Search Results (102)

Background: Gastroesophageal reflux symptoms (GERSs) represent the most prevalent phenotype of gastroesophageal reflux disease and frequently overlap with the symptoms of functional dyspepsia, posing diagnostic and therapeutic challenges. Limitations of long-term acid suppression have prompted interest in alternative mucosa-protective approaches. This study was conducted to evaluate the effectiveness of a novel multicomponent formulation (Tamacid-Pro^®) in patients with reflux-like symptoms and negative endoscopy. Methods: In this prospective observational study, consecutive adult patients undergoing upper gastrointestinal endoscopy at a tertiary centre between January 2025 and February 2026 were screened. Patients with upper gastrointestinal symptoms lasting ≥2 months, negative endoscopy, and no evidence of Helicobacter pylori infection were enrolled. Participants received Tamacid-Pro^® three times daily for 3 months. Symptom frequency and intensity were assessed at baseline and after treatment using the Reflux Disease Questionnaire (RDQ). Changes over time were analyzed using paired t-tests, and multivariable linear regression was performed to identify response predictors. Results: A total of 1035 patients were included. After 3 months of treatment, all RDQ items showed a statistically significant improvement in both frequency and intensity (p < 0.0001). Significant reductions were observed in the GERD composite score, as well as in heartburn, regurgitation, and dyspepsia dimensions (all p < 0.0001). In a multivariable analysis, female sex was independently associated with greater improvement across multiple symptom domains, whereas alcohol consumption was negatively associated with improvement in the heartburn dimension. Conclusions: In this large real-world cohort of endoscopy-negative patients, treatment with Tamacid-Pro^® was associated with significant improvement in both typical reflux and dyspeptic symptoms. These findings support the role of multicomponent, mucosa-protective formulations as a valuable therapeutic option in patients with GERSs and overlapping functional gastrointestinal disorders. Full article

A 65-year-old man with type 2 diabetes presented with abdominal pain. Although he had no typical reflux symptoms such as heartburn or acid regurgitation, esophagogastroduodenoscopy (EGD) showed findings suggestive of reflux esophagitis, and proton pump inhibitor therapy was initiated. Two months later, he was admitted with intractable vomiting. EGD demonstrated diffuse circumferential mucosal injury without black discoloration, predominantly in the distal esophagus. These findings were interpreted as severe reflux esophagitis (Los Angeles grade D; RE-D). Symptoms improved with supportive care, glycemic control, and continued PPI therapy; follow-up EGD showed marked improvement. Six months later, he re-presented with identical symptoms and endoscopic findings. Laboratory testing confirmed diabetic ketoacidosis (DKA), with ketonuria, elevated total ketone bodies (2469 µmol/L), and high-anion gap metabolic acidosis (anion gap 17.2 mEq/L). The diagnosis was revised to DKA-associated acute esophageal mucosal lesion (AEML). He improved with fluid resuscitation and insulin therapy, and medication adherence was reinforced. Follow-up EGD showed complete healing without recurrence. AEML has been proposed as a spectrum that includes acute esophageal necrosis (AEN; “black esophagus”) and esophagitis without black-appearing mucosa. This case highlights a diagnostic pitfall in which DKA-associated AEML without black discoloration may be misattributed to severe reflux esophagitis. When the clinical presentation or endoscopic appearance is severe or atypical, clinicians should consider AEML and evaluate for underlying systemic precipitants. Full article

