Announcement

Collapse
No announcement yet.

Endoscopic Treatment Promising for GERD

Collapse
X
 
  • Filter
  • Time
  • Show
Clear All
new posts

  • Endoscopic Treatment Promising for GERD

    Endoscopic Treatment Promising for GERD

    By David Douglas

    NEW YORK (Reuters Health) Oct 20 - Endoscopic full-thickness plication using the Plicator (NDO Surgical Inc.) appears to be successful in treating gastroesophageal reflux disease (GERD), according to researchers.

    "I had been involved with all of the previous sham-controlled studies for the endoscopic treatment of GERD," lead investigator Dr. Richard Rothstein told Reuters Health, "and was disappointed in their clinical outcomes."

    "This NDO Plicator sham-controlled study," he added, "included adequate numbers of subjects, employed an intention-to-treat analysis and demonstrated significant symptom improvement, decreased use of medications post-procedure, and reduced acid exposure time in the distal esophagus in the initial short-term follow-up."

    Dr. Rothstein of Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire and colleagues came to this conclusion after studying 159 patients with symptomatic GERD requiring proton pump inhibitor maintenance therapy.

    The patients were randomized to a sham procedure or to "endoscopic full-thickness restructuring of the gastric cardia with transmural suture," the researchers report in the September issue of Gastroenterology.

    At 3 months, 56% of the active treatment group showed at least a 50% improvement in GERD health-related quality-of-life scores compared with 18.5% of the sham treatment group. In addition, 50% of the active group completely ceased maintenance therapy versus 24% of the sham group.

    Dr. Rothstein added that he and his colleagues, "look forward to understanding the role of endoscopic treatments for GERD as we try to improve devices, optimize techniques and procedures, and follow patients long-term."

    The author of an accompanying editorial, Dr. Nicholas J. Shaheen of the University of North Carolina, Chapel Hill, told Reuters Health that the device shows promise and that the study was very well done.

    "However," he pointed out, "we need data comparing using the device to treatment with medicines, as well as to treatment with surgery, before we really know how and when to use it in taking care of patients with reflux."

    Gastroenterology 2006;131:704-712,952-954.

  • #2
    Originally posted by daw
    Endoscopic Treatment Promising for GERD

    At 3 months, 56% of the active treatment group showed at least a 50% improvement in GERD health-related quality-of-life scores compared with 18.5% of the sham treatment group. In addition, 50% of the active group completely ceased maintenance therapy versus 24% of the sham group.
    Daw Do you know if they just do these plicator studies on symptom scores ? Have you ever seen the full study ? All of the studies i've seen just talk about a reduction of symptoms, but never talk about a proven reduction of reflux via ph testing. Big difference , otherwise it wouldn't be very useful for Barretts for example.

    Comment


    • #3
      Hi Tricia
      In the other article I posted
      [url]http://forums.heartburn-help.com/showthread.php?t=6360[/url]
      It talks about this very study and mentions " Finally, esophageal pH-metry 3 months post procedure showed that patients who underwent endoscopic plication had significantly reduced esophageal acid exposure compared with baseline, as well as compared with patients in the sham-treated group (P < .001 and P = .01, respectively)".

      Comment


      • #4
        Daw

        Hi Daw Thanks Didn't notice that , lol now i'm trying to figure out why it would only reduce acid exposure in 50 percent. Thanks ... i must go ponder

        Comment


        • #5
          Tricia,
          Actually, if I read it right, it didn't give a percentage of acid improvment as measured by the post procedure ph tests. It did say that " 56% of patients randomized to plication had ≥ 50% improvement in GERD symptoms (assessed through the GERD-Health-Related Quality-of-Life [GERD-HRQL] instrument). So the question is why weren't more patients perceiving more relief and can we assume that those that did not percieve more relief did poorly on the post procedure ph tests?

          I think I'm starting to confuse myself.

          Comment


          • #6
            check this out

            Hey Daw Check this site out [url]http://myphysicians.com/[/url] ( featured in the Wall Street Journal ) You can ask any specialist .. cardiologist, gastroenterologist, etc a question for 20 bucks . There are also 30 minute phone consultations with the specialst of your choice for 65 dollars.

            Here is a free doctors site [url]http://www.doctorgeorge.com/drgsays.php[/url]

            I got them off of this pathology site ( some very good links in gastroenterology ) [url]http://www.pathguy.com/lectures/quackery.htm[/url]

            Comment


            • #7
              Originally posted by daw
              Tricia,
              Actually, if I read it right, it didn't give a percentage of acid improvment as measured by the post procedure ph tests. It did say that " 56% of patients randomized to plication had ≥ 50% improvement in GERD symptoms (assessed through the GERD-Health-Related Quality-of-Life [GERD-HRQL] instrument). So the question is why weren't more patients perceiving more relief and can we assume that those that did not percieve more relief did poorly on the post procedure ph tests?

              I think I'm starting to confuse myself.
              LOL you are confusing me too .....more pondering i guess

              Comment

              Working...
              X