Heartburn, Functional Dyspepsia, Anxiety/Depression, and Sleep Disturbances Are Associated With Clinically Significant Belching.

Background/aims: Belching is the act of expelling gas from the stomach or esophagus noisily through the oral cavity. Although it is a physiological phenomenon, belching may also be a symptom of upper gastrointestinal diseases such as reflux esophagitis and functional dyspepsia (FD). A detailed epidemiology of belching has not yet been reported.

Continuous warfarin administration versus heparin bridging therapy in post colorectal polypectomy haemorrhage: a study protocol for a multicentre randomised controlled trial (WHICH study).

Background: Endoscopic removal of colorectal adenoma is considered an effective treatment for reducing the mortality rates associated with colorectal cancer. Warfarin, a type of anticoagulant, is widely used for the treatment and prevention of thromboembolism; however, bleeding may increase with its administration after polypectomy. In recent times, a high incidence of bleeding after endoscopic polypectomy has been reported in patients receiving heparin bridge therapy.

Factors Associated with Potassium-Competitive Acid Blocker Non-Response in Patients with Proton Pump Inhibitor-Refractory Gastroesophageal Reflux Disease.

Background/aims: Approximately 20-40% of patients with gastroesophageal reflux disease (GERD) are refractory to proton pump inhibitor (PPI) treatment. The acid-inhibitory effect of vonoprazan, a novel potassium-competitive acid blocker (P-CAB), is significantly greater when compared to the effect of PPIs. We investigated the efficacy of vonoprazan treatment for PPI-refractory GERD and factors associated with P-CAB non-response.

Additional surgical resection after endoscopic mucosal dissection for early gastric cancer: A medium-sized hospital's experience.

Purpose: In Japan, the majority of early gastric cancers (EGCs) are now treated with endoscopic submucosal dissection (ESD). Patients with non-curative lesions treated by ESD are advised to undergo additional surgical resection (ASR) based on guidelines from the Japan Gastroenterological Endoscopy Society (JGES) and Japanese Gastric Cancer Association (JGCA). However, many studies have demonstrated that residual cancer and lymph node metastasis are only rarely found in ASR specimens.

Associations among gastroesophageal reflux disease, psychological stress, and sleep disturbances in Japanese adults.

Background And Aim: Gastroesophageal reflux disease (GERD) and psychological stress are associated with sleep disturbances. The aim of the present study was to examine the prevalence of sleep disturbances, anxiety, and depression by GERD subtypes and to identify factors associated with sleep disturbances in general population.

Methods: A total of 2002 Japanese subjects, who underwent annual health checkups, were enrolled and asked to fill out a questionnaire, including the frequency scale for the symptoms of GERD (FSSG), Athens Insomnia Scale (AIS), Rome III questionnaire, and Hospital Anxiety and Depression Scale (HADS).

Effects of esomeprazole on sleep in patients with gastroesophageal reflux disease as assessed on actigraphy.

Objective: Gastroesophageal reflux disease (GERD) is strongly associated with sleep disturbances. Although treatment with proton pump inhibitors (PPIs) helps to improve GERD symptoms and subjective sleep parameters, the effects of PPI therapy on objective sleep parameters are conflicting. The aim of this study was to examine the effects of esomeprazole treatment on GERD symptoms and sleep parameters assessed using actigraphs and questionnaires.

[The role of mucoprotective drugs in a treatment and prevention for NSAID-induced gastric ulcer].

NSAIDs compromise gastroduodenal defense mechanism mediated by inhibiting cyclooxygenase and leading to leukocyte infiltration or neutrophil adherence, and cause gastric ulcers. There are a number of mucoprotective drugs in Japan, and they were often used for NSAIDs-induced ulcer treatment. In vitro or in vivo studies, some mucoprotective drugs have been shown to have anti-inflammatory action due to the inhibition of leukocyte infiltration, production of inflammatory cytokines.

Roles of ZO-1 and epidermal growth factor in esophageal epithelial defense against acid.

Background: The tight junction plays a crucial role in structural esophageal epithelial defenses that maintain esophageal epithelial integrity. We examined the roles of ZO-1 and epidermal growth factor (EGF) in esophageal epithelial defense against acid using human esophageal epithelial cells.

Methods: Human esophageal epithelial cells (TE-1) were incubated with acidified medium in the presence or absence of various doses of EGF.

[Prevalence, diagnosis and treatment of extraesophageal manifestations of GERD].

Gastroesophageal reflux disease (GERD) is associated with a variety of extraesophageal symptoms including asthma, chronic cough, laryngeal disorders, and various ENT symptoms. Recent studies suggest that GERD underlies or contributes to chronic sinusitis, chronic otitis media, dental erosion, and obstructive sleep apnea syndrome (OSAS). In this article, we review the prevalence, diagnosis, and treatment of extraesophageal symptoms and including Montreal definition, a new definition and classification of GERD by an International Consensus Group.

[Rumination syndrome in an adult with normal intelligence].

A 32-year-old woman visited our department because of repeated regurgitation of food, and was diagnosed with rumination syndrome based on possession of symptoms typical for it. Although rumination syndrome is classified as a functional esophageal disorder according to the Rome II criteria, it is not well known in Japan, and there have been no previous reports of it in an adult with normal intelligence. Since patients with rumination syndrome are often misdiagnosed and receive unnecessary treatment, awareness of it by physicians is important.

Esophagogastric varices due to arterioportal shunt in a serous cystadenoma of the pancreas in von Hippel-Lindau disease.

Von Hippel-Lindau (VHL) disease is an autosomal dominant inherited disorder characterized by extensively vascularized tumors and cysts in specific organs. Angiogenesis is a striking future of VHL disease with its characteristic cysts and well-vascularized tumors. The hypervascular nature of VHL lesions has been linked to the overproduciton of vascular endothelial growth factor (VEGF) through increased expression of hypoxia inducible factor-1alpha (HIF-1alpha).