A Comparison of Alkaline Water and #Mediterranean Diet vs Proton #Pump Inhibition for Treatment of Laryngopharyngeal #Reflux
http://jamanetwork.com/journals/jamaotolaryngology/fullarticle/2652893

Laryngopharyngeal reflux (LPR) is a common disorder with protean manifestations in the head and neck. In this retrospective study, we report the efficacy of a wholly dietary approach using alkaline water, a plant-based, Mediterranean-style diet, and standard reflux precautions compared with that of the traditional treatment approach of proton pump inhibition (PPI) and standard reflux precautions

Conclusions and Relevance Our data suggest that the effect of PPI on the RSI Reflux Symptom Index based on proportion reaching a 6-point reduction in RSI is not significantly better than that of alkaline water, a plant-based, Mediterranean-style diet, and standard reflux precautions, although the difference in the 2 treatments could be clinically meaningful in favor of the dietary approach. The percent reduction in RSI was significantly greater with the dietary approach. Because the relationship between percent change and response to treatment has not been studied, the clinical significance of this difference requires further study. Nevertheless, this study suggests that a plant-based diet and alkaline water should be considered in the treatment of LPR. This approach may effectively improve symptoms and could avoid the costs and adverse effects of pharmacological intervention as well as afford the additional health benefits associated with a healthy, plant-based diet

Association Between #Laparoscopic Antireflux Surgery and Recurrence of Gastroesophageal #Reflux
http://jamanetwork.com/journals/jama/article-abstract/2653734

.. 470 patients (17.7%) had reflux recurrence; 393 (83.6%) received long-term antireflux medication and 77 (16.4%) underwent secondary antireflux surgery. Risk factors for reflux recurrence included female sex (hazard ratio HR, 1.57 95% CI, 1.29-1.90; 286 of 1301 women 22.0% and 184 of 1354 men 13.6% had recurrence of reflux), older age (HR, 1.41 95% CI, 1.10-1.81 for age ≥61 years compared with ≤45 years; recurrence among 156 of 715 patients and 133 of 989 patients, respectively), and comorbidity (HR, 1.36 95% CI, 1.13-1.65 for Charlson comorbidity index score ≥1 compared with 0; recurrence among 180 of 804 patients and 290 of 1851 patients, respectively). Hospital volume of antireflux surgery was not associated with risk of reflux recurrence (HR, 1.09 95% CI, 0.77-1.53 for hospital volume ≤24 surgeries compared with ≥76 surgeries; recurrence among 38 of 266 patients 14.3% and 271 of 1526 patients 17.8%, respectively).

Conclusions and Relevance Among patients who underwent primary laparoscopic antireflux surgery, 17.7% experienced recurrent gastroesophageal reflux requiring long-term medication use or secondary antireflux surgery. Risk factors for recurrence were older age, female sex, and comorbidity. Laparoscopic antireflux surgery was associated with a relatively high rate of recurrent gastroesophageal reflux disease requiring treatment, diminishing some of the benefits of the operation. Cohort studies, mainly based on questionnaires and interviews, have reported high rates of reflux recurrence after antireflux surgery, which may have contributed to a decline in its use. Reflux recurrence after laparoscopic antireflux surgery has not been assessed in a long-term population-based study of unselected patients

Association of Gastroesophageal #Reflux With #Malignancy of the Upper Aerodigestive Tract in Elderly Patients
https://jamanetwork.com/journals/jamaotolaryngology/article-abstract/2666578?redirect=true

A total of 13 805 patients (median range age, 74 66-99 years; 3418 women 24.76% and 10 387 men 75.24%) with malignancy of the UADT were compared with 13 805 patients without disease and were matched for sex, age group, and year of diagnosis. GERD was associated with a greater odds of developing malignancy of the larynx (adjusted odds ratio aOR, 2.86; 95% CI, 2.65-3.09), hypopharynx (aOR, 2.54; 95% CI 1.97-3.29), oropharynx (aOR, 2.47; 95% CI, 1.90-3.23), tonsil (aOR, 2.14; 95% CI, 1.82-2.53), nasopharynx (aOR, 2.04; 95% CI, 1.56-2.66), and paranasal sinuses (aOR, 1.40; 95% CI, 1.15-1.70).

Conclusions and Relevance GERD is associated with the presence of malignancy of the UADT in the US elderly population. This epidemiological association requires further examination to determine causality and diagnostic utility

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Gastro-Esophageal #Reflux Disease After Laparoscopic Mini-Gastric #Bypass and Roux-en-Y Gastric Bypass: Is There a Difference?

https://www.liebertpub.com/doi/10.1089/bari.2018.0018

The operative time was significantly longer in RYGB group compared to MGB group (p < 0.001). The percentage of excess weight loss was slightly higher in the MGB group after 6 months (p = 0.096). There were no cases of leakage or mortalities in the two groups. Complications were recorded in 30% of the MGB group and 40% of the RYGB group. Biliary reflux was detected endoscopically in 11 patients (36.6%) in the MGB group and none of the RYGB group. GERD symptoms were exaggerated in MGB group after 1 month compared to RYGB group (p = 0.008). At 12 months, symptoms improved significantly in the two groups; the scores were nonsignificantly higher in MGB group (p = 0.088). Esophagitis was more common in the MGB group than RYGB group (p = 0.008).

Conclusion: Laparoscopic Roux-en-Y gastric bypass and laparoscopic mini-gastric bypass appear to be equally effective in the treatment of morbid obesity regarding weight loss and resolution of obesity-related metabolic complications. On short-term follow-up, MGB exaggerated GERD symptoms, but in the long run, symptoms decreased markedly.

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Association Between #Beverage Intake and Incidence of Gastroesophageal #Reflux Symptoms

..Patients are frequently advised to eliminate coffee, tea, and/or soda to reduce symptoms of gastroesophageal reflux (GER), such as heartburn or regurgitation.

..After multivariable adjustment, hazard ratios (HRs) for women with the highest intake of each beverage (more than 6 servings/day) compared to women with the lowest intake (0 servings/day) were 1.34 for coffee (95% CI, 1.13–1.59; Ptrend<.0001), 1.26 for tea (95% CI, 1.03–1.55; Ptrend<.001), and 1.29 for soda (95% CI, 1.05–1.58; Ptrend<.0001). We obtained similar results when we stratified patients according to caffeine status. No association was observed between milk, water, or juice consumption and risk for GER symptoms. In a substitution analysis, replacement of 2 servings/day of coffee, tea, or soda with 2 servings of water was associated with reduced risk of GERD symptoms: coffee HR, 0.96 (95% CI, 0.92–1.00); tea HR, 0.96 (95% CI, 0.92–1.00); and soda HR, 0.92 (95% CI, 0.89– 0.96).

Conclusions
In an analysis of data from the prospective Nurses’ Health Study II, intake of coffee, tea, or soda was associated with an increased risk of GER symptoms. In contrast, consumption of water, juice, or milk were not associated with GER symptoms. Drinking water instead of coffee, tea, or soda reduced the risk of GER symptoms.

https://www.cghjournal.org/article/S1542-3565(19)31380-1/fulltext

Assessment of Gastroesophageal #Reflux Symptoms and #Sleep Quality Among Women in the Nurses’ Health Study II

https://2medical.news/2023/09/19/assessment-of-gastroesophageal-reflux-symptoms-and-sleep-quality-among-women-in-the-nurses-health-study-ii/