Acid Reflux (GERD)

Comparison on the reflux and nutritional status of different reconstruction methods after laparoscopic proximal gastrectomy: a systematic review and network meta-analysis.

Xin C, Wang Z, Zheng Z, Lu S, Wei X, Zhang J · Updates in surgery · 2026 · n=184

The rising prevalence of gastric cancer in the upper third of the stomach has generated considerable interest in laparoscopic proximal gastrectomy (LPG). Traditional esophagogastric anastomosis after LPG has been associated with postoperative reflux issues. Despite the availability of various improved reconstruction techniques, there is still ongoing debate on the optimal approach. This network meta-analysis seeks to assess the reflux and nutritional outcomes associated with various reconstruction techniques subsequent to LPG. A comprehensive literature search was performed across five databases: PubMed, Medline, Embase, Cochrane Library, and Web of Science. The reconstruction methods following LPG include esophagogastrostomy (EG), jejunal interposition (JI), jejunal pouch interposition (JPI), double-flap technique (DFT), double-tract reconstruction (DTR), gastric tube reconstruction (GT), and side overlap with fundoplication by Yamashita (SOFY). Network meta-analyses were performed t

Efficacy and mechanisms of Xiangsha Liujunzi Decoction for gastroesophageal reflux disease: A study integrating meta-analysis, network pharmacology and molecular docking.

Tian M, Wang K, Chen D · Phytomedicine : international journal of phytotherapy and phytopharmacology · 2026 · n=646

Reflux esophagitis (RE) significantly impairs quality of life. Xiangsha Liujunzi Decoction (XSLJZD) is used in traditional Chinese medicine for RE, but its efficacy and mechanisms remain to be systematically evaluated. This study integrated meta-analysis, network pharmacology, and molecular docking to evaluate the clinical efficacy of XSLJZD for RE and elucidate its mechanisms of action. Randomized controlled trials (RCTs) on XSLJZD for RE were systematically searched. Methodological quality was assessed using the Cochrane Risk of Bias tool, and data were synthesized with RevMan 5.3. Network pharmacology utilizing TCMSP identified active components, targets, and pathways. Molecular docking validated core compound-target interactions. Eight RCTs (n = 646) showed that XSLJZD significantly improved clinical outcomes compared with controls, demonstrating superior overall efficacy and reduced recurrence. Network analysis identified luteolin, baicalin, and β-sitosterol as core compo

Comparative Efficacy of P-CAB vs Proton Pump Inhibitors for Grade C/D Esophagitis: A Systematic Review and Network Meta-analysis.

Zhuang Q, Chen S, Zhou X, Jia X, Zhang M, Tan N · The American journal of gastroenterology · 2024

Los Angeles grade C/D esophagitis is a severe manifestation of gastroesophageal reflux disease that require active treatment and close follow-up. Potassium competitive acid blockers (P-CAB) are promising alternatives to proton pump inhibitors (PPI). We aimed to compare the efficacy and safety of P-CAB and PPI in healing grade C/D esophagitis to aid clinical decision-making. A systematic literature search was performed using PubMed, MEDLINE, and Cochrane Central Register of Controlled Trials. Randomized controlled trials were eligible for inclusion if efficacy of P-CAB and PPI in healing grade C/D esophagitis was reported. Pooled risk ratios and risk difference with 95% credible intervals were used to summarize estimated effect of each comparison. The benefit of treatments was ranked using the surface under the cumulative probability ranking score. Of 5,876 articles identified in the database, 24 studies were eligible. Studies included incorporated 3 P-CAB (vonoprazan, tegoprazan, and

GORD in adults.

Moayyedi P, Delaney B · BMJ clinical evidence · 2008

Up to 25% of people have symptoms of gastro-oesophageal reflux disease (GORD), but only 25-40% of these have oesophagitis visible on endoscopy. About 80% of people with GORD will have recurrent symptoms if treatment is stopped, and severe oesophagitis may result in oesophageal stricture or Barrett's oesophagus. We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of initial treatment of GORD associated with oesophagitis? What are the effects of maintenance treatment of GORD associated with oesophagitis? We searched: Medline, Embase, The Cochrane Library, and other important databases up to July 2007 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations, such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found 29 systematic reviews, RC

Dyspepsia.

Ford AC, Moayyedi P · Current opinion in gastroenterology · 2013

Dyspepsia affects up to 40% of the general population and significantly reduces quality of life. A small proportion of patients have peptic ulcer disease as cause and this can be treated empirically with Helicobacter pylori eradication therapy in those that are infected. Approximately 20% have gastro-oesophageal reflux disease and this can be effectively treated with proton pump inhibitor therapy. Patients who remain symptomatic may warrant an endoscopy, but most will have functional dyspepsia. Treatment of functional dyspepsia remains a challenge. Recent large randomized trials suggest tricyclic antidepressant therapy may be effective in functional dyspepsia. A phase III randomized controlled trial reports that a new prokinetic, acotiamide, reduces dyspepsia symptoms in functional dyspepsia patients. There are also preliminary data that suggest buspirone, a drug that promotes gastric accommodation, is also effective in functional dyspepsia. There are also data to suggest that functio

Decoding the complexity: mechanistic insights into comorbidities in idiopathic pulmonary fibrosis.

