Background
Although dietary factors seem to be associated with gastroesophageal reflux symptoms, their effects on reflux esophagitis and non-erosive reflux disease (NERD) are unclear. We evaluate ...dietary effects on NERD and reflux esophagitis.
Methods
A total of 11,690 health check-up persons completed questionnaires for reflux symptoms and 3-day recordings for dietary intake and underwent esophagogastroduodenoscopy from 2004 to 2008. Multiple logistic regression with odds ratio (OR) and 95% confidence interval (CI) was used to evaluate the relationship of dietary components with NERD or reflux esophagitis.
Results
Prevalence of NERD and reflux esophagitis was 7.7 and 7.2%, respectively. In adjusted analysis, highest quartile of beans (OR 0.78, 95% CI 0.64–0.95), 3rd quartile of vegetables (OR 0.74, 95% CI 0.60–0.91), 4th quartile of fruit (OR 0.78, 95% CI 0.64–0.95), 4th quartile of egg (OR 0.78, 95% CI 0.64–0.96), and 3rd quartile of fish (OR 0.80, 95% CI 0.66–0.98), and 4th quartile of milk (OR 0.78, 95% CI 0.65–0.94) reduced NERD. Reflux esophagitis had no association with food groups, whereas it was related with men, absence of
H. pylori
, hiatal hernia, BMI, and total energy intake. Furthermore, dietary effect on NERD was similar in men and women, whereas highest tertile of potato (OR 1.91) and milk (OR 1.87) increased reflux esophagitis only in women.
Conclusions
While many food groups affected NERD, reflux esophagitis was associated with BMI and total energy intake rather than dietary component. These results may suggest different approaches toward dietary management of NERD and reflux esophagitis.
Western guidelines recommend Helicobacter pylori eradication in H. pylori-associated gastric polyps, but Korean medical insurance does not approve its eradication. The aim of this study is to ...evaluate the effect of H. pylori eradication on gastric polyps.
Participants in a large screening cohort underwent baseline and follow-up esophagogastroduodenoscopy and H. pylori testing. The association between gastric polyps and H. pylori was estimated using odds ratios (ORs) adjusted for confounding factors and 95% confidence intervals (CIs). The effect of H. pylori eradication on the fate of polyps was also evaluated.
The screening cohort included 7603 participants (605 gastric polyps: 529 hyperplastic polyps, 63 fundic gland polyps, and 13 adenomas). H. pylori infection showed a positive association with hyperplastic polyps (OR 2.01; 95% CI 1.66-2.41), but was inversely related to fundic gland polyps (OR 0.05; 95% CI 0.02-0.17). Removed polyps by biopsy or endoscopic resection or tiny polyps less than 3 mm at baseline and positive conversion of H. pylori at follow-up were excluded. A total of 7060 persons were finally included to evaluate the effect of H. pylori eradication on the gastric polyp. Successful H. pylori eradication (OR 0.52; 95% CI 0.35-0.77) and persistent H. pylori-negative status (OR 0.59; 95% CI 0.46-0.76) reduced the risk of hyperplastic polyps compared with the persistent H. pylori-positive group. Successful H. pylori eradication markedly induced the disappearance of hyperplastic polyps compared with the persistent H. pylori-positive group (85.0 vs. 29.0%, P=0.001).
H. pylori infection increased the risk of hyperplastic polyps in both cross-sectional and longitudinal settings, and its eradication induced regression of hyperplastic polyps.
The protective effects of vitamin D and calcium on colorectal neoplasms are known. Bone mineral density (BMD) may be a reliable biomarker that reflects the long-term anticancer effect of vitamin D ...and calcium. This study aimed to evaluate the association between BMD and colorectal adenomas including high-risk adenoma.
A multicenter, cross-sectional, case-control study was conducted among participants with average risk of colorectal cancer who underwent BMD and screening colonoscopy between 2015 and 2019. The main outcome was the detection of colorectal neoplasms. The variable under consideration was low BMD (osteopenia/osteoporosis). The logistic regression model included baseline demographics, components of metabolic syndrome, fatty liver disease status, and aspirin and multivitamin use.
