Fundus was sutured to oesophagus by interrupted stitches. Crural stitches were placed in case the crura were far apart and the opening was too wide. Nasogastric tube was removed on postoperative day one and sips begun. Soft diet was begun on the evening of the first postoperative day and the patient was discharged the next day in case of an uneventful recovery.
All patients with suspected gastroesophageal reflux disease were evaluated for their symptoms and quality of life. Diagnosis of gastroesophageal reflux disease was confirmed by endoscopy and esophageal manometry. 50 such patients (with the necessary inclusion and exclusion criteria and giving written informed consent) were chosen for the study.
Levosulpiride, when compared with metoclopramide or domperidone, proved to be significantly more effective in controlling chemotherapy-induced nausea and vomiting and dyspeptic symptoms 7,22) . Also, it was well tolerated and no extrapyramidal signs were observed. This medicine should be used with caution in the elderly as the risk of side effects are increasingly high.
With itopride, it was 35% before and 71.40% during the treatment. The adverse effects observed during itopride treatment were abdominal pain (50%), nausea (35%), dizziness (21.6%), constipation (16.6%), rashes (10%), diarrhoea (10%), sleeping disorders (3.30%), agranulocytosis (3.3) and galactorrhoea (1.60%). The adverse effects seen with levosulpiride were abdominal pain (26.4%), nausea (17.80%), constipation (10%) and diarrhoea (5.7%). The most common symptom was dyspepsia present in 74% patients and regurgitation was the next common symptom (67.21%) and other symptoms included vomiting (55.2%), heartburn (52.3%), dysphagia (44%), chest pain (43.3%), loss of appetite (31.2%) and haematemesis (17.7%).
A PPI and Prokinetic may be helpful – but impossible to predict in a patient. It can take weeks of treatment before symptoms begin to improve. In some patients medication and lifestyle changes are insufficient to control symptoms and will require surgery. We have repeated a population-based survey of the pattern and prevalence of dyspeptic symptoms in 2460 subjects two years after the original survey, in order to document the changes in dyspeptic symptoms and consultation behaviour. A validated postal questionnaire was sent to 2460 subjects randomly selected in ten-year age bands from the lists of eight general practitioners working in the south of England.
Distal mean nocturnal baseline impedance on pH-impedance monitoring predicts reflux burden and symptomatic outcome in gastro-oesophageal reflux disease.
Itopride offered no additional healing benefit over that afforded by levosulpiride, but it resulted in slightly better scores in some assessment of symptoms. in an interview-based questionnaire amongst hospital employees reported the mean age of individuals with GERD to be 34.8Â±10.2 years and two thirds men had a BMI of 23.2Â±3.9.
Pantoprazole belongs to a class of drugs known as proton pump inhibitors (PPIs). Maintenance of Healing of Erosive or Ulcerative Gastroesophageal Reflux Disease (GERD).
Metoclopromide can also be given subcutaneously (by injection), thus allowing for administration and good absorption helping to abort episodes of vomiting. In June 1998, Janssen announced the relabelling of cisapride to reflect increased warnings regarding the association between use of the drug and adverse cardiac events.
The symptom recovery during treatment was good with both the drugs, but was more pronounced with levosulpiride. In a study by Choi et al, itopride decreased the total symptoms after treatment and they found 300 mg of itopride to be more effective than 150 mg. No adverse effects were reported in their study. Gastroesophageal Reflux Disease (GERD) is a common condition caused by reflux of the liquid acidic contents of the stomach into the oesophagus. Prokinetic medications can be used to treat or control the disease.
First of all, patient consultation was done, data was collected and an endoscopy test was done before starting treatment. Then, treatment was initiated with levosulpiride or itopride twice daily before meals.
You should follow some lifestyle modifications to prevent these symptoms-1) Don’t go to bed just after a full meal, eat meals atleast 2 hrs. Before lying down. 2) Don’t overeat.
Mean score for these 6 parameters improved further at 9 months from diagnosis. Increase in mean score for pain was statistically insignificant at 3 months; however, it was statistically significant at 9 months (Table 4). In the review done by Wileman et al. , there were statistically significant improvements in the health-related quality of life at three months and one year after surgery compared to medical therapy. After 3 months of medical management, mean score of heartburn showed statistically significant rise of 1.17 times (117%) in 20 patients.
Levosulpiride is marketed in Italy and South Korea, and is possibly available elsewhere in Europe and Asia. Levosulpiride does not appear to be available in North America. Levosulpiride is available as 25mg tablets, drops and in ampoules for parenteral administration. Generic versions of levosulpiride also appear to be available in some countries. Levosulpiride is primarily indicated in conditions like Anxiety, Depression, Gastro-esophageal reflux disease, Irritable bowel syndrome, Schizophrenia, Tourette’s syndrome, dyspeptic syndrome, essential cephalgia, and can also be given in adjunctive therapy as an alternative drug of choice in Peptic ulcer, Vertigo.
Avoid or limit the uptake of alcohol while taking this medicine as the risk of adverse effects are increasingly high. Contact your doctor if an excess of drowsiness is experienced.
Levosulpiride gives better quality of life earlier in the treatment than itopride and has lesser side effects and better healing outcome. After 15 days of therapy, the symptom score of patients treated with levosulpiride was positively influenced with better symptomatic relief and improvement in contrast to the itopride group. Overall analysis revealed that levosulpiride was superior to itopride with the greatest symptom score improvement.