Monther Bajbouj

Deutsches Herzzentrum München, München, Bavaria, Germany

Are you Monther Bajbouj?

Claim your profile

Publications (63)291.03 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: To determine the laryngeal H+K+-ATPase and pharyngeal pH in patients with laryngopharyngeal reflux (LPR)-symptoms as well as to assess the symptom scores during PPI therapy. Endoscopy was performed to exclude neoplasia and to collect biopsies from the posterior cricoid area (immunohistochemistry and PCR analysis). Immunohistochemical staining was performed with monoclonal mouse antibodies against human H+K+-ATPase. Quantitative real-time RT-PCR for each of the H+K+-ATPase subunits was performed. The pH values were assessed in the aerosolized environment of the oropharynx (DxpH Catheter) and compared to a subsequently applied combined pH/MII measurement. Twenty patients with LPR symptoms were included. In only one patient, the laryngeal H+K+-ATPase was verified by immunohistochemical staining. In another patient, real-time RT-PCR for each H+K+-ATPase subunit was positive. Fourteen out of twenty patients had pathological results in DxpH, and 6/20 patients had pathological results in pH/MII. Four patients had pathological results in both functional tests. Nine out of twenty patients responded to PPIs. The laryngeal H+K+-ATPase can only be sporadically detected in patients with LPR symptoms and is unlikely to cause the LPR symptoms. Alternative hypotheses for the pathomechanism are needed. The role of pharyngeal pH-metry remains unclear and its use can only be recommended for patients in a research study setting.
    World journal of gastroenterology : WJG. 01/2015; 21(3):982-7.
  • Endoscopy 01/2015; 47 Suppl 1(S 01):E47-8. · 5.20 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Bacterial colonization of biliary stents is one of the driving forces behind sludge formation which may result in stent occlusion. Major focus of the study was to analyze the spectrum and number of microorganisms in relation to the indwelling time of stents and the risk factors for sludge formation. 343 stents were sonicated to optimize the bacterial release from the biofilm and identified by matrix-associated laser desorption/ionization-time of flight mass spectrometer (MALDI-TOF). 2283 bacteria were analyzed in total. The most prevalent microorganisms were Enterococcus species (spp.) (504;22%), followed by Klebsiella spp. (218;10%) and Candida spp. (188;8%). Colonization of the stents mainly began with aerobic gram-positive bacteria (43/49;88%) and Candida spp. (25/49;51%), whereas stents with an indwelling time>60 days(d) showed an almost equal colonization rate by aerobic gram-negative (176/184;96%) and aerobic gram-positive bacteria (183/184;99%) and a high proportion of anaerobes (127/184;69%). Compared to stents without sludge, more Clostridium spp. [(P = 0.02; Odds Ratio (OR): 2.4; 95% confidence interval (95%CI): (1.1-4.9)]) and Staphylococcus spp. [(P = 0.03; OR (95%CI): 4.3 (1.1-16.5)] were cultured from stents with sludge. Multivariate analysis revealed a significant relationship between the number of microorganisms [P<0.01; OR (95%CI): 1.3(1.1-1.5)], the indwelling time [P<0.01; 1-15 d vs. 20-59 d: OR (95%CI): 5.6(1.4-22), 1-15 d vs. 60-3087 d: OR (95% CI): 9.5(2.5-35.7)], the presence of sideholes [P<0.01; OR (95%CI): 3.5(1.6-7.9)] and the occurrence of sludge. Stent occlusion was found in 70/343(20%) stents. In 35% of cases, stent occlusion resulted in a cholangitis or cholestasis. In conclusion, microbial colonization of the stents changed with the indwelling time. Sludge was associated with an altered spectrum and an increasing number of microorganisms, a long indwelling time and the presence of sideholes. Interestingly, stent occlusion did not necessarily lead to a symptomatic biliary obstruction.
    PLoS ONE 10/2014; 9(10):e110112. · 3.53 Impact Factor
  • M Bajbouj, H Feussner
    Zeitschrift fur Gastroenterologie. 06/2014; 52(6):603-605.