A total of 2,109 subjects were enrolled. The mean age was 52.1±10.8 years and 42.6% were male. The adenoma detection rate was 43%. Colorectal adenoma and high-risk adenoma were both more prevalent in subjects with low BMD than those with normal BMD (48.2% vs 38.8% and 12.1% vs 9.1%). In the univariate analysis, old age, male sex, smoking, metabolic components, fatty liver, and osteoporosis were significantly associated with the risk of adenoma and high-risk adenoma. In the multivariate analysis, osteoporosis was independently associated with risk of colorectal adenoma (odds ratio OR, 1.65; 95% confidence interval CI, 1.11 to 2.46; p=0.014) and high-risk adenoma (OR, 1.94; 95% CI, 1.14 to 3.29; p=0.014).
Osteoporosis is an independent risk factor of colorectal adenoma and high-risk adenoma.
Background
We aimed to examine the relationship of current Helicobacter pylori infection with lipid profile and cardiovascular disease and its eradication effect.
Methods
Healthy subjects, who ...underwent routine checkup between October 2003 and December 2007, were followed up until June 2009. Helicobacter pylori and lipid profiles were measured both baseline and follow‐up. Multiple logistic regression models for odds ratios (ORs) and 95% confidence intervals (CIs) were used to estimate the effects of H. pylori infection and its eradication, on lipids and cardiovascular disease.
Results
Current infection with H. pylori with 50.5% (6759/13383) at baseline increased low‐density lipoprotein (LDL) and decreased high‐density lipoprotein (HDL) than H. pylori‐negative group. Successful eradication of H. pylori decreased the risk of high LDL compared with the persistent infection (OR 0.76, 95% CI 0.59–96), which was comparable to that of the persistent negative group (OR 0.82, 95% CI 0.70–0.97), and decreased the risk of low HDL (OR 0.68, 95% CI 0.49–0.96). Current infection of H. pylori increased the risk of cardiovascular disease (OR 3.27, 95% CI 1.31–8.14) at baseline, but its eradication failed to decrease the risk at a 2‐year follow‐up. However, persistent negative infection decreased the risk (OR 0.57, 95% CI 0.35–0.94) comparing to persistent positive infection at follow‐up.
Conclusions
Current infection with H. pylori had a positive association with high LDL, low HDL, and cardiovascular disease. Successful H. pylori eradication decreased the risk of high LDL and low HDL, but did not reduce the risk of cardiovascular disease.
Purpose
Helicobacter pylori
infection is considered to have a positive association with colorectal neoplasms. In this study, we evaluated the association between
H. pylori
infection and colorectal ...adenomas, based on the characteristics of these adenomas in Korea, where the prevalence of
H. pylori
infection is high and the incidence of colorectal cancer continues to increase.
Methods
The study cohort consisted of 4,466 subjects who underwent colonoscopy and esophagogastroduodenoscopy during screening (1,245 colorectal adenomas vs. 3,221 polyp-free controls). We compared the rate of
H. pylori
infection between patients with adenoma and polyp-free control cases, using multivariable logistic regression analysis.
Results
The overall rate of positive
H. pylori
infection was higher in adenoma cases than in polyp-free control cases (55.0 vs. 48.5%,
p
< 0.001). The odds ratio (OR) of positive
H. pylori
infection in patients with adenoma compared to polyp-free controls was 1.28 (95% CI 1.11–1.47). The positive association of
H. pylori
infection with colorectal adenomas was more prominent in advanced adenomas (OR 1.84, 95% CI 1.25–2.70) and multiple adenomas (OR 1.72, 95% CI 1.26–2.35). Based on the location of these adenomas, the OR was significant only in patients with colonic adenomas (OR 1.31, 95% CI 1.13–1.52) and not in those with rectal adenoma (OR 0.85, 95% CI 0.58–1.24).
Conclusion
Helicobacter pylori
infection is an independent risk factor for colonic adenomas, especially in cases of advanced or multiple adenomas, but not for rectal adenomas.
