Retained Rice Cake: A Unique Upper Gastrointestinal Foreign Body: Case Report and a Literature Review.

As a rarely recognized foreign body in the upper gastrointestinal tract, rice cake frequently requires endoscopic removal. We herein report six patients with characteristic sonography, computed tomography (CT), spectroscopy, endoscopy, and histological findings. A review of all published cases, including ours, revealed that retained rice cake in the stomach typically shows the following: abdominal pain (93.

[Risk factors for reflux esophagitis and countermeasures-Diet].

Reflux esophagitis is increasing in Japan in association with cultural and societal changes to a more Western lifestyle. The major cause is reflux of gastric contents, consisting mainly of gastric acid, into the esophagus. For prevention, it is necessary to give attention to the contents of meals, as well as food form and eating habits.

Effect of Timing of Proton Pump Inhibitor Administration on Acid Suppression.

Background: Esomeprazole has been reported to show a strong acid suppression following preprandial as compared to postprandial administration, though no known study has compared the acid suppressing effects of other proton pump inhibitors between those administrations. The aim of this study was to compare intragastric pH levels following pre- and postprandial administrations of rabeprazole and esomeprazole.

Methods: In 15 Helicobacter pylori-negative healthy volunteers, we measured intragastric pH after 7 days of pre- and postprandial administrations of rabeprazole (10 mg) or esomeprazole (20 mg) using a 5-way crossover design.

[Relationship of acid-related diseases with lifestyle habit changes and environmental factors].

In association with significant alterations in lifestyle habits, such as more Westernized dietary habits, and environmental factors including improved hygiene, changes in gastric acid secretion and upper gastrointestinal motility have recently been noted in Japanese individuals. Formerly, peptic ulcers, especially those caused by Helicobacter pylori infection, was the major acid-related disease encountered in Japan. However, more recently, cases of NSAID--and aspirin-induced ulcers are increasing.

Evidence-based clinical practice guidelines for irritable bowel syndrome.

New strategies for the care of irritable bowel syndrome (IBS) are developing and several novel treatments have been globally produced. New methods of care should be customized geographically because each country has a specific medical system, life style, eating habit, gut microbiota, genes and so on. Several clinical guidelines for IBS have been proposed and the Japanese Society of Gastroenterology (JSGE) subsequently developed evidence-based clinical practice guidelines for IBS.

Intra-gastric pH following single oral administrations of rabeprazole and esomeprazole: double-blind cross-over comparison.

Comparisons between the acid inhibitory effects of rabeprazole and esomeprazole after single oral administration with standard doses have not been previously presented. We examined intra-gastric pH after oral administrations of these two proton pump inhibitors using 24-h pH monitoring. Fifty-four normal volunteers not infected by Helicobacter pylori were investigated.

Clinical characteristics of elderly patients with proton pump inhibitor-refractory non-erosive reflux disease from the G-PRIDE study who responded to rikkunshito.

Background: The incidence and severity of gastroesophageal reflux disease (GERD) in Japan tends to increase in elderly women. Rikkunshito (RKT), a traditional Japanese medicine, acts as a prokinetic agent and improves gastric emptying and gastric accommodation. Our previous prospective randomized placebo-controlled study showed that RKT combined with a standard-dose of rabeprazole (RPZ) significantly improved the acid-related dysmotility symptoms (ARD) in elderly patients with proton pump inhibitor (PPI)-refractory non-erosive reflux disease (NERD).

A randomized, placebo-controlled, double-blind clinical trial of rikkunshito for patients with non-erosive reflux disease refractory to proton-pump inhibitor: the G-PRIDE study.

Background: The aim of this study was to investigate the efficacy of rikkunshito (RKT), a traditional Japanese medicine, combined with proton pump inhibitor (PPI) in patients with PPI-refractory non-erosive reflux disease (NERD).

Methods: Patients with PPI-refractory NERD (n = 242) were randomly assigned to the RKT group [rabeprazole (10 mg/day) + RKT (7.5 g/t.

Generation of Gastroesophageal Reflux Disease Symptoms During Esophageal Acid Infusion With Concomitant Esophageal pH Monitoring in Healthy Adults.

Background/aims: The sensitivity of the upper and lower esophageal mucosa to acid is considered to differ. We investigated the relationship between pH changes in different sites of the esophagus and generation of gastroesophageal reflux symptoms during an acid infusion test.

Methods: An acid infusion catheter was placed at 5 or 15 cm above the lower esophageal sphincter (LES) in 18 healthy volunteers, while a 2-channel pH sensor catheter was also placed in each with the sensors set at 5 and 15 cm above the LES.

Effects of mosapride on esophageal motor activity and esophagogastric junction compliance in healthy volunteers.

Background: The effects of the prokinetic drug mosapride on esophageal motor activity vary at standard doses. In addition to esophageal motor activities, compliance of the esophagogastric junction (EGJ) is important for prevention of gastroesophageal reflux. However, the effects of mosapride on EGJ compliance have not been reported.

Case-control study of association of eosinophilic gastrointestinal disorders with Helicobacter pylori infection in Japan.