  • MMW Fortschritte der Medizin 04/2014; 156(7):54-7.
  • [Show abstract] [Hide abstract]
    ABSTRACT: To identify objective and subjective predictors for the reliable diagnosis of gastroesophageal reflux disease (GERD) and the response to proton pump inhibitor (PPI) therapy. Retrospectively, 683 consecutive patients suspected for GERD who underwent pH-metry/impedance measurement (pH/MII) were analyzed. All patients had previously undergone standard PPI treatment (e.g., pantoprazole 40 mg/d or comparable). Four hundred sixty patients were at least 10 d off PPIs (group A), whereas 223 patients were analyzed during their ongoing PPI therapy (group B). In addition, all patients completed a standardized symptom- and lifestyle-based questionnaire, including the therapeutic response to previous PPI trials on a 10-point scale. Uni- and multivariance analyses were performed to identify criteria associated with positive therapeutic response to PPIs. In group A, positive predictors (PPs) for response in empirical PPI trials were typical GERD symptoms (heartburn and regurgitation), a positive symptom index (SI) and pathological results in pH/MII, along with atypical symptoms, including hoarseness and fullness. In group B, regular alcohol consumption was associated with the therapeutic response. The PPs for pathological results in pH/MII in group A included positive SI, male gender, obesity, heartburn and regurgitation. In group B, the PPs were positive SI and vomiting. Analyzing for positive SI, the PPs were pathological pH and/or MII, heartburn regurgitation, fullness, nausea and vomiting in group A and pathological pH and/or MII in group B. Anamnestic parameters (gender, obesity, alcohol) can predict PPI responses. In non-obese, female patients with non-typical reflux symptoms, pH/MII should be considered instead of empirical PPIs.
    World Journal of Gastroenterology 04/2014; 20(14):4017-24. · 2.43 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Das Beschwerdebild Dysphagie ist ein weites diagnostisches Feld, in dem der Hausarzt eine zentrale Position einnimmt. In der Erstdiagnostik gilt es, mögliche Ursachen sowie Komorbiditäten genau abzuklären. Darauf aufbauend werden fachärztliche Kollegen hinzugezogen, denn die meisten Fälle sind nur interdisziplinär erfolgreich zu behandeln. Ein Wegweiser.
    MMW Fortschritte der Medizin 04/2014; 156(7):54-58.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Treatment of persistence to proton pump inhibitors or non-acid reflux episodes in patients with gastroesophageal reflux disease is challenging. Prucalopride, a selective high affinity serotonin (5-HT4) receptor agonist, might offer a possible new therapeutic alterative.Case presentations: We report four chronically constipated female gastroesophageal reflux disease-patients with reflux symptoms and an increased number of reflux episodes in combined esophageal pH and multichannel impedance monitoring treated with prucalopride (2mg per day). Symptoms were persistent to proton pump inhibitors and ranitidine. Gastroesophageal reflux was detected by pH or multichannel impedance (MII) monitoring. Numbers of all reflux episodes as well as non-acid reflux episodes were reduced in all of our patients. The objective findings were concordant with subjective reports of symptom relief. There were no major adverse events in any patient during therapy with prucalopride. Administration of prucalopride showed promising results in the treatment of persisting or weakly and/or non-acid reflux episodes in our case series in four constipated patients. Therefore, prucalopride can be regarded as a possible therapeutic option in the treatment of standard proton pump inhibitor-persistent reflux in the chronically constipated patient. However, further prospective trials are needed to prove our findings.
    Journal of Medical Case Reports 02/2014; 8(1):34.
