Gastroesophageal reflux disease (GERD) is a condition that develops when reflux of stomach contents causes troublesome symptoms and/or complications. The prevalence of GERD is increasing worldwide and in Asia-Pacific. The latest Korean guidelines for GERD were published in 2012, and several international guidelines and consensus statements for the management of GERD have also been recently published. Here, we review these guidelines and consensus statements in order to provide a better understanding of the diagnosis and treatment of GERD.
Consensus ; Diagnosis ; Gastroesophageal Reflux ; Gastrointestinal Contents ; Prevalence

Isthmiophora hortensis (Digenea: Echinostomatidae) is a dominant echinostome in animal reservoir hosts and humans in the Republic of Korea (Korea). We intended to investigate the infection status with this echinostome species in the several species of wild animals and describe the morphological characteristics in the faunistic view point. A total of 175 animal carcasses belonging to 3 families, i.e., Canidae, Felidae and Mustelidae, were collected from the southern regions of Korea from March 2010 to July 2017. Isthmiophora spp. worms were recovered from the small intestines of each animal under a stereomicroscope after washing of intestinal contents. Isthmiophora hortensis was recovered from 4 species of wild carnivores, i.e., Nyctereutes procyonoides (3/107: 2.8%), Mustela sibirica (11/31: 35.5%), Meles lucurus (2/3: 33.3%) and Martes flavigula (1/2: 50%). The other 3 carnivores comprising stray dogs, cat and leopard cat were negative for I. hortensis infection (0/2, 0/10 and 0/12, respectively). Specimens obtained from the Lutra lutra (6/8: 75%) were identified as a distinct species, I. inermis, by morphological comparison. Isthmiophora inermis has thinner body, elongate testes and different anterior limits of vitelline fields. Detailed morphological descriptions and comparisons with the morphological characteristics are provided. Conclusively, it was confirmed for the first time that 3 species of mustelid mammals, i.e., M. sibirica, M. lucurus, and M. flavigula, are to be the new definitive hosts of I. hortensis in Korea. Additionally, I. inermis is to be newly added in the Korean echinostome fauna.
Animals ; Animals, Wild ; Canidae ; Cats ; Dogs ; Felidae ; Gastrointestinal Contents ; Humans ; Intestine, Small ; Korea ; Mammals ; Mustelidae ; Otters ; Panthera ; Raccoon Dogs ; Republic of Korea ; Testis ; Vitellins

Gastroesophageal reflux disease (GERD) is a very common disease, and the prevalence in the general population has recently increased. GERD is a chronic relapsing disease associated with motility disorders of the upper gastrointestinal tract. Several factors are implicated in GERD, including hypotensive lower esophageal sphincter, frequent transient lower esophageal sphincter relaxation, esophageal hypersensitivity, reduced resistance of the esophageal mucosa against the refluxed contents, ineffective esophageal motility, abnormal bolus transport, deficits initiating secondary peristalsis, abnormal response to multiple rapid swallowing, and hiatal hernia. One or more of these mechanisms result in the reflux of stomach contents into the esophagus, delayed clearance of the refluxate, and the development of symptoms and/or complications. New techniques, such as 24-hour pH and multichannel intraluminal impedance monitoring, multichannel intraluminal impedance and esophageal manometry, high-resolution manometry, 3-dimensional high-resolution manometry, enoscopic functional luminal imaging probe, and 24-hour dynamic esophageal manometry, provide more information on esophageal motility and have clarified the pathophysiology of GERD. Proton pump inhibitors remain the preferred pharmaceutical option to treat GERD. The ideal target of GERD treatment is to restore esophageal motility and reconstruct the anti-reflux mechanism. This review focuses on current advances in esophageal motor dysfunction in patients with GERD and the influence of these developments on GERD treatment.
Deglutition ; Electric Impedance ; Esophageal Motility Disorders ; Esophageal Sphincter, Lower ; Esophagogastric Junction ; Esophagus ; Gastroesophageal Reflux ; Gastrointestinal Contents ; Hernia, Hiatal ; Humans ; Hydrogen-Ion Concentration ; Hypersensitivity ; Manometry ; Mucous Membrane ; Peristalsis ; Pharmaceutical Preparations ; Phenobarbital ; Prevalence ; Proton Pump Inhibitors ; Relaxation ; Upper Gastrointestinal Tract