Recent studies have suggested that decrease in Helicobacter pylori infection may predispose to allergic diseases. However, there are few reports of the relationships of eosinophilic gastrointestinal disorders (EGIDs), especially eosinophilic gastroenteritis (EGE), with H. pylori infection.

Continuous imaging of esophagogastric junction in patients with reflux esophagitis using 320-row area detector CT: a feasibility study.

Background And Aim: The function of the lower esophageal sphincter (LES) is evaluated using an esophageal manometric study. However, information regarding the surrounding organs is difficult to obtain with use of a sensor catheter. We investigated the utility of 320-row area detector computed tomography (CT) to evaluate morphological changes of the esophagogastric junction and surrounding organs.

Limited role of allergy testing in patients with eosinophilic gastrointestinal disorders.

Background And Aim: Allergies have been implicated in the pathogenesis of eosinophilic gastrointestinal disorders, although it remains unknown what type of allergen is closely associated with their development. The aim of this study is to investigate the possible involvement of food and/or aeroallergen factors in eosinophilic gastrointestinal disorders.

Methods: Eighteen patients with eosinophilic esophagitis (EoE), 23 with eosinophilic gastroenteritis (EGE), and 28 healthy volunteers were enrolled.

Observations of Acid Reflux and Motor Function in Distal Esophagus Using Simultaneous Measurements of Intra-esophageal pH and Pressure in 8 Directions With Novel Sensor Catheter - A Feasibility Study.

Background/aims: Esophagogastric junctional lesions, such as mucosal breaks with Los Angeles grade A or B reflux esophagitis, lacerations in Mallory Weiss syndrome, and short segment Barrett's esophagus, are mainly found in the right anterior wall of the distal esophagus. Asymmetrical lower esophageal sphincter pressure and resting radial asymmetrical acid reflux may be causes of this asymmetrical distribution of reflux esophagitis and short segment Barrett's esophagus. We developed a novel pH and pressure catheter to investigate the asymmetrical distributions of pH and intra-esophageal pressure in the distal esophagus.

Association between metabolic syndrome and prevalence of gastroesophageal reflux disease in a health screening facility in Japan.

Background: Abdominal fat accumulation, which induces high intra-abdominal pressure that causes increase in the gastroesophageal pressure gradient and hiatal hernia, as well as obesity, has been shown to increase the prevalence of gastroesophageal reflux disease (GERD). This study was performed to clarify the association between metabolic syndrome and the prevalence of GERD.

Methods: The study subjects were an adult population who visited a medical center for annual medical check-ups from April 2010 to March 2011.

Elevated plasma cytokines in Japanese patients with eosinophilic esophagitis and gastroenteritis.

Background/aim: The role of Th2-type cytokines in development of eosinophilic esophagitis (EoE) has been largely revealed, whereas research on the pathogenesis of eosinophilic gastroenteritis (EGE) has not been widely performed. We investigated the possible involvement of Th2-type cytokines in EGE by measuring plasma cytokine concentrations in patients with EGE as well as those with EoE.

Methods: 18 patients with EoE, 18 with EGE, and 30 normal volunteers were enrolled in the study.

Clinical characteristics of Japanese patients with eosinophilic esophagitis and eosinophilic gastroenteritis.

Background: The clinical characteristics of Japanese patients with eosinophilic esophagitis (EoE) and eosinophilic gastroenteritis (EGE) have not been fully clarified. For understanding the pathogenesis as well as providing support for accurate diagnosis, precise information regarding clinical characteristics of these diseases is important.

Methods: A questionnaire-based survey of EoE and EGE was conducted in 1,078 teaching hospitals.

Diarrhea caused by proton pump inhibitor administration: comparisons among lansoprazole, rabeprazole, and omeprazole.

Background: The number of patients who require treatment with proton pump inhibitors (PPIs) is increasing in Japan. One of their adverse effects is diarrhea.

Objectives: We investigated the incidence of diarrhea caused by 3 different PPIs: lansoprazole, rabeprazole, and omeprazole.

Efficacy of pectin solution for preventing gastro-esophageal reflux events in patients with percutaneous endoscopic gastrostomy.

The aim of this study was to determine the efficacy of pectin solution, which increases the viscosity of liquid nutrient, for prevention of gastro-esophageal reflux in comparison with half-solid nutrient. The subjects were 10 elderly patients undergoing percutaneous endoscopic gastrostomy feeding. Twenty-four-hour esophageal multichannel intraluminal impedance and pH testing was performed during intake of half-solid nutrient and a combination of pectin solution and liquid nutrient.

Radially asymmetric gastroesophageal acid reflux in the distal esophagus: examinations with novel pH sensor catheter equipped with 8 pH sensors.

Background: Esophageal mucosal breaks in patients with Los Angeles (LA) grade A or B esophagitis are mainly found in the right anterior wall of the distal esophagus. The aim of this study was to reveal radial acid exposure in the distal esophagus and determine whether radial asymmetry of acid exposure is a possible cause of radially asymmetric distribution of the lesions.

Methods: We developed a novel pH sensor catheter using a polyvinyl chloride catheter equipped with 8 antimony pH sensors radially arrayed at the same level.