Pharmaceutical, cosmetic, and food industries have contributed to the increasing interest in herbal phytochemicals. Salvia, a multifunctional culinary herb, meets phytotherapeutic requirements in the treatment of heartburn, excessive sweating, flatulence, and mouth, throat, and skin inflammatory conditions. Salviae folium is used in conductive education, i.e., a unique rehabilitation method for individuals with neurological and motor disorders designed to help in learning to perform activities independently. The comparative analysis of bioactive chemical compounds in S. officinalis, S. officinalis subsp. lavandulifolia, and S. sclarea herb showed that S. officinalis had the highest concentration of exogenous amino acids (53 mg·g⁻¹ DW), with a predominance of lecithin and phenylalanine, and endogenous amino acids were dominated by aspartic and glutamic acids. S. officinalis subsp. lavandulifolia was the richest source of omega-3, omega-6, and omega-9 fatty acids, followed by S. officinalis and S. sclarea. The vitamin C content was 4.9 (S. sclarea)–14.4 mg·100 g⁻¹ DW (S. officinalis). Phenolic acids were dominated by rosmarinic acid (S. officinalis > S. officinalis sub. lavandulifolia > S. sclarea) and ferulic acid (S. officinalis > S. sclarea > S. officinalis sub. lavandulifolia). Salvia sclarea is a rich source of p-coumaric acid. Among non-phenolic organic acids, the highest content of quinic and malic acids was found in S. sclarea and S. officinalis, respectively. The level of o-dihydroxyphenols was 2140 (S. officinalis)-2222 mg CAE·100·g⁻¹ DW (S. sclarea). The flavonoid content was 610 (S. officinalis subsp. lavandulifolia)-347 mg RU·100 g⁻¹ DW (S. sclarea). Flavonoids, flavonols, and flavanones were dominated by apigenin, kaempferol, and hesperidin, respectively. These metabolites may be potential components in phytotherapeutic products. Full article

Helichrysum odoratissimum (L.) Less. is used as a traditional medicine in South Africa to treat tuberculosis, abdominal pains, heartburn, coughs, colds, female sterility, eczema and wounds. In Uganda, the leaves are used to treat dental/oral diseases. This review aims to provide detailed information on the traditional uses, essential oils, phytochemistry, in silico studies, and pharmacological studies and propose possible future research directions on this widely investigated species. The data was gathered from various online electronic databases such as Science Direct, Scopus, Google Scholar, Web of Science, SciFinder, Wiley Online, SpringerLink, and PubMed. Reports on the essential oil composition of H. odoratissimum showed the dominance of monoterpenoids and sesquiterpenoid compounds. Several studies also reported the isolation of the non-volatile compounds, which were mainly flavonoids and terpenes. The species has been reported to have pharmacological activities such as antimicrobial, antimycobacterial, antioxidant activity, antidiabetic, antiproliferative, anti-inflammatory activity and antityrosinase activity. The most important study on H. odoratissimum was a clinical trial in human participants in South Africa addressing its in vivo irritancy potential. However, further research on the clinical and scientific aspects is needed to justify some of its other medicinal uses. Full article

Aloe vera (Aloe barbadensis Miller) represents a rich natural source of water, minerals, polysaccharides, vitamins, phenolic compounds and bioactive molecules that exert multiple health-promoting effects relevant to athletic performance. Its high content of water and minerals (magnesium, calcium, potassium) supports hydration and electrolyte balance during physical activity. At the same time, polysaccharides, especially acemannan, contribute to tissue regeneration, muscle recovery, immune modulation and gastrointestinal protection. Antioxidant compounds reduce exercise-induced oxidative stress, potentially improving recovery and limiting inflammatory damage. Aloe vera-based beverages, including leaf juices and fermented formulations, offer a practical and palatable vehicle for delivering these bioactives. In addition to supporting gut integrity and reducing symptoms such as reflux and heartburn, Aloe vera supplementation may enhance nutrient absorption and modulate glucose metabolism, contributing to better metabolic stability during exercise. The increasing commercial interest in natural functional beverages highlights the relevance of Aloe vera as a nutraceutical candidate for athletes. This review explores the multiple benefits of Aloe leaf derivatives, bridging traditional medicine and evidence-based applications for metabolic health (gastrointestinal comfort, hydration, antioxidant defence and post-exercise recovery). However, further clinical studies are needed to fully define dosage, efficacy and mechanisms of action. Full article