Aspiration is the entry of materials, such as pharyngeal secretions, food, or stomach contents, into the respiratory system. Dysphagia is the most common risk factor of aspiration, but there are many other risk factors. A single factor or multiple factors may be present to induce the aspiration, and the risk factors of aspiration should be considered multidimensional. The bedside water test is suitable as a screening test for an evaluation of aspiration. Videofluoroscopic swallowing study and flexible endoscopic evaluation of swallowing are the diagnostic tests of aspiration and the tests are required if the screening test shows signs of aspiration or silent aspiration is strongly suspected. The diagnostic test should assess not only the presence of aspiration, but also the pathophysiologic risk factors of aspiration.
Deglutition ; Deglutition Disorders ; Diagnosis ; Diagnostic Tests, Routine ; Gastrointestinal Contents ; Mass Screening ; Respiratory Aspiration ; Respiratory System ; Risk Factors ; Water

BACKGROUND/AIMS: Gastrointestinal reflux disease (GERD) is defined as ‘a condition that develops when the reflux of stomach contents causes troublesome symptoms and/or complications’. It is associated with various lung diseases, including bronchial asthma, chronic bronchitis, and bronchiectasis. GERD may also affect nontuberculous mycobacterial (NTM) lung disease. We presumed that the normal mucosal barrier of the bronchial epithelium is broken due to the aspiration of gastric juice and consequent chronic bronchial inflammation. This study investigated the prevalence of GERD in accordance with the presence or absence of NTM lung disease and analyzed the difference. METHODS: We screened patients with NTM lung disease in this hospital between January 2011 and December 2015. Among these patients, gastroscopic examinations as a health check-up were performed on 93 patients. We obtained the prevalence of Reflux esophagitis (RE) in patients with NTM and compared it with the prevalence of RE in the normal control subjects. RESULTS: Among 93 patients with NTM, patients without RE was 66.7% (62/93). RE-minimal change was diagnosed in 29.0% (27/93), and RE LA-A was diagnosed in 4.3% (4/93). Comparing the prevalence of RE minimal change, 29.0% (27/93) had NTM and 11.9% (3043/25536) did not have NTM. This was statistically significant. CONCLUSIONS: We showed a greater prevalence of RE minimal change in patients with NTM than those without NTM with statistical significance.
Asthma ; Bronchiectasis ; Bronchitis, Chronic ; Epithelium ; Esophagitis, Peptic ; Gastric Juice ; Gastroesophageal Reflux ; Gastrointestinal Contents ; Humans ; Inflammation ; Lung Diseases ; Lung ; Nontuberculous Mycobacteria ; Prevalence

