logo
Gastric Procedure Alleviates GERD Symptoms in Obesity

Gastric Procedure Alleviates GERD Symptoms in Obesity

Medscape8 hours ago
TOPLINE:
In patients with obesity, endoscopic gastric remodeling (EGR) — a minimally invasive procedure — is safe and effective in relieving both typical and atypical gastroesophageal reflux disease (GERD) symptoms at 12 months post-procedure, while also reducing proton pump inhibitor (PPI) use.
METHODOLOGY:
EGR is a minimally invasive alternative to bariatric surgery that reduces gastric volume by approximately 70%, though its effect on GERD symptoms remains unclear.
Researchers conducted a prospective cohort study at a tertiary referral bariatric center to examine EGR's effect on GERD symptoms in patients with at least one obesity-related comorbidity.
Patients completed GERD and health-related assessments before and 12 months after the procedure.
TAKEAWAY:
Researchers included 50 patients (mean age, 41 years; mean BMI at baseline, 38.4; 95.8% women; 44% with GERD) who underwent EGR using either endoscopic suturing (16%) or plication (84%).
All patients successfully underwent EGR without any serious adverse events.
Between baseline and 12 months post-procedure, the mean Reflux Symptom Index score decreased from 5.1 to 3.8 (P = .007) and PPI use from 38% to 20% (P = .047).
The presence of a hiatal hernia predicted a greater alleviation of GERD symptoms.
IN PRACTICE:
'EGR may be considered a preferred option to co-manage both obesity and GERD, particularly in the lower obesity class,' the authors wrote.
SOURCE:
This study was led by Pichamol Jirapinyo, MD, MPH, Brigham and Women's Hospital, Boston, and published online in Clinical and Translational Gastroenterology.
LIMITATIONS:
This study did not include esophageal pH monitoring before or after EGR. Most participants were non-Hispanic women, which may have limited generalizability. Factors such as dietary modifications and medication use were not assessed.
DISCLOSURES:
The study received no external funding. Several authors reported being consultants; receiving research support, grants, or royalties; and having other ties with pharmaceutical companies.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Orange background

Try Our AI Features

Explore what Daily8 AI can do for you:

Comments

No comments yet...

Related Articles

Does Medicare Cover Acupuncture for Neuropathy​?
Does Medicare Cover Acupuncture for Neuropathy​?

Health Line

time28 minutes ago

  • Health Line

Does Medicare Cover Acupuncture for Neuropathy​?

Original Medicare only covers acupuncture to treat chronic lower back pain. But some Part C plans might cover acupuncture for treating other pain conditions like neuropathy. Acupuncture, a holistic practice with a history spanning thousands of years, is thought to be effective for treating both acute and chronic pain, including neuropathy or nerve pain. In 2020, the Centers for Medicare & Medicaid Services (CMS) introduced new regulations concerning Medicare's coverage for acupuncture treatments. However, these new regulations do not extend to covering acupuncture for neuropathy treatment. Why does Medicare not pay for acupuncture for neuropathy? Original Medicare (parts A and B) only covers acupuncture when used to treat chronic lower back pain. The plan tends to cover medical care that is medically necessary and proven to be effective. Although neuropathic pain is common, and acupuncture does show some promise in treating it, more research is needed to confirm the treatment's effectiveness in this space. This means Original Medicare may consider acupuncture for neuropathy as experimental or without sufficient evidence for its effectiveness. How do I get Medicare to pay for acupuncture? You aren't likely to get acupuncture for neuropathy covered under Original Medicare. That said, you have the option of signing up for Medicare Advantage (Part C), which is an alternative to Original Medicare. Part C plans are managed by private insurers, and some Part C plans may offer benefits that Original Medicare does not offer. They may approve coverage for acupuncture for indications not covered by Original Medicare, including for neuropathy. Medicare Advantage Open Enrollment Medicare open enrollment occurs each year from October 15 through December 7. During this period, you may join, drop, or switch Original Medicare, Medicare Advantage, or Part D plans. You can find Part C plans available in your area by entering your zip code on Just remember, even if your plan approves coverage, you may need to see an acupuncture provider in your plan's network, depending on the type of plan you have. How many acupuncture visits does Medicare cover? Under Original Medicare, when you get acupuncture for chronic lower back pain, Medicare Part B covers 12 acupuncture sessions within 90 days and up to 20 sessions per year. If you show improvement during treatment, Part B may cover an additional eight sessions. However, this would not apply to acupuncture when needed for treating neuropathy. If you are enrolled in a Part C plan and your plan approves your acupuncture treatment for neuropathy, the number of sessions you can get covered will depend on your plan. How much would acupuncture for neuropathy cost under Medicare? Acupuncture for chronic lower back pain that falls under Part B will be covered once a person meets their annual deductible, which is $257 in 2025. After that, Part B will pay for 80% of the cost. If your Part C plan approves acupuncture for neuropathy, your coinsurance, deductible, and premium will depend on your plan. According to the Centers for Medicaid & Medicare (CMS), the average monthly premium for Part C plans is around $17 in 2025. In addition, to stay enrolled in a Part C plan, you still have to pay the Part B premium. That said, some Part C may cover your Part B premium. Does acupuncture get rid of neuropathy? Acupuncture involves inserting needles into pressure points to stimulate the nervous system, potentially releasing endorphins for natural pain relief and altering pain responses. Research suggests acupuncture could help treat peripheral neuropathy and neuropathic pain, and methods like electroacupuncture show promise in reducing nerve sensitivity and inflammation. Reviews have also found acupuncture beneficial for diabetic peripheral neuropathy, neuropathy from spinal cord injury, and chemotherapy-induced neuropathy, though more research is needed to verify the effectiveness. »Learn more: Acupuncture for Neuropathy Takeaway Acupuncture may be effective in treating both acute and chronic pain, including nerve pain or neuropathy. In 2020, the Centers for Medicare & Medicaid Services (CMS) implemented new rules regarding Medicare's coverage of acupuncture treatments. However, these regulations do not include coverage for acupuncture as a treatment for neuropathy. Currently, Original Medicare solely covers acupuncture for back pain. However, certain Part C plans may offer coverage for acupuncture to treat other conditions, such as neuropathy.