This scoping review aimed to summarize the current literature on the etiological and pathophysiological mechanisms associated with the development of retrograde cricopharyngeus dysfunction (R-CPD) through a PRISMA literature search. According to the current literature, a family history of R-CPD was reported in 28.0% of patients across studies, with childhood onset in 55.5% of cases. Gastroesophageal reflux disease and laryngopharyngeal reflux disease prevalence in R-CPD patients ranged from 16.3 to 51.9%, with improvement of heartburn symptoms after treatment. High-resolution manometry revealed dysmotility disorders in 43.5–80.0% of patients, with absent peristalsis in 11–25%. Carbonated drink provocative testing provided diagnostic usefulness in patients with unclear diagnoses by demonstrating failure of cricopharyngeal sphincter relaxation for retrograde gas. Notably, 75.5–79.9% of patients maintained symptom relief beyond the expected pharmacologic duration of botulinum toxin (approximately 6 months), suggesting potential neuroplastic adaptation or learned compensatory mechanisms in overcoming retrograde cricopharyngeal sphincter dysfunction. The pathophysiology of R-CPD remains incompletely understood, with a lack of epidemiological and pediatric studies. The genetic and environmental factors may play a key role, but future studies are needed to clarify their roles in the development of R-CPD. Full article

Eosinophilic esophagitis (EoE) is an emerging disease characterized by chronic inflammation of the esophagus. EoE is a multifactorial disorder, likely resulting from the combination of genetic predisposition, epithelial barrier dysfunction, environmental risk factors, and allergen sensitization, which lead to type 2 inflammation of the esophagus. The clinical manifestations are related to esophageal dysfunction and include dysphagia, food impaction, heartburn, regurgitation, and food refusal. These symptoms are sometimes superimposable and can often be confused with the symptoms of gastroesophageal reflux disease. To-date, EoE diagnosis relies on endoscopic examination and histological analysis of esophageal biopsies, with the diagnostic criterion defined as the presence of ≥15 eosinophils per high-power field (eos/HPF). As a result, both the diagnostic and the subsequent disease monitoring processes, including assessment of treatment, efficacy, and remission status, require repeated endoscopic procedures. These procedures are rather invasive for patients, particularly in the pediatric population, and impose a significant financial strain on healthcare systems. Therefore, in recent years, substantial efforts have been made to identify novel non-invasive or minimally invasive biomarkers. This review aims at synthesizing the current findings and at categorizing the most promising biomarkers according to the different biological sources to ultimately enable earlier detection, reduce patient discomfort, and guide personalized treatment strategies. Full article

Helicobacter pylori infection represents a well-established risk factor for the development of gastric carcinogenesis, yet reliable clinical or endoscopic predictors of infection remain poorly defined. Identifying non-invasive or endoscopic markers of this infection could improve early detection, which is crucial for effective prevention and clinical management. This single-center study included 737 patients who underwent upper gastrointestinal endoscopy. We compared clinical, laboratory, and endoscopic features between H. pylori-positive and H. pylori-negative individuals. A total of 263 with H. pylori-positive gastric biopsies and 474 with H. pylori-negative biopsies were enrolled in our study. Cerebrovascular disease (9.51% vs. 5.51%, p = 0.04, OR = 1.80), type 2 diabetes mellitus (T2DM—22.05% vs. 15.86%, p = 0.04, OR 1.5), and alcohol consumption (18.96% vs. 9.3%, p = 0.00, OR = 2.28) were significantly more prevalent among H. pylori-positive patients. Heartburn was more commonly reported in H. pylori-negative individuals (23.77% vs. 15.38%, p = 0.01, OR = 0.58). Laboratory parameters showed no significant differences between groups. Regarding endoscopic findings, corporal erythema (26.92% vs. 16.17%, p = 0.00, OR = 1.91), corporal erosions (11.54% vs. 5.32%, p = 0.00, OR = 2.32), and submucosal hemorrhages (20.91% vs. 11.6%, p = 0.00, OR = 2.01) were associated with H. pylori infection. In the multivariate logistic regression models, alcohol consumption and corporal lesions remained independent predictors of H. pylori-associated gastritis, even after adjusting for age, sex, and PPI use. This study identifies alcohol consumption and specific corporal mucosal changes as novel, independent predictors of H. pylori infection. Heartburn was negatively associated with active H. pylori infection, while the rest of the symptoms did not predict infection or mucosal lesions. The laboratory parameters did not differ significantly between groups. These findings underscore the potential of targeted endoscopic evaluation and risk-based screening (particularly among T2DM and alcohol-consuming populations) to enhance early detection and management of H. pylori-associated disease. Full article

