title: [Gastroesophageal reflux disease: clinical and pathophysiological features (part I)].
abstract: Gastroesophageal reflux disease (GERD) can be described as a clinical picture resulting from the reflux of stomach contents into the esophagus. The actual prevalence of GERD remains unestablished, although this disorder is generally common in old patients, male sex and in subsets of patients with pulmonary manifestations such as asthma. From a pathophysiological stand-point, GERD is thought to have a multifactorial etiology which involves genetics, anatomical, functional, environmental, hormonal and pharmacological factors. GERD has different clinical presentations which may be divided in three main classes: typical symptoms (heartburn and regurgitation); atypical or extraesophageal symptoms (angina-like chest pain, asthma, chronic cough and laryngitis); and complications (ulcers, strictures and Barrett's esophagus). In GERD diagnosis a key role is played by: accurate symptom evaluation, response to proton pump inhibitors and, finally, at least one in a life-time endoscopy. Moreover, barium swallow X-ray, 24-h esophageal pH monitoring and gastro-esophageal manometry can be useful to support diagnosis in some unusual cases or in cases partially or unresponsive to standard pharmacologic treatment.
authors.affiliation: Dipartimento di Medicina Interna e Gastroenterologia, Università degli Studi di Bologna, Italia. robecori@med.unibo.it
authors.forename: R
authors.initials: R
authors.lastname: Corinaldesi
authors.forename: B
authors.initials: B
authors.lastname: Salvioli
authors.forename: A
authors.initials: A
authors.lastname: Lioce
authors.forename: G
authors.initials: G
authors.lastname: Barbara
authors.forename: C
authors.initials: C
authors.lastname: Cremon
authors.forename: E
authors.initials: E
authors.lastname: Fustini
authors.forename: L
authors.initials: L
authors.lastname: Bini
authors.forename: R
authors.initials: R
authors.lastname: Cogliandro
authors.forename: E
authors.initials: E
authors.lastname: Boschi
authors.forename: C
authors.initials: C
authors.lastname: Felicani
authors.forename: V
authors.initials: V
authors.lastname: Stanghellini
authors.forename: R
authors.initials: R
authors.lastname: De Giorgio
mesh_terms: D000328:Adult; D000368:Aged; D001466:Barium Sulfate; D001471:Barrett Esophagus / Q000175:diagnosis / Q000209:etiology; D003287:Contrast Media; D004724:Endoscopy; D050782:Esophageal pH Monitoring; D004942:Esophagitis, Peptic / Q000175:diagnosis; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D006356:Heartburn / Q000209:etiology; D006551:Hernia, Hiatal / Q000175:diagnosis; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D015995:Prevalence; D054328:Proton Pump Inhibitors; D011859:Radiography; D012307:Risk Factors
chemical_list: D003287:Contrast Media; D054328:Proton Pump Inhibitors; D001466:Barium Sulfate