Mayors, doctor groups sue over Trump's efforts to restrict Obamacare enrollment
Mayors, doctor groups sue over Trump's efforts to restrict Obamacare enrollment

Associated Press

timean hour ago

  • Associated Press

Mayors, doctor groups sue over Trump's efforts to restrict Obamacare enrollment

WASHINGTON (AP) — New Trump administration rules that give millions of people a shorter timeframe to sign up for the Affordable Care Act's health care coverage are facing a legal challenge from Democratic mayors around the country. The rules, rolled out last month, reverse a Biden-era effort to expand access to the Affordable Care Act's health insurance, commonly called 'Obamacare' or the ACA. The previous Democratic administration expanded the enrollment window for the coverage, which led to record enrollment. The Department of Health and Human Services rolled out a series of new restrictions for Obamacare late last month, just as Congress was weighing a major bill that will decrease enrollment in the health care program that Republican President Donald Trump has scorned for years. As many as 2 million people — nearly 10% — are expected to lose coverage from the health department's new rules. The mayors of Baltimore, Chicago and Columbus, Ohio sued the federal health department on Tuesday over the rules, saying they will result in more uninsured residents and overburden city services. 'Cloaked in the pretense of government efficiency and fraud prevention, the 2025 Rule creates numerous barriers to affordable insurance coverage, negating the purpose of the ACA to extend affordable health coverage to all Americans, and instead increasing the population of underinsured and uninsured Americans,' the filing alleges. Two liberal advocacy groups — Doctors for America and Main Street Alliance — joined in on the complaint. The federal health department announced a series of changes late last month to the ACA. It will shorten the enrollment period for the federal marketplace by a month, limiting it to Nov. 1 to Dec. 15 in 2026. Income verification checks will become more stringent and a $5 fee will be tacked on for some people who automatically re-enroll in a free plan. Insurers will also be able to deny coverage to people who have not paid their premiums on past plans. The rules also bar roughly 100,000 immigrants who were brought to the U.S. as children from signing up for the coverage. HHS said in a statement that the polices 'are temporary measures to immediately tamp down on improper enrollments and the improper flow of federal funds.' The mayors — all Democrats — argue that the polices were introduced without an adequate public comment period on the policies. 'This unlawful rule will force families off their health insurance and raise costs on millions of Americans. This does nothing to help people and instead harms Americans' health and safety across our country,' said Skye Perryman, the president of Democracy Forward, which is representing the coalition of plaintiffs in the lawsuit. The lawsuit does not challenge the Trump administration's restriction on immigrants signing up for the coverage. The Biden administration saw gains in Obamacare enrollment as a major success of the Democratic president's term, noting that a record 24 million people signed up for the coverage, thanks to generous tax breaks offered through the 2022 Inflation Reduction Act. But the program has been a target of Trump, who has said it is riddled with problems that make the coverage unaffordable for many without large subsidies. Enrollment in the program dipped during his first term in office.

