Help
Subscribe


All of GastroHep is now free access! - Click here to register Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Functional heartburn in patients with PPI-refractory heartburn

A study published ahead of print in the Alimentary Pharmacology & Therapeutics examines histomorphological differentiation of non-erosive reflux disease and functional heartburn in patients with PPI-refractory heartburn.

News image

Proton pump inhibitor-refractory heartburn may be due to persistent gastro-esophageal reflux, esophageal hypersensitivity or functional heartburn.

The differentiation between non-erosive reflux disease and functional heartburn may be very difficult.

However, this differentiation is important for appropriate therapeutic management.

Dilated intercellular spaces, papillary elongation and basal cell hyperplasia can be all assessed by light microscopy.

Whether these mucosal abnormalities allow the differentiation of non-erosive reflux disease from functional heartburn in proton pump inhibitor-refractory patients is uncertain.

Dr Kandulski and colleagues from Germany assessed histopathological findings by light microscopy in patients with refractory heartburn to differentiate non-erosive reflux disease from functional heartburn.

The research team evaluated 62 patients with proton pump inhibitor-refractory symptoms who underwent esophagogastroduodenoscopy, and multichannel intraluminal impedance and pH monitoring (MII-pH) after pausing proton pump inhibitor medication for 2 weeks before investigation.

The team analyzed 25 subjects without upper gastrointestinal symptoms as controls.

Symptom assessment was based on the reflux disease questionnaire. 

Biopsies were taken 3–5 cm above the gastro-esophageal junction.

The most significant difference was found for dilated intercellular spaces
Alimentary Pharmacology & Therapeutics

Dilated intercellular spaces, papillary elongation, basal cell hyperplasia and infiltration of immune cells were evaluated and a sum score was calculated.

Based on endoscopy and MII-pH, GERD was diagnosed in 43 patients non-erosive reflux disease, and functional heartburn in 19 patients.

There was no difference in symptoms between the groups.

Each individual histopathological item was different between the groups.

Between non-erosive reflux disease and functional heartburn, the most significant difference was found for dilated intercellular spaces, and the histopathological sum score.

Dr Kandulski's team concluded, "These findings suggest that esophageal biopsies are useful to differentiate non-erosive reflux disease from functional heartburn."

"Increased dilated intercellular spaces and a histological sum score are the most significant histopathological abnormalities in non-erosive reflux disease as compared with functional heartburn."

Aliment Pharmacol Ther 2013: DOI: 10.1111/apt.12428
19 August 2013

Go to top of page Email this page Email this page to a colleague

 23 August 2014

Advanced search
 22 August 2014 
Endoscopic submucosal dissection for squamous esophageal cancer
 22 August 2014 
Adherence to Rome criteria in functional dyspepsia trials
 22 August 2014 
Outlier identification in colorectal surgery
 21 August 2014 
Screening for Barrett’s esophagus
 21 August 2014 
Colorectal cancer mortality in Brazil
 21 August 2014 
Eosinophilic esophagitis
 20 August 2014 
Rectal surgery mortality
 20 August 2014 
Chemotherapy-induced gastrointestinal mucositis
 20 August 2014 
Stool methylated DNA markers and colorectal cancer resection
 19 August 2014 
Recurrent C. difficile infection in out-patients
 19 August 2014 
Racial disparities and colon cancer
 19 August 2014 
Variability of colonoscopy preparation instructions
 18 August 2014 
The evolution of urban C. difficile
 18 August 2014 
Metabolomic analysis in IBD
 18 August 2014 
Enhanced T-cell response in acute-on-chronic Hep B
 15 August 2014 
Abdominal pain in IBS
 15 August 2014 
Gene expression biomarker in ulcerative colitis
 15 August 2014 
Population-based fecal immunochemical test screening
 14 August 2014 
Transnasal vs transoral endoscopy
 14 August 2014 
Radiation exposure in gastroenterology
 14 August 2014 
Dietary fibre and diverticular disease
 13 August 2014 
Flexible sigmoidoscopy screening
 13 August 2014 
Adherence to Rome criteria in functional dyspepsia
 13 August 2014 
Fecal immunochemical test screening
 12 August 2014 
Eosinophilic esophagitis and celiac disease
 12 August 2014 
Management of Lynch syndrome
 12 August 2014 
Risk of cancer under immunosuppressive therapy in IBD
 11 August 2014 
Risk of GI bleeds with anticoagulants
 11 August 2014 
Social media in health-care
 11 August 2014 
Gut microbiota in chemotherapy-induced GI mucositis
 08 August 2014 
Endoscopy nurse-administered propofol sedation performance
 08 August 2014 
Therapy for biliary tract cancer
 08 August 2014 
Surgeon volume and esophagectomy survival
 07 August 2014 
Global consensus on perianal fistulizing Crohn's disease
 07 August 2014 
Smoking cessation and age of onset of ulcerative colitis
 07 August 2014 
Colonoscopy length and training duration
 06 August 2014 
Hepatitis C virus infection in the United States
 06 August 2014 
Pediatric to adult IBD care
 06 August 2014 
Biomarker of disease activity in IBD
 05 August 2014 
Rising incidence of celiac disease
 05 August 2014 
Socioeconomic status and IBS
 05 August 2014 
Bowel dysfunction after sphincter-preserving rectal cancer surgery
 04 August 2014 
Relative adrenal insufficiency and chronic liver disease
 04 August 2014 
Colonoscopy screening protocol for liver transplant recipients
 04 August 2014 
Patient-reported outcomes after upper GI bleed
 01 August 2014 
Capsule colonoscopy vs CT colonography for polyp screening
 01 August 2014 
Complications after obesity surgery
 01 August 2014 
Fully covered self-expanding metal stents for benign biliary strictures
 31 July 2014 
Biomarkers in liver fibrosis
 31 July 2014 
Risk factors of large colorectal polyps
 31 July 2014 
Diverticular disease and colon cancer
 30 July 2014 
Small intestinal permeability in diarrhea predominant IBS
 30 July 2014 
Mineral rich water and constipation
 30 July 2014 
Interval between screening colonoscopies
 29 July 2014 
Fluticasone in eosinophilic esophagitis
 29 July 2014 
Causes of GI bleeding in cirrhosis
 29 July 2014 
ALT increases in Hep B
 28 July 2014 
Statins reduce Barrett's
 28 July 2014 
Score predicts risk for Barrett’s esophagus
 28 July 2014 
Gastric cancer prevention

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2014 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us