Rajeshkumar, G (2014) Correlation of gastro esophageal valve, symptomatology and 24 hour pH monitoring in GERD patients with refractory symptoms in South India - A Cross Sectional study. Masters thesis, Madras Medical College, Chennai.
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Abstract
INTRODUCTION : Gastro Esophageal Reflux Disease (GERD) is a most commonly encountered problem in day today practice. It result from failure of the anti reflux barrier which expose esophageal mucosa to abnormal acid reflux / GER (Gastro Esophageal Reflux) which in turn results variety of symptoms such as heartburn, odynophagia, hoarseness of voice, Increased mucus in the throat, foreign body sensation of throat or globus, water brash, and many atypical symptoms such as chronic cough, recurrent sore throat and asthma if long standing. Behind liver disease, it was considered the costlier GI disease with ranking second in 2004 with the prevalence rate in general population varies between 42% to 45% and 24% of the population will experience heartburn daily or more often. In spite of effective treatment, around 20–40% of patients showed partial or lack of response to medical therapy that are labeled as refractory GERD and these set of patient are difficult to treat. It is caused by a failure of the anti reflux barrier (ARB). Gastro esophageal valve (GEV) is one of the components of it. Alteration of this valve which in turn alters of lower esophageal sphincter length and pressure which results mechanically defective sphincter. Esophageal acid exposure is directly proportional to the degree of gastro esophageal valve geometry. Reinforcement of the GEV by means of endoscopic methods or surgery may improve the symptoms in these patients with refractory symptoms. Our present study was design to identify the type of gastro esophageal valve in GERD patients with refractory symptoms and correlation of symptoms and 24 hour pH monitoring findings. AIM OF THE STUDY : This study was conducted to identify the grades of gastro esophageal valve (GEV) in gastro esophageal reflux disease (GERD) patients with refractory symptoms and to correlate the grades of GEV with 24 hour pH monitoring findings. METHODS : 30 patients with symptoms of GERD inspite of proton pump inhibitor therapy (omeprazole 20mg, twice daily) for 4 weeks were studied in Rajiv Gandhi general hospital, madras medical college, Chennai-3 RESULTS : This study revealed higher grade of gastro esophageal valve(grade 3 & grade 4) had abnormal acid reflux evidenced by 24 hour pH monitoring (percent of time pH < 4, Demeester score) than grade 1 & grade 2 GEV. Patients with grade 3& grade 4 GEV had more incidences of distal esophagitis than grade 1 & grade 2. CONCLUSION : Presence of abnormal gastro esophageal valves which are detected by retro flexion of upper GI endoscopy may predict the positive esophageal acid exposure and complication such as erosive esophagitis.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | gastro esophageal valve ; symptomatology ; 24 hour pH monitoring ; GERD patients ; refractory symptoms ; South India ; Cross Sectional study. |
| Subjects: | MEDICAL > Gastroenterology |
| Depositing User: | Kambaraman B |
| Date Deposited: | 13 Jul 2017 04:11 |
| Last Modified: | 13 Jul 2017 04:11 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/1567 |
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