  • [Show abstract] [Hide abstract]
    ABSTRACT: We evaluated the serum levels of eosinophil cationic protein (ECP) and mast cell tryptase (MCT) as surrogate markers for response to treatment in adults with eosinophilic esophagitis (EoE) under topical steroid therapy with fluticasone. EoE is a chronic disease characterized histologically by eosinophilic inflammation of the esophagus. Esophageal mastocytosis and mast cell activation have been implicated in EoE pathogenesis. Fifteen patients with EoE completed this prospective observational study. Before and after 3 months of therapy with fluticasone, eosinophilic and mast cell counts were analyzed from histologic samples of the esophagus and were correlated with serum markers ECP and MCT. Fluticasone-therapy significantly decreased mean eosinophils [from 42.2 to 16.2 eosinophils/high-power field (hpf); P=0.004] and mast cells (from 13.9 to 5.1 mast cells/hpf; P=0.001) in the esophageal epithelium. There was a significant decrease of mean ECP (from 15.6 to 5.5 μg/L; P=0.024) and MCT-serum-values (from 4.7 to 3.8 μg/L; P=0.029) under therapy. Serum-ECP correlated significantly with histologic eosinophilic counts after fluticasone-therapy (r=0.54; P=0.038) in contrast to serum-MCT. Serum-ECP but not serum-MCT could be a promising noninvasive biomarker to assess response to topical corticosteroid therapy in EoE. These findings should be confirmed by larger studies; number, NCT01624129.
    Journal of clinical gastroenterology 10/2013; · 2.21 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Aim: To determine the long-term effect of argon plasma coagulation (APC) of gastric inlet patches in the cervical esophagus for patients suffering from globus sensation. Methods: We intended to follow up all patients between 2004 and 2011 (n = 49) who received argon plasma ablation of gastric inlet patches for globus sensation at our clinic. Symptoms were assessed by a visual analogue scale (VAS) in 31 of 49 patients. Follow-up endoscopy of the upper gastrointestinal tract was performed to confirm residual or relapsed cervical inlet patches. Results: After a median period of 27 months, APC was assessed as a successful therapy in 23 of 31 patients (74%). VAS scores decreased significantly from 7.6 to 4.0 in the long term. Twenty-two of 31 patients were willing to undergo follow-up endoscopy. Endoscopy revealed recurrent/residual gastric inlet patches after APC in 11 of 22 cases. These patients suffered from a significant relapse of symptoms in the postinterventional period (p < 0.001). Conclusion: This retrospective study indicates that APC of gastric inlet patches for the treatment of globus sensation might be a sufficient therapy option. Recurrences or residual heterotopic gastric mucosa are possible and seem to be associated with a relapse of symptoms. Therefore, endoscopic follow-up and retreatment might be necessary if globus sensation is not sufficiently eliminated. © 2013 S. Karger AG, Basel.
    Digestion 10/2013; 88(3):165-171. · 2.03 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Acute upper abdominal pain is a frequent symptom leading to hospital admission.
    United European Gastroenterology Journal. 10/2013; 1(5):329-334.
  • [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND AND AIMS:: Endoscopic therapy holds an important role in the management of benign biliary strictures. This study compares the long-term outcome of stenting therapy depending on the underlying cause of the stricture. METHODS:: In a retrospective cohort study, 228 patients with benign biliary strictures were identified using an endoscopic database, hospital charts, and cholangiograms between January 1992 and December 2008. Long-term follow-up was evaluated with cholangiograms, transabdominal ultrasound, laboratory parameters, and physical examination. The median follow-up period was 44.7 months. RESULTS:: Endoscopic management showed best long-term results in patients with stone-associated biliary stricture. In this subgroup, endoscopic therapy could be successfully completed in 92% (71/77) of the patients. Patients with postoperative biliary stricture had good outcome in 83% (53/64) of cases. Idiopathic strictures presented a successful outcome in 58% (15/26). Biliary strictures caused by chronic pancreatitis had a significantly poorer outcome compared with strictures of other origin. Therapeutic success of endoscopic therapy could only be observed in 31% of patients (19/61). CONCLUSIONS:: Long-term outcome of endoscopic therapy for benign strictures was significantly dependent on the underlying cause of the stricture. In particular, patients with biliary strictures due to chronic pancreatitis benefit least from endoscopic therapy, whereas patients with stone-associated strictures had the highest therapeutic success rate.