Fast Five Quiz: The Presentation and Diagnosis of GPA
Fast Five Quiz: The Presentation and Diagnosis of GPA

Medscape

timean hour ago

  • Medscape

Fast Five Quiz: The Presentation and Diagnosis of GPA

Formerly known as Wegener granulomatosis, the granulomatosis with polyangiitis (GPA) subtype of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis can impact a variety of organ systems, often presenting with a diverse range of clinical features that complicate timely diagnosis. Knowing how to identify the symptoms and diagnose this rare disease is paramount for adequate treatment. What do you know about the presentation and diagnosis of GPA? Check your knowledge with this quick quiz. Upper and lower respiratory tract involvement, along with the skin, eyes, and nervous system (with or without kidney manifestations) are the classic presentations of ANCA vasculitis, with most common presentations of GPA being respiratory, renal, and ear, nose, and throat (ENT) symptoms. ENT manifestations are distinctive and include nasal tissue crusting, mucosal damage causing epistaxis, cartilage deterioration leading to saddle nose deformity, erosive sinus disease, and subglottic stenosis. Isolated liver involvement in GPA is considered rare. Gastrointestinal involvement can occur in patients with GPA, but it is also not common. Though neurological symptoms can be seen in patients with GPA, isolated involvement is not as common as upper and lower respiratory tract involvement. Learn more about the presentation of GPA. MRI is suggested for detecting pachymeningitis and retro-orbital lesions in patients with GPA, with researchers who have evaluated patient cases of GPA stating that the 'exploration of pachymeningitis relies on MRI.' Further, MRI is usually more effective than CT when detecting pachymeningitis. F-18-fluorodeoxyglucose PET with CT is usually used to detect occult inflammation and exclude malignancy and infection in this population; however, data have shown this method has high sensitivity for detecting cardiovascular, lung, nasal/sinus, and kidney involvements. Standard radiograph is not usually used in this setting. Learn more about imaging for GPA. The distinctive renal pathology in GPA is characterized by pauci-immune focal and segmental necrotizing and crescentic glomerulonephritis. This histological pattern features inflammatory destruction of small blood vessels with scant or undetectable immune complex deposits in vessel walls. Microscopic examination of kidney tissue typically reveals areas of fibrinoid necrosis within glomeruli and proliferative changes outside capillaries forming crescents; inflammation of small vessels with neutrophil infiltration and endothelial alterations might be observed as well. When examined with immunofluorescence techniques, the tissue shows minimal or absent staining for immunoglobulins and complement factors, confirming the pauci-immune nature of the condition. Though membranous nephropathy, minimal change disease, and lupus nephritis are types of glomerulonephritis, they are not characteristic of GPA. Learn more about renal histology in GPA. PR3-ANCA shows the strongest association with GPA. Various sources have shown that PR3-ANCA is present in approximately 80% of patients with GPA but can be positive in 2%-27% of patients with microscopic polyangiitis (MPA). Though ANCA testing offers valuable diagnostic insights, clinicians should evaluate results alongside clinical presentations and tissue examinations, since these antibodies occasionally appear in other inflammatory disorders or as medication side effects. MPO-ANCA is associated with GPA but it is not as common as PR3-ANCA. Anti-neutrophil elastase and ANTI-LAMP2 can be seen with ANCA-associated vasculitis but are not specific for GPA. Learn more about ANCA detection in GPA. The presence of lung nodules serves as a key distinguishing feature of GPA when compared with MPA. Although both conditions might present with pulmonary bleeding from capillaritis, nodular formations or cavitary nodules strongly suggest GPA rather than MPA. Conversely, pulmonary fibrosis typically appears in patients with MPA and rarely develops in those with GPA. Interstitial lung disease in an interstitial pneumonia pattern is associated with MPA. Learn more about pulmonary histology in GPA.

DOWNLOAD THE APP

Get Started Now: Download the App

Ready to dive into a world of global content with local flavor? Download Daily8 app today from your preferred app store and start exploring.
app-storeplay-store