To identify the factors influencing cecal insertion time (CIT) and to evaluate the effect of obesity indices on CIT.
We retrospectively reviewed the data for participants who received both ...colonoscopy and abdominal computed tomography (CT) from February 2008 to May 2008 as part of a comprehensive health screening program. Age, gender, obesity indices body mass index (BMI), waist-to-hip circumference ratio (WHR), waist circumference (WC), visceral adipose tissue (VAT) volume and subcutaneous adipose tissue (SAT) volume on abdominal CT, history of prior abdominal surgery, constipation, experience of the colonoscopist, quality of bowel preparation, diverticulosis and time required to reach the cecum were analyzed. CIT was categorized as longer than 10 min (prolonged CIT) and shorter than or equal to 10 min, and then the factors that required a CIT longer than 10 min were examined.
A total of 1678 participants were enrolled. The mean age was 50.42 ± 9.931 years and 60.3% were men. The mean BMI, WHR, WC, VAT volume and SAT volume were 23.92 ± 2.964 kg/m
, 0.90 ± 0.076, 86.95 ± 8.030 cm, 905.29 ± 475.220 cm
and 1707.72 ± 576.550 cm
, respectively. The number of patients who underwent abdominal surgery was 268 (16.0%). Colonoscopy was performed by an attending physician alone in 61.9% of cases and with the involvement of a fellow in 38.1% of cases. The median CIT was 7 min (range 2-56 min, IQR 5-10 min), and mean CIT was 8.58 ± 5.291 min. Being female, BMI, VAT volume and involvement of fellow were significantly associated with a prolonged CIT in univariable analysis. In multivariable analysis, being female (OR = 1.29,
= 0.047), lower BMI (< 23 kg/m
) (OR = 1.62,
= 0.004) or higher BMI (≥ 25 kg/m
) (OR = 1.80,
< 0.001), low VAT volume (< 500 cm
) (OR = 1.50,
= 0.013) and fellow involvement (OR = 1.73,
< 0.001) were significant predictors of prolonged CIT. In subgroup analyses for gender, lower BMI or higher BMI and fellow involvement were predictors for prolonged CIT in both genders. However, low VAT volume was associated with prolonged CIT in only women (OR = 1.54,
= 0.034).
Being female, having a lower or higher BMI than the normal range, a low VAT volume, and fellow involvement were predictors of a longer CIT.
Background: The increased demand for genetic testing and counseling necessitates healthcare professionals (HCPs) to improve their genetic competency through training programs. This systematic review ...identified HCPs’ learning needs and their perspectives on essential information for families with hereditary cancer. Methods: This review covered studies published from 2013 to 2024 across five databases. Data were analyzed using a content analysis. Results: Thirteen studies involving 332 HCPs were analyzed. Most studies focused on the learning needs of physicians caring for families affected by Hereditary Breast and Ovarian Cancer in North America and Europe. HCPs required training emphasizing practical counseling skills over the basics of genetics. Learning needs varied by profession: physicians needed training in assessing cancer risk and supporting decision-making in risk management; nurses required information on resources and the genetic care system; genetic counselors sought guidance on family communication and planning. Essential information identified for families included risk-reducing strategies, personalized cancer risk assessment, family implications, psychological issues, (cascade) genetic testing, and social concerns. Conclusions: The findings have implications for the development of training programs for HCPs, emphasizing the need for tailored training based on professions. Future research should explore the needs of HCPs caring for families with diverse hereditary cancers and cultural backgrounds.
Western guidelines recommend
eradication in
-associated gastric polyps; however, there is no standard guideline in Korea. The aim of this study is to assess the effect of
eradication on the ...regression of gastric hyperplastic polyps in National Cancer Screening Cohort, representative of general population.
Among participants in National Cancer Screening Program, subjects who had
positive gastric hyperplastic polyps less than 10 mm and underwent follow-up endoscopy and
testing were enrolled. The effect of
eradication on hyperplastic gastric polyps was estimated using odds ratios (ORs) and 95% confidence intervals (CIs).