    Journal of clinical gastroenterology 06/2013; · 2.21 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study analyzed clinical long-term outcomes after endoscopic therapy, including the incidence and treatment of relapse. This study included 19 consecutive patients (12 male, 7 female, median age 54 years) with obstructive chronic pancreatitis who were admitted to the 2(nd) Medical Department of the Technical University of Munich. All patients presented severe chronic pancreatitis (stage III°) according to the Cambridge classification. The majority of the patients suffered intermittent pain attacks. 6 of 19 patients had strictures of the pancreatic duct; 13 of 19 patients had strictures and stones. The first endoscopic retrograde pancreatography (ERP) included an endoscopic sphincterotomy, dilatation of the pancreatic duct, and stent placement. The first control ERP was performed 4 wk after the initial intervention, and the subsequent control ERP was performed after 3 mo to re-evaluate the clinical and morphological conditions. Clinical follow-up was performed annually to document the course of pain and the management of relapse. The course of pain was assessed by a pain scale from 0 to 10. The date and choice of the therapeutic procedure were documented in case of relapse. Initial endoscopic intervention was successfully completed in 17 of 19 patients. All 17 patients reported partial or complete pain relief after endoscopic intervention. Endoscopic therapy failed in 2 patients. Both patients were excluded from further analysis. One failed patient underwent surgery, and the other patient was treated conservatively with pain medication. Seventeen of 19 patients were followed after the successful completion of endoscopic stent therapy. Three of 17 patients were lost to follow-up. One patient was not available for interviews after the 1(st) year of follow-up. Two patients died during the 3(rd) year of follow-up. In both patients chronic pancreatitis was excluded as the cause of death. One patient died of myocardial infarction, and one patient succumbed to pneumonia. All three patients were excluded from follow-up analysis. Follow-up was successfully completed in 14 of 17 patients. 4 patients at time point 3, 2 patients at time point 4, 3 patients at time point 5 and 2 patients at time point 6 and time point 7 used continuous pain medication after endoscopic therapy. No relapse occurred in 57% (8/14) of patients. All 8 patients exhibited significantly reduced or no pain complaints during the 5-year follow-up. Seven of 8 patients were completely pain free 5 years after endoscopic therapy. Only 1 patient reported continuous moderate pain. In contrast, 7 relapses occurred in 6 of the 14 patients. Two relapses were observed during the 1(st) year, 2 relapses occurred during the 2(nd) year, one relapse was observed during the 3(rd) year, one relapse occurred during the 4(th) year, and one relapse occurred during the 5(th) follow-up year. Four of these six patients received conservative treatment with endoscopic therapy or analgesics. Relapse was conservatively treated using repeated stent therapy in 2 patients. Analgesic treatment was successful in the other 2 patients. 57% of patients exhibited long-term benefits after endoscopic therapy. Therefore, endoscopic therapy should be the treatment of choice in patients being inoperable or refusing surgical treatment.
    World Journal of Gastroenterology 02/2013; 19(5):715-20. · 2.43 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Myospherulosis is a rare tumor caused by interaction of extravasated erythrocytes and exogenous or endogenous lipids. Fifty-nine articles presented 181 patients with myospherulosis since first description in 1969. Myospherulosis seems to occur in any age and in any part of the body; however, most frequent sites are paranasal sinus and subcutaneous tissue. In most cases, exogenous lipids from postoperative packing are damaging the erythrocytes, but also spontaneous cases are described. Diagnosis is made by histology but can be already suggested by radiographic imaging. Differential diagnoses include infections by fungi or algae due to histopathologic similarity. Besides that, radiographic imaging and morphology can wrongly be interpreted as carcinomas, metastases, osteofibrosis, or echinococcosis. Myospherulosis is a benign process, with symptoms deriving from the space occupying character and surgical excision can bring cure. We discuss the clinical presentation, diagnosis, and treatment and provide a systematic review of the literature on myospherulosis.
