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	<title>Acid Reflux + Barrett&#8217;s &#8211; Dr. Matt W Johnson BSc MBBS FRCP MD</title>
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	<link>http://www.drmattwjohnson.com</link>
	<description>Consultant Gastroenterologist &#38; General Physician</description>
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		<title>High Soluble Fibre Diet helps Reflux</title>
		<link>http://www.drmattwjohnson.com/uncategorized/high-soluble-fibre-diet-helps-reflux/</link>
		
		<dc:creator><![CDATA[Dr Matt W Johnson]]></dc:creator>
		<pubDate>Sun, 28 Feb 2021 00:36:20 +0000</pubDate>
				<category><![CDATA[Acid Reflux + Barrett's]]></category>
		<category><![CDATA[Uncategorized]]></category>
		<category><![CDATA[Acid Reflux]]></category>
		<category><![CDATA[High Soluble Fibre Diet]]></category>
		<guid isPermaLink="false">http://www.drmattwjohnson.com/?p=1456</guid>

					<description><![CDATA[Further evidence can be found in these two articles looking at the benefit of a high soluble fibre diet and avoidance of known dietary triggers in helping settle acid-reflux symptoms.]]></description>
										<content:encoded><![CDATA[
<p>Further evidence can be found in these two articles looking at the benefit of a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5989243/">high soluble fibre diet</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6702398/">avoidance of known dietary triggers</a> in helping settle acid-reflux symptoms.  </p>
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		<item>
		<title>Dispelling the myths about  PPI side effects</title>
		<link>http://www.drmattwjohnson.com/uncategorized/dispelling-the-myths-about-ppi-side-effects/</link>
		
		<dc:creator><![CDATA[Dr Matt W Johnson]]></dc:creator>
		<pubDate>Sun, 28 Feb 2021 00:26:13 +0000</pubDate>
				<category><![CDATA[Acid Reflux + Barrett's]]></category>
		<category><![CDATA[Uncategorized]]></category>
		<guid isPermaLink="false">http://www.drmattwjohnson.com/?p=1454</guid>

					<description><![CDATA[Anyone concerned about the side effects of longterm PPIs should flick through this Review article from 2017 and the BSG&#8217;s Positional Statement.]]></description>
										<content:encoded><![CDATA[
<p>Anyone concerned about the side effects of longterm PPIs should flick through this <a href="https://www.nature.com/articles/nrgastro.2017.117">Review article</a> from 2017 and the <a href="https://www.bsg.org.uk/clinical-resource/bsg-position-statement-proton-pump-inhibitors-ppis-and-the-risk-of-gastric-cancer/">BSG&#8217;s Positional Statement</a>.</p>
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			</item>
		<item>
		<title>Wedgehog</title>
		<link>http://www.drmattwjohnson.com/acid-reflux-barretts/wedgehog/</link>
		
		<dc:creator><![CDATA[Dr Matt W Johnson]]></dc:creator>
		<pubDate>Sun, 28 Feb 2021 00:17:25 +0000</pubDate>
				<category><![CDATA[Acid Reflux + Barrett's]]></category>
		<guid isPermaLink="false">http://www.drmattwjohnson.com/?p=1452</guid>

					<description><![CDATA[I have no shares in this company, but I am often asked about anti-reflux wedge pillows. This is a link to a well established company that supplies the NHS, and can be found on Amazon.]]></description>
										<content:encoded><![CDATA[
<p>I have no shares in this company, but I am often asked about anti-reflux wedge pillows. This is a <a href="https://wedgehog.co.uk/collections/adult-wedgehogÂ®">link</a> to a well established company that supplies the NHS, and can be found on <a href="https://www.amazon.co.uk/WedgehogÂ®-Quilted-Reflux-Heartburn-Indigestion/dp/B00CQZ6I62/ref=sr_1_4?dchild=1&amp;keywords=wedgehog&amp;qid=1614471354&amp;sr=8-4">Amazon</a>.</p>
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			</item>
		<item>
		<title>New National Barrett&#8217;s Surveillance Guidelines</title>
		<link>http://www.drmattwjohnson.com/acid-reflux-barretts/new-national-barretts-surveillance-guidelines/</link>
		
		<dc:creator><![CDATA[Dr Matt W Johnson]]></dc:creator>
		<pubDate>Fri, 02 May 2014 20:51:57 +0000</pubDate>
				<category><![CDATA[Acid Reflux + Barrett's]]></category>
		<guid isPermaLink="false">http://www.drmattwjohnson.com/?p=660</guid>