Gastroesophageal reflux disease (GERD) is associated with symptoms such as heartburn, resulting from gastric content reflux. Alginate-based raft-forming gel formulations represent a non-pharmacological strategy for GERD management by forming a floating gel barrier in the stomach. This study evaluated three commercial anti-reflux oral gel systems under simulated fed-state gastric conditions, using in vitro magnetic resonance relaxometry techniques. Magnetic resonance imaging (MRI) was performed in 0.01 M hydrochloric acid (HCl) to visualize gel raft formation, spatial structure, and spatial distribution of effective T₂ relaxation time. Nuclear magnetic resonance (NMR) relaxometry in 0.01 M deuterium chloride (DCl) measured T₁ and T₂ relaxation times of the protons that were initially included in the preparation to assess its molecular mobility within the gel matrix. Two formulations formed floating, coherent gels, whereas the remaining one exhibited only polymer swelling without flotation. In one case, relaxometry data revealed a solid-like component that can be detected, indicating enhanced mechanical stability. The performance of each formulation was influenced by interactions among alginate, bicarbonates, and calcium ions, which determined gel consistency and flotation behavior. MRI and NMR relaxometry in vitro provide valuable non-invasive insights into the structural and functional behavior of alginate-based gel formulations. This approach supports the rational design of advanced gel-based therapies for GERD by linking molecular composition with in situ performance. Full article

Heartburn is a prevalent and frequently self-managed condition, with a myriad of over-the-counter (OTC) treatment options available for self-care. The potential for misinterpretation of drug labels and improper OTC medication selection may result in inadequate treatment, potential drug interactions, as well as medication overuse, misuse, or delay in seeking treatment for a more serious health condition. As highly accessible healthcare professionals, pharmacists play a crucial role in validating self-diagnoses, in guiding appropriate OTC medication selection and use, and in educating patients on both pharmacologic and non-pharmacologic management strategies for heartburn. It is essential for pharmacists to remain informed about the latest developments in disease management and treatment options. This narrative review provides an updated perspective on the epidemiology, risk factors, pathophysiology, and clinical manifestations associated with heartburn while underscoring the expanding role of pharmacists in patient care. This review includes a structured assessment framework and clinical management algorithm designed to enhance pharmacists’ ability to identify red flag symptoms, optimize OTC medication use, and facilitate timely referrals when necessary. By incorporating evidence-based guidance with patient-centered counseling, pharmacists can enhance treatment outcomes, optimize, medication use, promote adherence, and ensure safer self-care practices. As self-medication trends and the role of pharmacists evolves, this review offers a comprehensive resource to equip pharmacists with the latest knowledge and practical tools for optimizing heartburn management and promoting patient safety. Full article

