GERD Awareness Week: FDA news, endoscopic fundoplication, laparoscopic surgery

Gastroesophageal reflux disease affects 1 in 5 people in the United States.; although common, the disease is often unrecognized and misunderstood, the International Foundation for Gastrointestinal Disorders reported.

“This year, we will raise awareness about living with GERD and what many patients face daily,” Cecil T. Rooker, president of IFFGD, said in a released statement. “The symptoms of GERD can be painful and often unpredictable, which can, on turn, have a tremendous impact on a person’s quality of life.”

November 20 to 26, 2022 marked the 23^rd annual GERD Awareness Week. Founded by the International Foundation for Gastrointestinal Disorders (IFFGD) in 1999, this annual awareness aims to encourage those with GERD-related symptoms to consult their physician, educate the general public and provide support to those with this chronic condition.

IFFGD further informed patients to look out for the two most common symptoms of GERD — heartburn and acid regurgitation. Other symptoms include difficulty or pain when swallowing, excessive belching, the feeling of food sticking in the esophagus, chronic sore throat, gum inflammation, erosion of tooth enamel, morning hoarseness and a sour taste in the mouth.

In recognition of GERD Awareness Week, Healio compiled10 recent reports on FDA devices, endoscopic fundoplication, Vonoprazan, laparoscopic anti-reflux surgery and more.

FDA backs EndoStim’s neurostimulation implant for GERD control

The FDA has granted breakthrough device designation to EndoStim for its implantable device which serves as a treatment option for patients with refractory GERD, according to a manufacturer release.

The EndoStim System is a neurostimulation device which is implanted laparoscopically and designed to provide long-term reflux control via automatically delivered mild electrical signals to the lower esophageal sphincter throughout the day. Programmed wirelessly by the physician, the system “automatically stimulates” the lower esophageal sphincter without any sensation to the patient, allowing the muscle to function normally. Read more.

Endoscopic fundoplication ‘should be considered’ for medication refractory GERD

CHARLOTTE, N.C. — Endoscopic fundoplication demonstrated comparable efficacy to its surgical counterpart in the treatment of patients with medication refractory GERD, according to a presentation at the ACG Annual Scientific Meeting.

“Endoscopic procedures for medication refractory GERD have been available for a couple of decades now, but there have not been any studies comparing them to the surgical procedures,” Ravi Teja Pasam, MBBS, MPH, of Lahey Hospital & Medical Center in Burlington, Massachusetts, told Healio. “This prompted us to perform this network meta-analysis, which would indirectly provide some answers.” Read more.

Vonoprazan offers ‘complete, rapid, sustained’ relief in nonerosive reflux disease

CHARLOTTE, N.C. — Vonoprazan bested placebo for on-demand treatment of episodic heartburn in patients with nonerosive reflux disease and may offer an alternative to daily therapy, noted a presenter at the ACG Annual Scientific Meeting.

“There is a need for noncontinuous therapy for GERD, especially by those with [nonerosive reflux disease (NERD)] and episodic heartburn,” Ronnie Fass, MD, head of the Esophageal and Swallowing Center and director of the division of gastroenterology and hepatology at MetroHealth Medical Center, told Healio. “On-demand is a noncontinuous therapeutic approach for GERD, where patients determine when they need to take the medication and for how long.” Read more.

Study dispels misconceptions of anti-reflux surgery with proof of symptom resolution

SAN DIEGO — Patients who underwent laparoscopic anti-reflux surgery for GERD experienced long-term improvement in symptoms commonly misperceived to persist, according to study results.

“Our take home-message is to make patients as well as our colleagues — not only the surgeons but also the primary care physicians and gastroenterologists — who are all seeing these patients with GERD symptoms understand that anti-reflux surgery aversion is not the right message for patients,” Mian Hashim Hanif, MD, a fellow at Luminis Health Anne Arundel Medical Center in Maryland, told Healio. “It is very effective, and it has shown to resolve symptoms which are reported online and falsely spreading among the social media platforms. We have proved by our study that there is almost complete resolution of these symptoms.” Read more.

