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ENDOSCOPIC GASTROPLICATION REDUCES PPI USE IN PATIENTS WITH REFLUX
Improving the barrier to gastro-oesophageal reflux using endoscopic suturing is undoubtedly attractive, but placebo effects are likely to be large. This study, the first randomised sham-controlled trial of this treatment, is therefore welcomed. Patients who were reliant on proton pump inhibitors (PPIs) were randomised to three groups; active treatment, sham treatment or observation only. Sixty patients were enrolled and partial or complete 3-month data were available for 57 of them. After 3 months, 65% of patients in the active group had reduced use of PPIs compared with 25% in the sham group and none in the observation-only group. The benefit persisted, although with diminishing magnitude at 6 and 12 months. Symptoms and quality of life were also improved. Surprisingly, both active and sham groups showed a similar fall in acid exposure, raising the question of exactly how endoscopic gastroplication works. The authors found a large percentage of loose sutures during re-treatment, which was needed in 29% within the year of follow up. They caution against the widespread adoption of such a technique until it has been further improved.
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Use of antisecretory agents expressed as percent of baseline dose.
GREATER POTENCY OF FAT COMPARED WITH CARBOHYDRATE ON GASTRIC ACCOMMODATION AND SENSITIVITY TO DISTENSION
Patients with dyspepsia often complain of early satiety and bloating, symptoms that may reflect either impaired postprandial gastric accommodation or …
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