Selman M, Buendia-Roldan I, Pardo A · The European respiratory journal · 2025

The complex pathogenic relationships between idiopathic pulmonary fibrosis (IPF) and its usually associated comorbidities remain poorly understood. While evidence suggests that some comorbidities may directly influence the development or progression of IPF, or vice versa, whether these associations are causal or arise independently due to shared risk factors, such as ageing, smoking, lifestyle and genetic susceptibility, is still uncertain. Some comorbidities, such as metabolic syndromes, gastro-oesophageal reflux disease and obstructive sleep apnoea, precede the development of IPF. In contrast, others, such as pulmonary hypertension and lung cancer, often become apparent after IPF onset or during its progression. These timing patterns suggest a directional relationship in their associations. The issue is further complicated by the fact that patients often have multiple comorbidities, which may interact and exacerbate one another, creating a vicious cycle. To clarify these correlations

Causal relationship between gastroesophageal reflux disease and IgA nephropathy: a Mendelian randomization analysis.

Han Q, Duan Y, Jin M, Ma L, Zhao X, Ren Q · Renal failure · 2025

IgA nephropathy (IgAN) incidence is higher in gastroesophageal reflux disease (GERD) patients than those without. However, the causal link between them is unclear. This study aims to elucidate the causal relationship between GERD and IgAN through bidirectional Mendelian randomization (MR) analysis. The chi-square test was employed to assess whether the incidence of IgAN was associated with GERD. Multivariate logistic regression was used to assess whether GERD is an independent risk factor for IgAN. Univariable and multivariable MR analyses were conducted to estimate the associations between GERD and IgAN. The MR analysis included inverse-variance weighted, MR-Egger, weighted median, simple mode, and weighted mode methods. Additionally, pleiotropy, heterogeneity, and sensitivity analyses were performed. In two independent clinical cohorts, GERD patients showed a significantly elevated risk of IgAN. After adjusting for confounding factors such as age, gender, BMI, and hypertension, the

AGA Clinical Practice Update on Integrating Potassium-Competitive Acid Blockers Into Clinical Practice: Expert Review.

Patel A, Laine L, Moayyedi P, Wu J · Gastroenterology · 2024

The purpose of this American Gastroenterological Association (AGA) Institute Clinical Practice Update (CPU) is to summarize the available evidence and offer expert Best Practice Advice on the integration of potassium-competitive acid blockers (P-CABs) in the clinical management of foregut disorders, specifically including gastroesophageal reflux disease, Helicobacter pylori infection, and peptic ulcer disease. This expert review was commissioned and approved by the AGA Institute Governing Board and CPU Committee to provide timely guidance on a topic of high clinical importance to the AGA membership. This CPU expert review underwent internal peer review by the CPU Committee and external peer review through the standard procedures of Gastroenterology. These Best Practice Advice statements were developed based on review of the published literature and expert consensus opinion. Because formal systematic reviews were not performed, these Best Practice Advice statements do not carry formal

Gastroesophageal Reflux Disease (GERD)

MedlinePlus

This page provides an overview of GERD, including its causes, symptoms, diagnosis, and treatment options, for a general public audience.

A Double-blind, Randomized, Placebo-controlled, Two-centre, Phase IIa Pharmacodynamic Cross-over Study to Assess the Effect of AZD2516 on the Total Number of Reflux Episodes in Healthy Male Volunteers

n=20 · NCT01154634 · COMPLETED · COMPLETED

The purpose of this study is to investigate the pharmacodynamic effect of AZD2516 in healthy male subjects.

Evaluation of Diagnostic Performances of Esophageal Post Prandial High Resolution Impedance- Manometry (HRIM) in Patients With Gastro-esophageal Reflux Disease (GERD) Resistant to Proton Pump Inhibitor (PPI) Treatment : Pilot Study (MHR POST-PRANDIALE)

n=9 · NCT03306485 · COMPLETED · COMPLETED

Nine to 30% of the population suffers from gastro-esophageal reflux disease (GERD) - suggestive symptoms (heartburn, regurgitation, chest pain, chronic couch, sore throat). Proton pump inhibitor (PPI) is usually the first line treatment. However 20 to 60% of patients have persistent symptoms on proton pump inhibitor. Complementary examinations are then required to determine the cause of persistent symptoms (non compliance to treatment, persistent esophageal acid exposure despite proton pump inhibitor, non acid reflux, reflux hypersensitivity, functional symptoms, rumination syndrome…). The gold standard to detect reflux episodes in patients on proton pump inhibitor therapy is 24-h ambulatory esophageal pH-impedance monitoring. Esophageal High Resolution Impedance-Manometry might help to determine gastro-esophageal reflux disease mechanisms especially when performed post prandially. Further some publications demonstrated that the number of reflux episodes detected during the post prandial period might be well correlated to the total number of reflux episodes recorded during 24 h. The hypothesis of this study is that 1-hour post prandial esophageal High Resolution Impedance-Manometry might be useful to diagnose gastro-esophageal reflux disease and can replace in some instances 24-h esophageal pH-impedance monitoring. Therefore the aim is to compare the number of reflux episodes detected with esophageal High Resolution Impedance-Manometry performed during 1-h post prandial period to the total number of reflux episodes detected during 24-h ambulatory esophageal pH-impedance monitoring.

A Multicenter, Double-blind, Randomized, Placebo-controlled Phase 3 Study to Evaluate the Efficacy and Safety of CJ-12420 in Patients With Non-erosive Reflux Disease

n=324 · NCT02556021 · COMPLETED · COMPLETED

The purpose of this study is to demonstrate the superiority of efficacy of CJ-12420, once daily (QD), compared to placebo in patients with non-erosive reflux disease at Week 4

GERD

TRIP Database

TRIP Database is a clinical search engine designed to allow users to quickly and easily find high-quality research evidence to support their practice, including on topics like GERD.