Some small mammals occur as household pests and harbour a number of parasites that could be of public health importance. This study profiled the helminth and protozoan parasites in trapped small mammals within and around human dwelling places (houses) located across 4 major towns (Auchi, Benin, Ekpoma, and Uromi) and environs in Edo state, Nigeria. Six genera (Apodemus sp., Crocidura sp., Mastomys natalensis, Mus musculus, Rattus sp., and Sorex sp.) were identified from 502 trapped small mammals. Overall, M. musculus (71.9%) and Rattus rattus (20.1%) were the most frequently trapped. In total, on examination of blood, gastrointestinal contents, and brain tissues, 12 helminth taxa (Angiostrongylus sp., Aspicularis sp., Capillaria sp., Gongylonema sp., Heterakis spumosa, Hymenolepis diminuta, Hymenolepis nana, Mastophorus muris, Moniliformis moniliformis, Nippostrongylus brasiliensis, Strongyloides sp., Trichosomoides sp., and Trichuris sp.), and 6 protozoan parasites (Babesia sp., Trypanosoma lewisi, Plasmodium sp., Eimeria sp., Isospora sp., and Toxoplasma gondii) were isolated. Most prevalent helminths with relatively heavy mean intensity were Strongyloides sp. and Heterakis spumosa, while Plasmodium, Eimeria, and Isospora were the most prevalent protozoan parasites. Generally, intrinsic factors like sex and age had marginal influence on the rate and burden of infection in M. musculus and R. rattus. Although the infection rate and prevalence of zoonotic parasites were low, they were largely recovered in rodents from Ekpoma. This study elucidates the public health implication of the presence of zoonotic parasites in these small mammals.
Animals ; Benin ; Brain ; Capillaria ; Eimeria ; Family Characteristics ; Gastrointestinal Contents ; Helminths ; Humans ; Hymenolepis diminuta ; Hymenolepis nana ; Intrinsic Factor ; Isospora ; Mammals ; Mice ; Moniliformis ; Murinae ; Nigeria ; Nippostrongylus ; Parasites ; Plasmodium ; Prevalence ; Public Health ; Rats ; Rodentia ; Spiruroidea ; Strongyloides ; Toxoplasma ; Trichuris ; Trypanosoma lewisi

Rodents are important reservoirs of diseases affecting people and livestock, and are major sources of parasite contamination of agricultural products. We surveyed the infection status of intestinal helminths in 2 species of field mice, Apodemus agrarius and A. peninsulae, captured in the agricultural fields of Gangwon-do and Chungcheongnam-do, Korea. Total 83 mice (57 A. agrarius and 26 A. peninsulae) were collected in 2 surveyed areas, and the intestines of each mouse were opened with scissors, and then intestinal contents were examined with microscope. Total 6 species of intestinal helminth were detected in 61 (73.5%) out of 83 mice examined. Four species of nematode, i.e., Nippostrongylus brasiliensis, Aspiculuris tetraptera, Heterakis spp. and ascarid, were found in 40 (48.2%), 14 (16.9%), 11 (13.3%) and 13 (15.7%) mice respectively. One species of cestode, Hymenolepis diminuta and 1 unidentified egg were also detected in the intestines of 14 (16.9%) and 1 (1.2%) mice, respectively. Conclusively, this study identified 5 helminth species in the gastrointestinal tracts of wild rodents captured in some areas in central and northern Korea, and N. brasiliensis was the most prevalent (dominant) species rather than zoonotic ones.
Animals ; Cestoda ; Chungcheongnam-do ; Gangwon-do ; Gastrointestinal Contents ; Gastrointestinal Tract ; Helminths ; Hymenolepis diminuta ; Intestines ; Korea ; Livestock ; Mice ; Murinae ; Nippostrongylus ; Ovum ; Parasites ; Rodentia

BACKGROUND/AIMS: The aim of this study was to assess whether increased intestinal gas or fat content in the abdominal cavity is related to abdominal bloating, using three-dimensional abdominal computed tomography scan. METHODS: Twenty-nine healthy individuals without abdominal bloating and organic disease (15 women; mean age, 49 years; range of age, 23–73 years) and 30 patients with chronic recurrent abdominal bloating-diagnosed with functional bloating (10 women; mean age, 53 years; range of age, 35–75 years) - participated in this study. The mean values of measured parameters were compared using independent sample t-test. RESULTS: The mean volume of total colon gas in bloated patients was similar to that in control subjects. The distribution of intra-abdominal gas was also similar between the two groups. However, the amount of gas in the transverse colon tended to be significantly higher in patients with bloating than in controls (p=0.06). Body mass index was similar between the two groups (23.4±3.2 kg/m2 and 22.3±3.1 kg/m2, respectively). Moreover, no significant differences with respect to circumferential area, subcutaneous fat, visceral fat area, and total fat area were found between the two groups. CONCLUSIONS: Bloating might not just be the result of gastrointestinal gas or intra-abdominal fat. Other contributing factors, such as localized abnormality in gas distribution and visceral hypersensitivity, may be involved.
Abdominal Cavity ; Abdominal Fat* ; Body Mass Index ; Colon ; Colon, Transverse ; Female ; Gastrointestinal Contents ; Humans ; Hypersensitivity ; Intra-Abdominal Fat ; Irritable Bowel Syndrome ; Multidetector Computed Tomography ; Subcutaneous Fat