Background: Dyspeptic symptoms are very common in the general population, with an estimated prevalence of 14% to 41%, and the majority of patients experience symptoms without an organic cause for them (so-called functional dyspepsia). While the pathophysiology of functional dyspepsia remains elusive, the impact of functional dyspepsia on quality of life is detrimental. The treatment involves a change in lifestyle—a healthy diet and physical activity—in combination with pharmacological treatments. However, currently, there is no standard therapy for this condition, although a nutritional approach appears to be feasible and well accepted by patients. In this context, the intake of some mineral water types might be able to play an important role. Objective: The aim of the present study was to evaluate whether the regular intake of bicarbonate natural mineral water (Aqua Carpatica from source “F2 Păltiniș”) is able to positively influence the symptomatic process of dyspepsia, promoting digestion and improving the quality of life of patients. Methods: The patients enrolled in this open-label study had diagnosis of functional dyspepsia formulated in accordance with the Rome III criteria. During the 4-week study, patients had to ingest tap water at 1.5 L/day (wash-out period: 2 weeks), and in the 2-week subsequent period, they had to ingest alkaline natural mineral water at 1.5 L/day. The primary efficacy endpoint of this study includes a statistically significant improvement (p < 0.05) in the “heartburn”, “regurgitation”, and “dyspepsia” subscales and the total Reflux Disease Questionnaire’s (RDQ) score with respect to the effects of alkaline natural mineral water. As secondary endpoints, we considered statistically significant improvements (p < 0.05) in quality-of-life scores (Psychological General Well-Being Index—Short form; PGWB-S), the patient’s self-assessment of the state of efficiency of their digestion, and their sense of post-prandial fullness, as well as the use of antacids. Results: Forty-five patients were enrolled: all were Caucasian and mostly women (25, 55.6% vs. 20 men, 44.4%), and they were aged between 25 and 75 years (50.6 ± 13.5 years; mean ± SD). The results of this preliminary study show a significant improvement in functional dyspepsia symptoms—as assessed via the RDQ—and an improvement in quality of life—as assessed using the PGWB-S score—after the intake of alkaline natural mineral water. Conclusions: This preliminary study provides clinical evidence for a recommendation of alkaline natural mineral water as a symptomatic treatment of dyspepsia. Full article

Objective: This study aims to examine long-term diseases, conditions, self-control, and self-management in kidney transplant recipients. Method: This is a descriptive correlational study, including a total of n = 130 kidney transplant recipients. The data were collected using a demographic information form, the Post-Kidney Transplant Diseases and Conditions Assessment Form, and the Self-Control and Self-Management Scale. Data analysis was conducted using descriptive statistical methods and one-way ANOVA, and paired sample t-tests. Results: Of the kidney transplant recipients, 40% were aged between 31 and 45 years, and 54.6% were male. The long-term diseases and conditions they developed after kidney transplantation were hypertension (46.2%), heart failure (26.2%), diabetes mellitus (10.8%), heartburn (35.4%), acute kidney failure (26.2%), urinary tract infection (39.2%), sleep disorders (23.1%), and chronic pain (50%). In addition, 31.5% of the kidney transplant recipients had poor self-control and self-management. Conclusions: Long-term postoperative mortality in kidney transplant recipients is mostly caused by diseases developing in vital organs. Therefore, it is crucial to recognize these diseases and conditions for their diagnosis. This study found various diseases and conditions in almost all body systems of kidney transplant recipients. Additionally, there were patients with poor self-control and self-management. We consider that the results of our study will increase awareness among clinicians. Full article

Dysphagia is a commonly encountered condition in clinical practice, with a rising incidence reported particularly in South Korea. It can be broadly classified into oropharyngeal dysphagia and esophageal dysphagia, and distinguishing between the two is crucial for establishing rehabilitation treatment strategies. Oropharyngeal dysphagia frequently occurs in central nervous system diseases such as stroke, dementia, and Parkinson’s disease and has a significant impact on prognosis. Additionally, because there is a high risk of life-threatening aspiration pneumonia in patients complaining of dysphagia, an accurate diagnosis must be made during the early stages of the condition. Patients with oropharyngeal dysphagia may report difficulty initiating swallowing and may experience coughing, choking, nasopharyngeal reflux, aspiration, and a sensation of leftover food in the pharynx during swallowing. Patients with esophageal dysphagia may report a sensation of food getting stuck in the esophagus for a few seconds after the initiation of swallowing. Esophageal dysphagia should be characterized by analyzing whether the foods causing dysphagia are solid, liquid, or both, as well as by the progression of symptoms, whether they are progressive or intermittent; their severity; and associated symptoms such as weight loss, heartburn, or regurgitation. Video fluoroscopic swallowing study (VFSS), fiberoptic endoscopic evaluation of swallowing (FEES), and esophagogastroduodenoscopy (EGD) are invaluable in determining the causes, severity, and treatment strategies for dysphagia. Since swallowing disorders are significant factors influencing the course and prognosis regardless of the type of disease, clinicians should adopt a systematic approach to such disorders. Full article

