Gerd Walter’s research works

In clinical practice, disappearance of these symptoms following treatment with proton pump inhibitors (PPIs) allows general physicians to reasonably conclude that the patient had acid-related dyspepsia [1]. Dyspepsia is usually defined as upper abdominal pain or retrosternal pain, discomfort, heartburn, nausea, vomiting, or other symptoms considered to arise from the upper alimentary tract. When these symptoms cause deterioration of patients’ daily life quality, PPIs are generally used for treatment because they are more effective than histamine H2 receptor antagonists for reflux-like (heartburn) or ulcer-like (episodic epigastric pain) dyspepsia.

Our patient-control study suggested that GERD, as defined by the FSSG score, was more prevalent in PD patients than in the healthy controls. The prevalence rate was 26.5%. The presence of PD increased the prevalence rate of GERD to 4.1 times higher than that of the age-matched controls. These findings indicated that PD can be a risk factor of GERD.

Helicobacter pylori (H. pylori) infection can induce motor fluctuations by interrupting the absorption of levodopa in PD patients [26-29]. Eradication of H.

Although PD is still the most well-known movement disorder, growing recognition of variable nonmotor symptoms suggests that PD is a systemic disease. Nonmotor symptoms of PD are a major cause of disability for PD patients, and recognition and treatment of nonmotor symptoms are important to maintain comprehensive healthcare for PD patients [3, 10, 11].

Because clinical symptoms of GERD are treatable, efforts to recognize the presence of GERD should be made to preserve the quality of life of PD patients. However, there remains a certain limitation to interpret the results. We cannot exclude the possibility that our results were peculiar to the outpatient. The aim of this study is to investigate the frequency and clinical features of gastroesophageal reflex disease (GERD) in Parkinson’s disease (PD). Consecutively recruited PD patients and controls were questioned about heartburn and GERD with a questionnaire.

Gastroesophageal reflux symptoms characterized by heartburn and regurgitation are generally recognized as clinical symptoms of gastroesophageal reflex disease (GERD). GERD can also show dyspeptic manifestations other than reflux symptoms.

The results of the analysis comparing between PD with and without GERD suggested that GERD was clinically characterized by subjective heartburn and was more common in the advanced stage presenting with the wearing-off phenomenon. The analysis also suggested that GERD could cause deterioration of patients’ daily living activities and quality of life and that GERD was associated with the presence of other nonmotor symptoms. Furthermore, daily living activity and nonmotor symptoms can be independent relating factors of GERD in PD. These results suggest that GERD is a frequent nonmotor problem and a deteriorating factor of daily living activity in PD patients.

Reflux is another common problem that may precede the onset of pregnancy, begin with the onset of NVP, or worsen as the pregnancy progresses. Like NVP, the normal physiologic changes of pregnancy contribute to its development and often make management difficult.

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