    Annals of diagnostic pathology 01/2013; · 1.11 Impact Factor
  • C.K. Thoeringer, M. Bajbouj, D. Saur
    Verdauungskrankheiten 01/2013; 31(07):180-186.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Esophageal gastric inlet patches (EGIPs) comprise an island of heterotopic gastric columnar epithelium in the cervical esophagus with a reported prevalence of up to 10%. Usually the diagnosis is made by chance in the course of an upper GI endoscopy. After histopathologic examination EGIPs can be classified as oxyntic (mucosal glands contain parietal cells), as mucoid type (mucosa is composed solely of glands with mucous cells) or as mixed type (presence of both: glands with parietal cells and glands of mucous cells). Despite their overall low incidence of clinically relevant conditions EGIPs seem to be a significant entity. Few individuals with EGIPs report symptoms; globus sensations, dysphagia, hoarseness or chronic cough, that are often misinterpreted as an atypical manifestation of Gastroesophageal Reflux Disease (GERD). It is known, that these symptoms significantly compromise the patients’ quality of life. Therefore therapy should be initiated. However, PPI-response seems to be poor in these patients. We were able to show, that an interventional ablative endoscopic therapy by Argon Plasma Coagulation (APC) can be a safe and effective procedure. However, further researches are required to better understand the clinical significance of EGIPs and their association to symptoms.
    Techniques in Gastrointestinal Endoscopy 01/2013;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Die moderne Funktionsdiagnostik des Ösophagus sollte eine möglichst exakte Beurteilung der Struktur und Funktion der Speiseröhre ermöglichen, um die vom Patienten beschriebenen Symptome, die zugrunde liegende Pathologie und möglichst auch das zu erwartende Therapieansprechen zuverlässig beurteilen zu können. In diesem Beitrag werden neue, vielversprechende Technologien und Methoden der manometrischen Diagnostik sowie der Diagnostik der gastroösophagealen Refluxerkrankung vorgestellt.
    Der Gastroenterologe 11/2012; 7(6).
  • Source
    Journal of clinical pathology 10/2012; · 2.55 Impact Factor
  • Zeitschrift für Gastroenterologie 08/2012; 50(08). · 1.67 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this randomized study was to determine whether intervention based on additional capnographic monitoring reduces the incidence of arterial oxygen desaturation during propofol sedation for colonoscopy. Patients (American Society of Anesthesiologists classification (ASA) 1-3) scheduled for colonoscopy under propofol sedation were randomly assigned to either a control arm with standard monitoring (standard arm) or an interventional arm in which additional capnographic monitoring (capnography arm) was available. In both study arms, detection of apnea or altered respiration induced withholding propofol administration, stimulation of the patient, chin lift maneuver, or further measures. The primary study end point was the incidence of arterial oxygen desaturation (defined as a fall in oxygen saturation (SaO(2)) of ≥5% or <90%); secondary end points included the occurrences of hypoxemia (SaO(2) <90%), severe hypoxemia (SaO(2) ≤85%), bradycardia, hypotension, and the quality of sedation (patient cooperation and patient satisfaction). A total of 760 patients were enrolled at three German endoscopy centers. The intention-to-treat analysis revealed a significant reduction of the incidence of oxygen desaturation in the capnography arm in comparison with the standard arm (38.9% vs. 53.2%; P<0.001). The numbers of patients with a fall in SaO(2) <90% and ≤85% were also significantly different (12.5% vs. 19.8%; P=0.008 and 3.7 vs. 7.8%; P=0.018). There were no differences regarding the rates of bradycardia and hypotension. Quality of sedation was similar in both groups. Results of statistical analyses were maintained for the per-protocol population. Additional capnographic monitoring of ventilatory activity reduces the incidence of oxygen desaturation and hypoxemia during propofol sedation for colonoscopy.
    The American Journal of Gastroenterology 05/2012; 107(8):1205-12. · 9.21 Impact Factor

Publication Stats

680 Citations
291.03 Total Impact Points


  • 2013–2015
    • Deutsches Herzzentrum München
      München, Bavaria, Germany
    • Universität Witten/Herdecke
      Witten, North Rhine-Westphalia, Germany
  • 2005–2014
    • Technische Universität München
      • • Medizinische Klinik und Poliklinik II
      • • Medizinische Klinik und Poliklinik III - Hämatologie/Onkologie
      München, Bavaria, Germany