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Nippon Shokakibyo Gakkai zasshi The Japanese journal of gastro-enterology 01/2006; 102(12):1493-502.
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ABSTRACT: The effects of postprandial water intake on the gastrointestinal tract have not been systematically investigated in humans.
In 8 healthy volunteers, the gastric antral pressure was measured with a strain gauge transducer, while the esophageal and lower esophageal sphincter pressures were measured with an infused catheter with a Dent sleeve. The esophageal pH at 5 cm above the lower sphincter was measured with a microglass electrode. A standard test meal (560 kcal) was eaten and 500 ml water was ingested 1 h later. The plasma cholecystokinin level was assessed at 4-min intervals. As a control, the same study was done on another day with sham water intake.
At 4 min after water intake, there was a significant decrease in gastric antral motility and a significant increase in the plasma cholecystokinin level. Water intake also significantly increased the occurrence of gastroesophageal reflux.
The rapid increase in cholecystokinin after water intake may be initiated by a feedback mechanism related to inflow of fatty chyme into the duodenum that inhibits gastric antral activity.
Scandinavian Journal of Gastroenterology 11/2005; 40(10):1176-81. · 2.02 Impact Factor
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Yasuyuki Shimoyama,
Motoyasu Kusano,
Sayaka Sugimoto,
Osamu Kawamura,
Masaki Maeda,
Keiko Minashi,
Shikou Kuribayashi, Tatsuya Higuchi,
Hiroaki Zai,
Kyoko Ino,
Tsutomu Horikoshi,
Fumitaka Moki,
Tadashi Sugiyama,
Munetoshi Toki,
Tsuneo Ohwada,
Masatomo Mori
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ABSTRACT: An early and accurate evaluation by a general practitioner is needed to screen out non-gastroesophageal reflux disease (GERD) patients. A recent questionnaire (QUEST) highlighted problems with specificity and complexity, so the aim of the present study was to design a simplified questionnaire.
When admitted to hospital to undergo an upper gastrointestinal endoscopy for suspected GERD, 333 patients completed a 50-item questionnaire requiring 'yes/no' answers to different combinations of questions relating to symptoms of upper gastrointestinal tract conditions (e.g. GERD, ulcers and functional dyspepsia) and psychosomatic symptoms. The endoscopic diagnosis was then correlated with the rate of positive answers to each question.
Based on the analysis of the 50 items, the 8-10 questions most often answered affirmatively by each of the GERD and non-GERD groups were chosen for the simplified questionnaire. Three draft questionnaires were compiled. After calculating the sensitivity, specificity and accuracy in relation to the diagnosis of GERD and other conditions, it was found that questionnaire B (selection of persons answering 'yes' to at least one of questions 1-5 and exclusion of persons answering 'yes' to at least three of questions 7-10) had a high sensitivity, high specificity and low false positive rate.
A novel questionnaire was developed. It was designed to detect the symptoms of GERD while simultaneously excluding non-GERD patients. This simplified nine-item simplified questionnaire had a sensitivity of 79.8%, a specificity of 53.6% and an accuracy of 63.4%.
Journal of Gastroenterology and Hepatology 05/2005; 20(4):643-7. · 2.87 Impact Factor
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Motoyasu Kusano,
Yasuyuki Shimoyama,
Sayaka Sugimoto,
Osamu Kawamura,
Masaki Maeda,
Keiko Minashi,
Shiko Kuribayashi, Tatsuya Higuchi,
Hiroaki Zai,
Kyoko Ino,
Tsutomu Horikoshi,
Tadashi Sugiyama,
Munetoshi Toki,
Tsuneo Ohwada,
Masatomo Mori
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ABSTRACT: The aim of this study was to produce a simplified questionnaire for evaluation of the symptoms of gastroesophageal reflux disease (GERD).
A total of 124 patients with an endoscopic diagnosis of GERD completed a 50-part questionnaire, requiring only "yes" or "no" answers, that covered various symptoms related to the upper gastrointestinal tract, as well as psychosomatic symptoms. The 12 questions to which patients most often answered "yes" were selected, and were assigned scores (never = 0; occasionally = 1; sometimes = 2; often = 3; and always = 4) to produce a frequency scale for symptoms of GERD (FSSG). Sensitivity, specificity, and accuracy of the FSSG questionnaire were evaluated in another group of patients with GERD and non-GERD. The usefulness of this questionnaire was evaluated in 26 other GERD patients who were treated with proton pump inhibitors for 8 weeks.
When the cutoff score was set at 8 points, the FSSG showed a sensitivity of 62%, a specificity of 59%, and an accuracy of 60%, whereas a cutoff score of 10 points altered these values to 55%, 69%, and 63%. The score obtained using the questionnaire correlated well with the extent of endoscopic improvement in patients with mild or severe GERD.
This new questionnaire is useful for the objective evaluation of symptoms in GERD patients.
Journal of Gastroenterology 10/2004; 39(9):888-91. · 4.16 Impact Factor
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Nihon Naika Gakkai Zasshi 01/2004; 92(12):2420-2.
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Motoyasu Kusano,
Sayaka Sugimoto,
Osamu Kawamura,
Keiko Minashi,
Masaki Maeda,
Yasuyuki Shimoyama,
Kyoko Ino,
Naoko Mimura, Tatsuya Higuchi,
Yoichi Kon,
Kazuma Kikuchi,
Tohko Shirota,
Masahumi Mizuide,
Naoko Oshimoto,
Munetoshi Toki,
Tsuneo Ohwada,
Masatomo Mori
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ABSTRACT: Background: We previously reported that a new endoscopic classification of gastroesophageal reflux disease, the Los Angeles classification, showed considerable observer variation depending on the experience of the endoscopist. In the present study, we evaluated some modifications of the classification to determine whether we could decrease observer variation.Methods: Fifty endoscopic photographs, each showing four images of the squamo-columnar junction, were prospectively obtained from 50 consecutive patients with gastroesophageal reflux disease. Two groups of eight endoscopists divided by their endoscopic experience, group 1 (100–500 procedures) and group 2 (more than 500 procedures), assessed the photographs using classifications with the following modifications: (i) addition of grade O to describe healed mucosal breaks and setting grade B as more than 5 mm or 10 mm; or (ii) addition of grade O and setting grade D as 75–99% or 100% circumferential.Results: Changing the definition of grade B or grade D did not increase the kappa values for either group of observers.Conclusions: These modifications of the Los Angeles classification were unable to decrease observer variation.
Digestive Endoscopy 12/2003; 16(1):9 - 11. · 1.19 Impact Factor
