Clinical Research Directory

AJYR+GV vs RYGB for GERD

This study focuses on gastroesophageal reflux disease (GERD), a condition in which stomach acid flows back into the esophagus (the tube that carries food from the mouth to the stomach), causing heartburn and other symptoms. GERD is common among people with obesity.The standard surgical treatment for these patients is Roux-en-Y gastric bypass, a surgery that makes the stomach smaller and reroutes part of the digestive tract. This procedure promotes weight loss and usually improves reflux. However, recent studies show that up to 20% of patients continue to have, or develop, reflux after this surgery. Untreated reflux can seriously impair quality of life and may lead to complications such as esophageal ulcers and esophageal cancer. In addition, the bypass leaves parts of the digestive tract that cannot be examined with routine endoscopy, which may make it harder to detect cancers in those areas in the future.This study will compare the standard gastric bypass with a newer procedure that combines sleeve gastrectomy (removal of most of the stomach, leaving a narrow tube) with a Roux-en-Y antrum-jejunal anastomosis (a connection between the lower part of the stomach and the small intestine). This new technique may control reflux as effectively as the bypass while keeping the whole digestive tract accessible to endoscopic examination.Adults with obesity and GERD who are candidates for bariatric surgery may participate. Participants will be randomly assigned (by chance, like a coin flip) to receive one of the two procedures. The main goals of the study are to evaluate whether the new technique treats or controls reflux as well as, or better than, the standard bypass; to compare weight loss between the two procedures; to compare changes in metabolism (how the body processes sugar and fats); to check whether the duodenum (the first part of the small intestine) can be easily examined by endoscopy after the new procedure; and to understand how food moves through the digestive tract after the new procedure.

Transit Bipartition After Sleeve Gastrectomy

This prospective, single-center study will evaluate adults undergoing revisional conversion from sleeve gastrectomy to intestinal transit bipartition. Forty participants will complete clinical, endoscopic, physiological, metabolic, hormonal, imaging, and stool assessments before surgery and during follow-up. The primary outcome is the within-participant change in solid-meal gastric emptying half-time (T½), measured by standardized scintigraphy from baseline to 6 months. Secondary and exploratory outcomes include reflux symptoms, DeMeester score and acid exposure, route-specific gastric transit, GLP-1 and ghrelin responses, glucose metabolism, fecal elastase, gut microbiota, body-weight trajectory, comorbidities, gastroileal anastomotic caliber, and safety.

A Pre-market, Two-stages Interventional Clinical Investigation to Evaluate the Safety and the Performance of Fibroin Syrup in Reducing the Gastroesophageal Reflux Disease (GERD) Symptomatology in Nonerosive Reflux Disease (NERD) Patients

This study involves a medical device in the form of syrup, not yet on the market and tested for the first time in humans, named "FIBROIN SYRUP". The intended use is to reduce the GastroEsophageal Reflux Disease (GERD) symptoms such as heartburn, epigastric pain, irritative and nocturnal cough, dysphagia and dysphonia, which may occur especially after meals or during the night due to lying position. "FIBROIN SYRUP" has never been tested on humans and this study aims to evaluate the safety, tolerability and efficacy of the medical device when taken after the main meals (breakfast, lunch, and dinner; total: 3 sticks/day) for 6 weeks.