OBJECTIVES: To study the correlation between the movement distance of small intestinal contents and survival time in female SD rat models after one-time satiation, and to evaluate its application value for postmortem interval estimation. METHODS: Adult female SD rats were randomly divided into postprandial groups （1, 2, 3, 4 and 5 h after feeding） and control group. The postprandial groups were fed for 1 h, meanwhile control group was kept fasting. All rats were sacrificed at the given time. The contents in stomach and small intestine were observed, described, compared and photographed, and the movement distance of small intestinal contents was measured. The data of postprandial groups were analysed by one-way analysis of variance. RESULTS: The stomach and duodenum of control group were empty with a little thin and yellow small intestinal liquid. The gastral cavities of 1 h postprandial group were full of undigested food. The evolutionary changes of character, colour and content were observed in the gastric and small intestinal contents of other postprandial groups. The movement distance of intestinal contents increased while the empty part decreased gradually. The differences among the postprandial groups were statistically significant （P<0.05）. CONCLUSIONS After a 24 h fasting with free drinking and the following 1 h feeding, an ideal animal model can be established successfully on female SD rats, which can provide an experimental basis for postmortem interval estimation based on the changes of small intestinal contents in forensic practice.
Animals ; Body Fluids ; Female ; Gastrointestinal Contents ; Male ; Rats ; Rats, Sprague-Dawley ; Stomach

PURPOSE: I introduce the use of transanal intestinal long tube (TILT) using nasogastric tube. TILT passes from anus to the anastomosis, helping to decompress a dilated bowel loop. METHODS: TILT procedure was limited to those patients predicting a severe luminal size discrepancy after intestinal anastomosis, and who had postoperative prolonged ileus. We retrospectively reviewed the medical records of 10 infants (7 male an 3 female patients) who were treated using the TILT procedure between 2012 and 2016. RESULTS: Median gestational age was 27⁺⁵ weeks and birth weight was 940 g. The first operation was done at a median of 4.5 days after birth due to necrotizing enterocolitis perforation (4 cases), isolated intestinal perforation (3 cases), meconium related ileus (1 case), congenital ileal volvulus (1 case), and ileal atresia (1 case). Nine cases of ileostomy closure were planned at a median of 130.5 days with a body weight of 3,060 g. For the ileal atresia case, TILT procedure without additional small bowel resection was performed to treat postoperative prolonged ileus. Nine out of ten were well functioned and defecation via anus was observed in a median of 4.5 days. Milk feeding began at a median of 6 days and the long intestinal tube was removed in a median of 14.5 days. CONCLUSION: I suggested that TILT procedure could be a noninvasive operative option, predicting of size mismatched anastomosis causing prolonged ileus. Passive drainage of proximal intestinal contents might be helpful for decompress endoluminal pressure during the time of anastomosis healing with bowel movement recovery.
Anal Canal ; Anastomosis, Surgical ; Birth Weight ; Body Weight ; Decompression ; Defecation ; Drainage ; Enterocolitis, Necrotizing ; Female ; Gastrointestinal Contents ; Gestational Age ; Humans ; Ileostomy ; Ileus ; Infant ; Intestinal Obstruction ; Intestinal Perforation ; Intestinal Volvulus ; Male ; Meconium ; Medical Records ; Methods* ; Milk ; Parturition ; Phenobarbital ; Retrospective Studies