The primary treatment goals in patients with gastroesophageal reflux disease are relief of symptoms, prevention of symptom relapse, healing of erosive esophagitis, and prevention of complications of esophagitis. In patients with reflux esophagitis, treatment is directed at acid suppression through the use of lifestyle modifications (e.g., elevating the head of the bed, modifying the size and composition of meals) and pharmacologic agents (a histamine H2-receptor antagonist [H2RA] taken on demand or a proton pump inhibitor IPPI] taken 30 to 60 minutes before the first meal of the day). The preferred empiric approach is step-up therapy (treat initially with an H2RA for eight weeks; if symptoms do not improve, change to a PPI) or step-down therapy (treat initially with a PPI; then titrate to the lowest effective medication type and dosage). In patients with erosive esophagitis identified on endoscopy, a PPI is the initial treatment of choice. Diagnostic testing should be reserved for patients who exhibit warning signs (i.e., weight loss, dysphagia, gastrointestinal bleeding) and patients who are at risk for complications of esophagitis (i.e., esophageal stricture formation, Barrett's esophagus, adenocarcinoma). Antireflux surgery, including open and laparoscopic versions of Nissen fundoplication, is an alternative treatment in patients who have chronic reflux with recalcitrant symptoms. Newer endoscopic modalities, including the Stretta and endocinch procedures, are less invasive and have fewer complications than antireflux surgery, but response rates are lower.

Management of gastroesophageal reflux disease

Summary


Background Few population-based studies have examined comorbidity in relation to gastro-oesophageal reflux disease (GERD).



Aim  To study the association between cardiovascular disease, diabetes, gastrointestinal symptoms and GERD.



Methods  Population-based, cross-sectional, case-control study based on a large Norwegian health survey conducted in 1995–97. Among 65 333 participants, 3153 persons reporting severe reflux symptoms were defined as cases, and 40 210 persons without such symptoms were defined as controls. Data on cardiovascular disease, diabetes, gastrointestinal symptoms and potential confounders were collected through questionnaires. Odds ratios (OR) with 95% confidence intervals (CI) were estimated using unconditional logistic regression, in crude and adjusted models.



Results  In the crude models, positive associations were observed between myocardial infarction (OR 1.7, 95% CI 1.4–2.1), angina pectoris (OR 2.5, 95% CI 2.1–2.9) and stroke (OR 1.6, 95% CI 1.2–2.1) and risk of GERD. The associations were attenuated in the adjusted models, but remained significant for angina pectoris (OR 1.9, 95% CI 1.6–2.2). No association was observed between diabetes and GERD. Strong positive associations were seen between all studied gastrointestinal symptoms, i.e. nausea, diarrhoea and constipation, and risk of GERD.



Conclusions  This population-based study indicates that myocardial infarction, angina pectoris, stroke and symptoms of nausea, diarrhoea and constipation are associated with GERD.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2036.2007.03537.x

Severe symptoms of gastro-oesophageal reflux disease are associated with cardiovascular disease and other gastrointestinal symptoms, but not diabetes: a population-based study.

The purpose of this study was to determine the rate of documented counseling on lifestyle modifications in patients presenting to the primary care setting with a diagnosis of gastroesophageal reflux disease. Retrospective chart review was conducted for 502 active patients with a primary or secondary diagnosis of gastroesophageal reflux disease from two internal medicine clinics at the University of Kansas School of Medicine-Wichita. Charts were reviewed for documented counseling on four specific lifestyle modifications: (a) smoking and alcohol cessation, (b) dietary changes, (c) head of bed elevation, and (e) postprandial avoidance of recumbency. Only 12% of patients in this sample received documented counseling on lifestyle modifications. Of those patients receiving documented counseling, 71% were counseled on dietary changes, 41% smoking or alcohol cessation, 28% head of bed elevation, and 21% postprandial avoidance of recumbency. Documentation indicated that patients with gastroesophageal reflux disease are not adequately counseled regarding recommended lifestyle modifications.

Lifestyle modification counseling in patients with gastroesophageal reflux disease.

