Net Guides: Gastric Reflux Supportive Care

//BOOKSHELF

GERD: Reflux to Esophageal Adenocarcinoma

Authors: Parakrama T. Chandrasoma, Tom Demeester

Publisher: Elsevier Science

ISBN-13: 9780123694164

ISBN: 0123694167

This hardcover book is about gastroesophageal reflux disease (GERD). GERD, also known as gastric reflux or acid reflux disease, is a condition that is a relatively common side effect of various chemotherapy drugs. This book features literature that documents the entire pathogenesis of GERD and applies it to clinical treatment of the disease. It also presents reflux carditis as a new diagnostic criterion of the disease and defines the dilated end-stage esophagus as well as the earliest microscopic phase of GERD that present diagnostic criteria fail to encompass. The book also discusses the clinical features of GERD, and serves as a reference for any medical professionals involved in the treatment of the disease. Other features of the book include an outline of how GERD causes cellular changes in the esophagus and approximately 350 images to help illustrate key points.

http://bit.ly/ffKq0u

//THE EDUCATED PATIENT™

Heartburn and chemotherapy

Chemocare.com is a Website developed by the Cleveland Clinic Foundation that provides patients with information on chemotherapy and how to live before, during, and after treatment. One page of the site focuses on gastric reflux as a side effect of chemotherapy. This page discusses what heartburn is and how chemotherapy can cause it, steps a patient can take to manage gastric reflux, as well as descriptions of H2 blockers and proton-pump inhibitors and examples of these drugs that physicians may prescribe to treat gastric reflux. This page also features a set of guidelines advising when a patient should call his or her physician when experiencing heartburn caused by chemotherapy. Chemocare.com has other useful information on managing chemotherapy side effects and chemotherapy in general that is available in both English and Spanish, so it may be worth recommending to patients regardless of whether they suffer from gastric reflux.

http://www.chemocare.com/managing/heartburn.asp

//ONLINE CME

Implementing the AGA institute guidelines for GERD: strategies based on supporting evidence

Credits: 1.00

Fee: None

Expires: July 1, 2011

This CME activity is based on a medical position statement and technical review on the management of GERD published in 2008 by the American Gastroenterological Association Institute (AGA). This publication then underwent a literature review process and the author’s conclusions were finalized and discussed by a panel of stakeholders, including payers, patients, surgeons, internists, and community gastroenterologists. This panel used the United States Preventive Services Task Force system of grading recommendations by evaluating the strength and quality of evidence for each key point made in the article. This CME also includes those grades. After completing this activity, participants should be able to describe the GERD management issues addressed by the AGA Institute. Participants should also be able to identify the levels of evidence supporting key recommendations for GERD differential diagnosis and treatment, and be able to discuss possible changes in practice for the management of GERD, as well as the rationale behind them.

http://www.medscape.org/viewarticle/724262

//eABSTRACT

Arbaclofen placarbil decreases reflux with good tolerability in patients with GERD

Journal: Journal of Neurogastroenterology and Motility

Author: Kim GH

Purpose: Arbaclofen placarbil (AP), formerly known as XP19986, is a novel transported prodrug of the active R-isomer of baclofen that overcomes the limitations of racemic baclofen. Racemic baclofen is an agonist of the y-aminobutyric acid receptor and has been shown to decrease gastric reflux through the inhibition of transient lower esophageal sphincter relaxations, with which GERD is commonly associated. Unfortunately, racemic baclofen has a short half-life, requiring frequent dosing. It also causes sedation, dizziness, nausea, and fatigue. The purpose of this study was to test the efficacy and safety of AP in the treatment of patients with GERD by comparing AP with placebo.

Results: In all, 50 patients were enrolled into 4 escalating doses of AP: 10, 20, 40, and 60 mg. Of the group, 44 patients were included in the efficacy analysis. The study found a statistically significant (17%) decrease in reflux episodes over 12 hours after treatment with AP compared with placebo. AP was found to be most effective at the 60-mg dosing, and was well tolerated at all dose levels. The author concluded that although the study was small, AP was worth considering as an alternative for patients with GERD that is refractory to proton pump inhibitors, since up to 40% of patients fail to completely respond symptomatically to proton pump inhibitors at standard doses.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2978402/?tool=pubmed

//CLINICAL TRIAL

Transoral incisionless fundoplication (TIF) registry study for treatment of GERD

Study Type: Interventional

Age/Sex Requirements: 18-75 years

Sponsor: EndoGastric Solutions

ClinicalTrials.gov Identifier: NCT01118585

Purpose: This clinical trial will test a procedure known as TIF in the treatment of GERD. In the TIF procedure, a device called EsophyX is inserted through the patient’s mouth and used to construct an antireflux valve and tighten the lower esophageal sphincter, which should eliminate the GERD. The TIF procedure is noninvasive and repeatable. The primary outcome measure of the study is the elimination of all GERD symptoms. Secondary measures include the elimination of proton pump inhibitor usage, esophageal acid exposure, healing of reflux esophagitis, safety outcomes, and the long-term elimination of GERD symptoms.

http://bit.ly/dWYFpa

http://www.endogastricsolutions.com/esophyx_overview.htm

PHARMA FOCUS

Prilosec (omeprazole)

Prilosec is a proton pump inhibitor that prevents heartburn by reducing the amount of acid produced in the stomach. The standard course of treatment with Prilosec is 1 pill daily for 14 days, up to 3 times per year. Each pill should last for 24 hours, so no heartburn should be experienced for the duration of the 14-day course, not only relieving symptoms but also allowing erosive esophagitis time to heal. Caution should be taken when prescribing Prilosec to patients who have had heartburn with lightheadedness, sweating, or dizziness; chest or shoulder pain with shortness of breath; frequent wheezing, especially with heartburn; unexplained weight loss; nausea or vomiting; or stomach pain.

http://www.prilosecotc.com/en_US/hcp/Pages/Home.aspx

http://www.drugs.com/prilosec.html