Faculty Bibliography

Purpose The aim of this study was to characterize the reflux events in patients with laryngeal symptoms unresponsive to proton pump inhibitor (PPI) therapy. Background Gastroesophageal reflux disease (GERD) is commonly implicated as the cause of laryngeal symptoms. Methods We retrospectively reviewed the pH/impedance records of 21 patients evaluated for persistent throat symptoms despite PPI therapy. They were compared to 30 others with typical reflux symptoms despite medication. Results Five of 21 (24%) patients in the 'throat group' had normal reflux values, 13 (62%) continued to have abnormal acid reflux, and three (14%) had abnormal nonacid reflux but normal acid reflux while on medication. These results did not differ from those with typical symptoms unresponsive to medication. Conclusion In patients with chronic laryngeal symptoms despite PPI therapy, a substantial minority have no reflux at all, but the majority have abnormal amounts of acid reflux despite their taking PPI medication

Obesity is an important public health problem in the United States. Because of its potential effects on gastric leptin homeostasis, Helicobacter pylori may play a role in regulating body weight. The authors' aim in this study was to examine the association between H. pylori colonization and overweight status. Nonpregnant participants in the Third National Health and Nutrition Examination Survey (1988-1994) aged > or = 20 years who had had H. pylori testing performed and body mass index (weight (kg)/height (m2)) measured were studied. Overweight was defined as a body mass index greater than or equal to 25. On the basis of serologic results, the participants were categorized into three H. pylori status groups: H. pylori-positive and cytotoxin-associated gene A (cagA)-positive (H. pylori+ cagA+), H. pylori-positive and cagA-negative (H. pylori+ cagA-), and H. pylori-negative (H. pylori-). Of the 7,003 subjects with complete body mass index and H. pylori data, 2,634 (weighted percentage, 22.9%) were H. pylori+ cagA+, 1,385 (15.1%) were H. pylori+ cagA-, and 2,984 (62.0%) were H. pylori-. The adjusted odds of being overweight were 1.17 (95% confidence interval: 0.98, 1.39; p = 0.075) for the H. pylori+ cagA+ group and 0.99 (95% confidence interval: 0.80, 1.22; p = 0.92) for the H. pylori+ cagA- group in comparison with H. pylori- subjects. Serum leptin levels did not differ significantly between the three H. pylori groups. In this US population-based study, there was no significant association between H. pylori colonization, cagA+ strains of H. pylori, and being overweight