Gastroesophageal reflux disease (GERD) continues to be an area of active AT-406 research in the Asia-Pacific region in the recent years. In the past few years there has been an increase in the frequency of GERD in Asia. In a re-survey of community residents who were interviewed in an earlier study in 1994 there was a more than 4-fold increase in the frequency of heartburn. This trend could not be explained by genetic factors was also increasing (< 0.001) while that of duodenal ulcer was decreasing (< 0.005) from 1992 to 1999. The lower frequency of GERD in Asian populations in the early 90’s was unlikely to be solely caused by the known extrinsic risk AT-406 factors. Genetic factors were probably involved as Asians have a smaller parietal cell mass and a lower acid output compared with Caucasians. The lower prevalence of and smaller body mass index in the Asian population might also have accounted for the lower prevalence of GERD in Asia. The cause of the opposing time trend of GERD and duodenal ulcer disease in Asia was unclear but might be related to the declining rate of (and GERD remains controversial. In a systemic review of 20 studies the prevalence of infection in subjects with GERD was significantly lower than that in those without GERD. Geographical location was a strong contributor to the heterogeneity between studies. Although the prevalence of in the general population was discovered to become higher in the East sufferers from china and taiwan with reflux disease got a lesser prevalence of infections than sufferers from European countries and THE UNITED STATES. Since associations usually do not confirm causality a far more important question is certainly whether eradication of escalates the threat of GERD. Hamada and co-workers dealt with this issue by evaluating the prevalence of brand-new starting point reflux among 286 sufferers who underwent eradication therapy with this of 286 age group- and disease-matched created reflux which prevalence was greater than the 0.3% recorded among those without therapy. Reflux esophagitis when present was minor generally. The current presence of and severe corpus gastritis was linked to the introduction of reflux esophagitis after eradication therapy closely. The data recommended that elevated gastric acidity AT-406 secretion after eradication might just be among the many factors in charge of the increased threat of GERD pursuing eradication. Alternatively within a post hoc evaluation AT-406 of 8 potential dual blind US studies of therapy for sufferers with energetic duodenal ulcers or a brief history of duodenal ulcers no difference was within the probability of developing brand-new GERD symptoms or in people cured of infections compared with people that have persistent infection. There is no association of eradication with worsening symptoms in people that have preexisting GERD. The chance for sufferers who were successfully cured of their disease to experience a worsening of their GERD symptoms was less than that for those with persistent contamination (odds ratio: 0.47 95 confidence interval: 0.24-0.91). However this study had its limitations. Although the overall number of subjects included in the analysis was large the numbers of patients in some of the subgroup analyses were small. In addition follow-up was less than 2 months in 7 of the 8 studies included in the analysis. Nevertheless this study Rabbit polyclonal to GAL. suggested that eradication should not be withheld for fear of causing or worsening GERD. The findings in this study that patients with preexisting GERD were less likely to develop worse symptoms must not be taken to mean that patients with GERD improved after eradication. At present the treatment of in patients with GERD remains controversial. TREATMENT OF GERD In a study investigating the healthcare-seeking behavior of Asian subjects with heartburn the decision to medicate and to seek medical guidance was linked to symptom severity but not to ethnicity. The mainstay of treatment for GERD is usually acid suppression. Proton pump inhibitors provide the most rapid symptomatic relief and the highest healing rates for or pressure and post-procedure 24-hour pH. Finally endoscopic implantation of inert materials such as Enteryx has been shown to improve symptom scores standard of living and 24-hour pH with decrease in the usage of acidity suppression six months after treatment. Footnotes Edited by Xu.