ACG updates guidelines for GERD diagnosis, management

The ACG updated guidelines for GERD to include pharmacologic, lifestyle, surgical and endoscopic management. The changes were published in the American Journal of Gastroenterology.

“The ethos of the new GERD guidelines is to synthesize the highest quality, yet still practical, recommendations for the diagnosis and management of patients with GERD,” Philip O. Katz, MD, MACG, professor of medicine at Weill Cornell Medicine in New York City, told. “They have been developed for the clinician to enhance their opportunity to provide the best possible evidence-based patient care, using the full menu of diagnostic tests and therapeutic interventions for these often-complex patients. We hope you find them useful in your everyday practice.” Read more.

Multidisciplinary intervention reduces weight, acid suppression therapy use in GERD

LAS VEGAS – Gastroenterologist and dietitian-led lifestyle intervention programs reduced weight and use of acid suppression therapy among patients with GERD, according to a presenter at ACG Annual Scientific Meeting.

“We know that incidence of GERD has been associated with excess body weight and obesity, and the proposed pathophysiology for this association includes a higher prevalence of functional impairment of the esophagogastric junction in these patients as well as higher abdominothoracic pressure grading,” Aiya Aboubakr, MD, of New York-Presbyterian/Weill Cornell Medical Center, said during a presentation. “In this context, weight loss is often recommended as part of lifestyle intervention for GERD, but the data are conflicting.” Read more.

VIDEO: Sleep positioning device reduces GERD symptoms in lung transplant recipients

In this video exclusive, Scott Gabbard, MD, from Cleveland Clinic, discussed a sleep positioning device used to manage GERD in lung transplant recipients.

He said the device significantly improves GERD symptoms when patients lay in the supine position. Read more.

Prevalence, risk factors of infantile GERD

The prevalence of infant GERD was highest in the first 3 months of life and decreased with age, according to a study at Digestive Disease Week.

“Functional gastrointestinal disorders are common in infants under the age of 1, including GERD, diarrhea and constipation, which are a frequent cause of concern for parents and have a significant healthcare burden,” Vanessa McLoughlin, Singapore Institute for Clinical Sciences, University of Oxford medical sciences division, said. “Research into prevalence and natural history is very limited and often restricted to western populations with no previous studies reporting the prevalence GERD in Asian infants; although, we do know that in adults the prevalence of GERD varies dramatically between ethnic populations.” Read more.

Endoscopic full-thickness fundoplication improves quality of life in PPI-dependent GERD

Endoscopic full-thickness fundoplication was safe and effective for the improvement of quality of life in patients with proton pump inhibitor-dependent GERD, according to a study published in Gut.

“This endoluminal procedure is a promising alternative option to surgery in appropriately selected group of patients, who may not want to continue PPI long term,” Rakesh Kalapala, MD, from the Asian Institute of Gastroenterology in Hyderabad, India, and colleagues wrote. “Preferred cohort of patients who would benefit from EFTP includes those with PPI dependence, abnormal acid or non-acid reflux and small hiatus hernia. The procedure is short and with very few side effects. Large, prospective trials with long-term follow-up are required to conclude the benefits of this procedure after 1 year.” Read more.

Short meal-to-bedtime linked to GERD in pregnancy

Short meal-to-bedtime may be a predominant risk factor of GERD in pregnant women, according to a study published in the Journal of Clinical Gastroenterology.

“This dieting habit was also significantly associated with reflux symptom frequency and reflux-related insomnia in pregnancy,” Duc T. Quach, MD, PhD, and colleagues wrote. “This could be an important target for a nonpharmaceutical approach to manage GERD in pregnancy in future studies.” Read more.

Reference:

IFFGD. GERD Awareness Week. Available at: https://aboutgerd.org/living-with-gerd/gerd-awareness-week/#:~:text=The%2023rd%20Annual%20GERD%20Awareness,is%20a%20very%20common%20disorder. Accessed: Nov. 21, 2022.

IFFGD. Media toolkit. Available at: https://www.dropbox.com/s/kul3l28yuu3itmk/2022%20GERD%20Awareness%20Week%20Toolkit_pdf.pdf?dl=0. Accessed: Nov. 21, 2022.