The study examines the factors affecting the adoption of ERP for logistics operations in apparel manufacturers in Biyagama, Sri Lanka. The investments in ERP solutions have become strategic decision which can have a wide range of advantages to business enterprises. The decision of adaptation or investment in ERP is influenced by many factors. These factors influence on the management behavior of ERP and technology investment. Then, the research problem is what are factors affecting the adoption of ERP in apparel manufacturers in Biyagama? The research objectives of the study are to identity the factors affecting the adoption of ERP by literature reviews and develop a conceptual framework to represent the adoption of ERP in Biyagama, Sri Lanka. The study caters a significant in term of practical, personal and academic significance to the industry; the study methodology of the study is the formal survey where 101 executive officers/managers were interviewed through the questionnaire survey. The comprehensive literature survey was conducted to identify the indicators for the study and 40 indicators were identified for developing the model. The exploratory factor analysis was performed to categorize the indicators. The study has defined the scope through sample size, study approach, time horizon. The study items are grouped under 6 variables including the level of organizational readiness for ERP, level of organizational fit for ERP, level of investment and business type, level of risk and failure, organizational intention and change management, etc. Article visualizations:

https://oapub.org/soc/index.php/EJMMS/article/download/562/1143

A study on factors affecting the adoption of erp for logistics operations in apparel manufacturing industry in biyagama, sri lanka

Most countries, South Africa included, are still grappling with gross gender underrepresentation in the senior education management and leadership positions. This article highlights the plight of women and their struggle to access senior leadership positions in education and aims to challenge the long-standing adage that women must teach, and males must lead. This study does not ignore the fact that there have been changes in the recruitment of women in leadership positions. It recognizes that there is evidence that even the women who are already in leadership positions are not afforded the same treatment as their male counterparts. The research study made use of quantitative research methods, and data was analysed using mathematically based methods, statistics. A sample was drawn from three different schools within the Tshwane District and was handed prepared questionnaires to respond to. Findings in this study highlight the barriers contributing towards women being underrepresented in leadership positions, to include, among others; gender roles stereotypes tying women to household chores as well as childrearing responsibilities. Recommendations are made on the following aspects, namely, recruitment and selection committees, education policies, deconstructing gender roles stereotypes as well as providing strong mentorship for women in leadership positions.

Education inequalities : an investigation of gender representation in leadership positions of selected secondary schools of Gauteng province.

Gastroesophageal reflux disease is a common, usually lifelong, disorder resulting from chronic abnormal exposure of the lower esophagus to gastric contents. Motor dysfunction of the lower esophageal sphincter is the primary cause of this disease. At this writing, no medical therapies can completely resolve abnormal lower esophageal sphincter function; therefore, the treatment of gastroesophageal reflux disease centers on suppression of intragastric acid secretion. Available acid-suppressant medications include proton pump inhibitors, H2-receptor antagonists, and antacids. Of these, the proton pump inhibitors are recognized generally as the mainstays of both short-term and long-term therapy for gastroesophageal reflux disease. All have a low incidence of side effects and are well tolerated by most patients. Five proton pump inhibitors are available currently for patients with gastroesophageal reflux disease. Of these, esomeprazole has shown greater efficacy in controlling intragastric acidity than the others. For patients with erosive esophagitis, esomeprazole has demonstrated higher healing rates and more rapid sustained resolution of heartburn than omeprazole or lansoprazole after up to 8 weeks of once-daily treatment. Because new therapies for gastroesophageal reflux disease are highly effective, patients can be reassured that their disease will be well controlled and their symptoms resolved with a safe and appropriate treatment.

Gastroesophageal reflux disease: current treatment approaches.

The purpose of this article is to provide an overview of the research process and highlight some of the most important aspects. The definition of research and some general terminology are reviewed. Included in this article are discussions of the following: defining a problem, reviewing the literature, types of study designs, sampling, types of measurement, reliability and validity, limitations and assumptions, data analysis, ethical concerns with human subjects, and time management. Examples of published research are used to illustrate the points where necessary. A supplemental bibliography is provided to direct the interested reader to more in-depth discussions of the various aspects of the research process.

A beginner's guide to research.

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

Wendy Biddle

Author Tools

Chat about Author

Papers

Gastroesophageal reflux disease: current treatment approaches.

A beginner's guide to research.

Gastroesophageal reflux disease: current treatment approaches.