Background/Objectives: Iron deficiency anemia is a prevalent hematological condition globally, with treatment often complicated by adverse effects that compromise patient adherence and clinical outcomes. This study investigated the prevalence, severity, and management of side effects associated with anemia treatments among Romanian patients, aiming to identify key factors influencing treatment adherence and patient satisfaction. Methods: A prospective observational cross-sectional study was conducted using a questionnaire distributed to adult patients diagnosed with anemia. Data were collected from 382 participants, covering demographic variables, anemia causes, treatment types, and patient-reported side effects. Results: Of the participants, 45% reported side effects, with a higher prevalence in intravenous (52%) than oral administration (48%). Common side effects included gastrointestinal symptoms (nausea/vomiting, heartburn, abdominal pain) and systemic symptoms (fatigue, headaches). Our analysis revealed that as the patient age increased, the severity of treatment-related side effects also intensified (p < 0.01), particularly in gastrointestinal discomfort. Similarly, BMI was a significant predictor (p < 0.05), suggesting that metabolic factors play a role in symptom manifestation. Notably, severe side effects were significantly associated with treatment modifications and lower patient satisfaction. Supplements like magnesium and vitamin D3 showed positive effects in mitigating the side effects, whereas probiotics and vitamin C had mixed outcomes. Conclusions: The study highlights the significant burden of side effects in anemia treatment, emphasizing the need for personalized management strategies to improve adherence and clinical outcomes. Full article

Background/Objectives: Helicobacter pylori (H. pylori) is a significant global health issue causing chronic gastritis, peptic ulcers, and gastric malignancies. Unfortunately, many, particularly in the Middle East, continue to exhibit alarming rates of prevalence. This study aimed to elucidate local epidemiological patterns of H. pylori and examine its histopathological impact on the gastric mucosa. Methods: This retrospective-cross-sectional study included 805 symptomatic adults (329 males, 476 females) who underwent endoscopic evaluation at King Salman Hospital, Ha’il, Saudi Arabia. Biopsies from the antrum and body were processed using routine formalin fixation and paraffin embedding. Staining with hematoxylin–eosin (H&E) and Giemsa permitted assessment of chronic gastritis and detection of H. pylori. Data were evaluated by IBM SPSS (version 23, IBM Corp., Armonk, NY) for associations among infection, histopathology, and patient characteristics. Results: A total of 727 (90.3%) were H. pylori-positive with marginally higher rates in females (91.2%) than males (89.0%). Infection spanned all age groups, reaching 100% in males aged 60–80 years. Overall chronic GI complications were identified in 726 (99.9%), with chronic gastritis being the most profound histopathologically (19.3%). Lymphoid aggregates in 93.0% biopsies reflected a pronounced immune response. Advanced lesions, including metaplasia (0.8%), atrophy (0.3%), and lymphoma (0.1%), were uncommon, though indicative of potential malignant progression. Despite both sexes exhibiting universal symptoms of gastritis, dyspepsia, and heartburn, there were no statistically significant gender-based differences (p > 0.05); specifically, post-H. pylori signs such as vomiting, nausea, weight loss, bleeding or hematemesis occurred equally in all. Histopathology consistently revealed chronic active gastritis with glandular distortion, lymphoplasmacytic infiltration, and occasional mucosal erosions. Giemsa staining further confirmed abundant spiral shapes underscoring a high bacterial load. Conclusion: These findings highlight the age-specific persistently elevating rates of H. pylori significantly associated with chronic gastric inflammatory complications. Although advanced gastric lesions remain rare, reflecting regional epidemiology, early screening, and sleeve treatment efforts, the potential for malignant transformation makes it imperative for continued vigorous eradication, therapy, and vigilant follow-up to avert severe disease outcomes. Full article