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- 저자 : Naotaka Ogasawara (검색결과 2 건)
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Naotaka Ogasawara,Yasushi Funaki,Kunio Kasugai,Masahide Ebi,Yasuhiro Tamura,Shinya Izawa,Makoto Sasaki 대한소화기 기능성질환∙운동학회 2022 Journal of Neurogastroenterology and Motility (JNM Vol.28 No.2
Background/AimsDetailed evaluations of overlapping constipation and gastroesophageal reflux disease (GERD) have not been conducted in Japan. The REACTION-J2 study examined the overlap of these diseases in Japan. MethodsThis internet-based survey recruited participants from general public survey panels. Questions included demographic and medical data and assessments based on validated measures for constipation and GERD. Associations between background factors affecting constipation/GERD overlap, disease measures, and treatment were also evaluated. ResultsAmong 10 000 survey responses received, functional constipation (Rome IV diagnostic criteria) was reported by 439 participants; chronic constipation (Japanese guidelines) by 3804 participants; and subjective constipation symptoms by 2563 participants. The number of participants with constipation/GERD overlap ranged from 73 to 1533 depending on the criteria used. Regardless of the definition used, all GERD groups had significantly higher odds of being constipated than non-GERD participants: the OR (95% CI) for all 9 combinations of definitions ranged between 1.56 (1.21, 2.01) and 2.67 (2.44, 2.92) (all P ≤ 0.001). Straining, hard stools, and sensations of incomplete evacuation and anorectal obstruction/blockage, according to chronic constipation criteria, were common. Participants with constipation/GERD overlap had poorer quality of life (P < 0.001) and worse GERD symptom scores (P < 0.001). The frequency of abnormal stools was highest (P < 0.001) in the constipation/GERD overlap group. In the overlap group, 52.4% and 26.0% used gastric and constipation medication, respectively. ConclusionIndividuals with constipation/GERD overlap tend to have worsened symptoms and quality of life.
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Naotaka Ogasawara,Mari Mizuno,Ryuta Masui,Yoshihiro Kondo,Yoshiharu Yamaguchi,Kenichiro Yanamoto,Hisatsugu Noda,Noriko Okaniwa,Makoto Sasaki,Kunio Kasugai 대한소화기내시경학회 2014 Clinical Endoscopy Vol.47 No.2
Background/Aims: Despite improvements in endoscopic hemostasis and pharmacological therapies, upper gastrointestinal (UGI) ulcersrepeatedly bleed in 10% to 20% of patients, and those without early endoscopic reintervention or definitive surgery might be at ahigh risk for mortality. This study aimed to identify the risk factors for intractability to initial endoscopic hemostasis. Methods: We analyzed intractability among 428 patients who underwent emergency endoscopy for bleeding UGI ulcers within 24hours of arrival at the hospital. Results: Durable hemostasis was achieved in 354 patients by using initial endoscopic procedures. Sixty-nine patients with Forrest typesIa, Ib, IIa, and IIb at the second-look endoscopy were considered intractable to the initial endoscopic hemostasis. Multivariate analysisindicated that age ≥70 years (odds ratio [OR], 2.06; 95% confidence interval [CI], 1.07 to 4.03), shock on admission (OR, 5.26; 95% CI,2.43 to 11.6), hemoglobin <8.0 mg/dL (OR, 2.80; 95% CI, 1.39 to 5.91), serum albumin <3.3 g/dL (OR, 2.23; 95% CI, 1.07 to 4.89), exposedvessels with a diameter of ≥2 mm on the bottom of ulcers (OR, 4.38; 95% CI, 1.25 to 7.01), and Forrest type Ia and Ib (OR, 2.21;95% CI, 1.33 to 3.00) predicted intractable endoscopic hemostasis. Conclusions: Various factors contribute to intractable endoscopic hemostasis. Careful observation after endoscopic hemostasis is importantfor patients at a high risk for incomplete hemostasis.
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