopharyngeal reflux test results, the diagnostic coincidence rate was 84.44% (114/135), and the positive predictive value was 85.71% (114/133), which showed good criterion validity. After 8 weeks treatment of PPI, RSS decreased significantly (pretreatment 84.79±42.50,posttreatment 20.11±22.82,t=-10.54, P<0.001), indicating good reactivity of RSS. The score of quality of life impact (Qol) in possible LPRD patients was obviously higher than that of healthy volunteers (t=7.15,P<0.001). All patients and volunteers believed that RSS was a good way to evaluate their symptoms. Conclusions: The new score RSS have good internal and external reliability, criterion validity and reactivity. RSS can be one of the important reference indexes to evaluate LPRD.
Humans ; Laryngopharyngeal Reflux/diagnosis* ; Reproducibility of Results ; Retrospective Studies ; Quality of Life ; Proton Pump Inhibitors/therapeutic use* ; China

No abstract available.
Gastroesophageal Reflux/economics/*therapy ; Histamine Antagonists/therapeutic use ; Humans ; Practice Guidelines as Topic ; Proton Pump Inhibitors/therapeutic use

Peptic ulcer is one of the most prevalent diseases in gastrointestinal field. Recently, evolution was made for pathophysiology of peptic ulcer from "no acid, no ulcer" to Helicobacter pylori and non-steroidal anti-inflammatory drugs. The prevalence of peptic ulcer disease is estimated about 10% in Korea, and has declined due to Helicobacter pylori eradication therapy. Peptic ulcer has the cycle of exacerbation and improvement in the clinical course, and has not occasionally any clinical symptom. Helicobacter pylori eradication has made the marked reduction of relapse of peptic ulcer disease. Although nationwide endoscopic screening has enabled accurate diagnosis of peptic ulcer disease, general guideline for diagnosis of peptic ulcer has not made in Korea. Herein, we propose a guideline for the diagnosis of peptic ulcer according to domestic, international clinical studies, and experts opinions with level of evidence and grade of recommendation.
Anticoagulants/therapeutic use ; Endoscopy, Gastrointestinal ; Helicobacter Infections/diagnosis ; Helicobacter pylori ; Humans ; Peptic Ulcer/*diagnosis ; Proton Pump Inhibitors/therapeutic use

Esophageal pain that manifests as heartburn or chest pain, is a prevalent problem. Esophageal chest pain is most often caused by gastroesophageal reflux disease (GERD), but can also result from inflammatory processes, infections involving the esophagus, and contractions of the esophageal muscle. The mechanisms and pathways of esophageal chest pain are poorly understood. Vagal and spinal afferent pathways carry sensory information from the esophagus. Recently, esophageal hypersensitivity is identified as an important factor in the development of esophageal pain. A number of techniques are available to evaluate esophageal chest pain such as endoscopy and/or proton-pump inhibitor trial, esophageal manometry, a combined impedance-pH study, and esophageal ultrasound imaging. Proton pump inhibitors (PPIs) have the huge success in the treatment of GERD. Other drugs such as imipramine, trazadone, sertraline, tricyclics, and theophylline have been introduced for the control of esophageal chest pain in partial responders to PPI and the patients with esophageal hypersensitivity. Novel drugs which act on different targets are anticipated to treat esophageal pain in the future.
Chest Pain/*etiology ; Esophageal pH Monitoring ; Gastroesophageal Reflux/*diagnosis/drug therapy/ultrasonography ; Humans ; Manometry ; Proton Pump Inhibitors/therapeutic use

Noncardiac chest pain (NCCP) is defined as recurring, angina-like, retrosternal chest pain of noncardiac origin. Although patients with NCCP have excellent long-term prognosis, most suffer persistently from their symptoms. Several pathophysiological mechanisms have been suggested, including gastroesophageal reflux disease (GERD), esophageal motility disorder, esophageal hypersensitivity, and psychological comorbidity. Among them, GERD is the most common cause of NCCP. Therefore, GERD should first be considered as the underlying cause of symptoms in patients with NCCP. Empirical proton pump inhibitor (PPI) treatment with a preferably double dose for more than 2 months could be cost-effective. PPI test can also be used for diagnosis of GERD-related NCCP, but it should be considered for patients with NCCP occurring at least weekly and its duration should be at least 2 weeks. However, upper endoscopy and esophageal pH monitoring are necessary when the diagnosis of GERD is uncertain. Esophageal impedance-pH monitoring could further improve the diagnostic yield. Patients with GERD-related NCCP should preferably be treated with a double dose PPI until symptoms remit (may require more than 2 months of therapy for optimal symptom control), followed by dose tapering to determine the lowest PPI dose that can control symptoms. However, treatment of patients with non-GERD-related NCCP is challenging. An empirical treatment of antidepressants could be considered. If there are specific esophageal motility disorders, smooth muscle relaxants or endoscopic treatment may be considered in selected cases. If none of these traditional treatments is effective, a psychology consultation for cognitive behavioral therapy should be considered.
Chest Pain/*diagnosis/etiology ; Esophageal pH Monitoring ; Gastroesophageal Reflux/complications/*diagnosis/drug therapy ; Humans ; Manometry ; Proton Pump Inhibitors/therapeutic use