A total of 183
infected subjects with hyperplastic polyp at baseline underwent follow-up endoscopy and
test after mean of 2.2 years. Successful
eradication markedly induced the disappearance of hyperplastic polyps comparing to non-eradication group (83.7% vs. 34.1%,
= 0.001). Successful eradication increased the possibility of disappearance of hyperplastic polyps (adjusted OR, 5.56; 95% CI, 2.63 to 11.11). Polyp size was inversely related with the disappearance of hyperplastic polyps (adjusted OR, 59; 95% CI, 0.48 to 0.71).
Eradication of
infection may induce disappearance of gastric hyperplastic polyps in National Cancer Screening Cohort.
We evaluated the association between current Helicobacter pylori infection and reflux esophagitis and the effect of H. pylori eradication on reflux esophagitis in a healthy screening population.
A ...total of 10,102 subjects in a comprehensive screening cohort were enrolled, and 4,007 subjects had follow-up after a median of 2 years. Effects of H. pylori infection on reflux esophagitis were estimated with odds ratios (ORs) and 95% confidence intervals (CIs) using multiple logistic regression analysis. We evaluated the change in prevalence of reflux esophagitis and reflux symptoms after H. pylori eradication vs. persistence.
The prevalence of reflux esophagitis (as classified by the Los Angeles system) was 4.9% (490/10,102). Whereas the prevalence of reflux esophagitis was 6.4% (319/4,971) in subjects without H. pylori infection, it was 3.3% (171/5,131) in subjects with infection (P<0.001). H. pylori infection had a strong negative association with reflux esophagitis in multivariate analysis (OR 0.42; 95% CI, 0.34-0.51). Compared with the prevalence of reflux esophagitis in the persistent infection group, the prevalence of reflux esophagitis increased after successful H. pylori eradication (OR 2.34; 95% CI, 1.45-3.76; P<0.001), which was comparable to that of the H. pylori-negative group (OR 2.42; 95% CI, 1.73-3.36; P<0.001). However, reflux symptoms had no association with H. pylori infection or eradication.
In a healthy screening population, H. pylori infection had a strong negative association with reflux esophagitis, but H. pylori eradication increased the prevalence of erosive esophagitis to the level of H. pylori-negative individuals. Long-term clinical significance of newly developed erosive esophagitis after H. pylori eradication should be evaluated prospectively.
The effect of dietary micronutrients on non-erosive reflux disease (NERD) and reflux esophagitis is unclear. We aim to evaluate the gender-specific effect of micronutrient on erosive esophagitis and ...NERD.
A total of 11 690 participants underwent endoscopy and completed 3-day recordings for dietary intake and questionnaires for reflux symptoms from 2004 to 2008. To evaluate the effect of dietary micronutrients on NERD or erosive esophagitis, adjusted regression analysis with odds ratio (OR) and 95% confidence interval (CI) was used. In addition, we performed gender-specific analysis.
Prevalence of NERD and erosive esophagitis was 6.8% and 11.2% in men and 9.1% and 2.4% in women. In adjusted analysis, high intake of vitamin A (OR, 0.78; 95% CI, 0.64-0.96), retinol (OR, 0.73; 95% CI, 0.59-0.90), vitamin B2 (OR, 0.68; 95% CI, 0.54-0.87), vitamin B6 (OR, 0.75; 95% CI, 0.58-0.96), folic acid (OR, 0.77; 95% CI, 0.62-0.96), calcium (OR, 0.66; 95% CI, 0.53-0.82), and iron (OR, 0.68; 95% CI, 0.53-0.87) had an inverse association with NERD. However, erosive esophagitis has no relationship with micronutrients except vitamin C (OR, 0.78; 95% CI, 0.62-0.98). High dietary intake of calcium reduced the risk of NERD in men and high dietary intake of many micronutrients reduced NERD in women.
While many dietary micronutrients reduced NERD, they had no effect on erosive esophagitis. The effect of micronutrient on NERD was more prominent in women than men.
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