					<description><![CDATA[Findings Surveillance Intestinal metaplasia of the cardia Not recommended Irregular Z line Not recommended &#60;3cm without IM Repeat gastroscopy with quadrantic biopsies â€“ if still no IM, discharge from surveillance &#60;3cm with IM Every 3-5 years (agreed 4 yearly L&#38;D) &#62;3cmÂ  Every 2-3 years (agreed 2 yearly L&#38;D)]]></description>
										<content:encoded><![CDATA[<table cellspacing="0" cellpadding="0">
<tbody>
<tr>
<td valign="top"><span style="color: #000000; font-family: Arial; font-size: medium;"><b>Findings</b></span></td>
<td valign="top"><span style="color: #000000; font-family: Arial; font-size: medium;"><b>Surveillance</b></span></td>
</tr>
<tr>
<td valign="top"><span style="color: #000000; font-family: Arial; font-size: medium;">Intestinal metaplasia of the cardia</span></td>
<td valign="top"><span style="color: #000000; font-family: Arial; font-size: medium;">Not recommended</span></td>
</tr>
<tr>
<td valign="top"><span style="color: #000000; font-family: Arial; font-size: medium;">Irregular Z line</span></td>
<td valign="top"><span style="color: #000000; font-family: Arial; font-size: medium;">Not recommended</span></td>
</tr>
<tr>
<td valign="top"><span style="color: #000000; font-family: Arial; font-size: medium;">&lt;3cm without IM</span></td>
<td valign="top"><span style="color: #000000; font-family: Arial; font-size: medium;">Repeat gastroscopy with quadrantic biopsies â€“ if still no IM, discharge from surveillance</span></td>
</tr>
<tr>
<td valign="top"><span style="color: #000000; font-family: Arial; font-size: medium;">&lt;3cm with IM</span></td>
<td valign="top"><span style="color: #000000; font-family: Arial; font-size: medium;">Every 3-5 years (agreed 4 yearly L&amp;D)</span></td>
</tr>
<tr>
<td valign="top"><span style="color: #000000; font-family: Arial; font-size: medium;">&gt;3cmÂ </span></td>
<td valign="top"><span style="color: #000000; font-family: Arial; font-size: medium;">Every 2-3 years (agreed 2 yearly L&amp;D)</span></td>
</tr>
</tbody>
</table>
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			</item>
		<item>
		<title>New Reflux Catagorisation</title>
		<link>http://www.drmattwjohnson.com/acid-reflux-barretts/new-reflux-catagorisation/</link>
		
		<dc:creator><![CDATA[Dr Matt W Johnson]]></dc:creator>
		<pubDate>Sun, 06 Sep 2009 19:56:05 +0000</pubDate>
				<category><![CDATA[Acid Reflux + Barrett's]]></category>
		<guid isPermaLink="false">http://www.drmattwjohnson.com/?p=137</guid>

					<description><![CDATA[Reflux Reflux symptoms can be experienced secondary to a range of problems that are not always acid related. Even in those related to acid reflux the OGD can be macroscopically normal in 85%. 15-30% of case are due to true gastro-oesophageal reflux disease, >70% is related to non erosive reflux disease (NERD) A recent trial by E. Savarino has helped&#8230;]]></description>
										<content:encoded><![CDATA[<p>Reflux</p>
<p>Reflux symptoms can be experienced secondary to a range of problems that are not always acid related. Even in those related to acid reflux the OGD can be macroscopically normal in 85%.<br />
15-30% of case are due to true gastro-oesophageal reflux disease,<br />
>70% is related to non erosive reflux disease (NERD)<br />
A recent trial by E. Savarino has helped differentiate these patients further by using assessments of their acid exposure time (AET) and symptom association probability (SAP).<br />
 <a href="http://gut.bmj.com/cgi/content/full/58/9/1185">Gut 2009;58:1185-1191</a></p>
<p>Of the 200 patients reviewed with presumed NERD, they found 3 main clinical catagories;Â <br />
1) NERD pH+ive Â    &#8211; 41%<br />
Â Â  Â  Â  Â  Â  Â  Â  Â  Â  Â  Â     &#8211; +ive AET<br />
2) Hypersensitive   &#8211; 32%<br />
Â Â  Â  Â  Â  Â  Â  Â  Â  Â  Â  Â     &#8211; Norm AET / +ive SAP<br />
Â Â  Â  Â  Â  Â  Â  Â  Â  Â  Â  Â     &#8211; secondary to non/acid reflux<br />
3) Functional  Â   Â  Â  &#8211; 27%<br />
Â Â  Â  Â  Â  Â  Â  Â  Â  Â      Â  Â &#8211; Norm AET / -ive SAP<br />
Â Â  Â  Â  Â  Â  Â  Â  Â  Â  Â  Â <br />
The Rome III criteria for Functional Reflux also suggests that these patients should also have no response to anti acid / proton pump inhibitors (PPIs). Typically these patients also suffer from associated nausea, early satiety, bloating and postprandial fullness. It was felt that these patients have more in common with those suffering functional dyspepsia, than those with true NERD.</p>
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