Publications by authors named "S J Spechler"
Background & Aims: Dilated intercellular space (DIS) in esophageal epithelium, a sign of impaired barrier function, is a characteristic finding of GERD that also is found in obese patients without GERD. We have explored molecular mechanisms whereby adipose tissue products might impair esophageal barrier integrity.
Methods: We established cultures of visceral fat obtained during foregut surgery from obese and non-obese patients.
Background: Patients with erosive oesophagitis, and those with persistent symptomatic non-erosive gastro-oesophageal reflux disease, require long-term maintenance treatment with acid-suppressing agents.
Aim: To evaluate the safety of vonoprazan, a potassium-competitive acid blocker, in an integrated analysis of data from clinical trials in adults.
Methods: We included 14 clinical trials of vonoprazan conducted in multiple countries.
Functional Lumen Imaging Probe Panometry Findings in Obese Patient Populations.
Neurogastroenterol Motil
December 2024
Article Synopsis
- This study evaluated functional lumen imaging probe (FLIP) metrics in obese patients, both surgically naïve and those who had undergone bariatric surgeries like sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB).
- Researchers found that common symptoms were dysphagia and chest pain across all patient groups, with notable differences in FLIP response patterns, particularly in patients who had bariatric surgery.
- Despite many patients showing FLIP abnormalities, these did not correlate with esophageal symptoms or high-resolution manometry (HRM) findings, indicating a need for further investigation into esophageal issues in this population.
Article Synopsis
- * The study hypothesized that a positive response to botulinum toxin (BT) injections in the lower esophageal sphincter (LES) could help diagnose which EGJOO patients might benefit from further invasive treatments.
- * Results showed that 46% of patients had a good response to BT, and those who responded well were likely to also benefit from subsequent invasive therapies, indicating that BT response may be a useful diagnostic tool.
Approximately 30% of patients with typical gastroesophageal reflux disease (GERD) symptoms have endoscopic evidence of erosive esophagitis (EE). The severity of EE is commonly graded using the Los Angeles (LA) classification system as grade A (minimal) to D (very severe), depending on the extent of endoscopically visible mucosal breaks (Supplementary Figure 1). Accurate grading of EE severity is crucial in clinical trials of medical EE treatments, as EE severity strongly influences both initial rates of healing and the likelihood of recurrence during maintenance treatment.
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