New developments in gastroesophageal reflux disease diagnosis and therapy.
OBJECTIVE
Gastroesophageal reflux disease is a highly prevalent chronic condition in Western populations. It has a profound effect on our society in terms of economic cost and quality of life. There have been major advances in understanding of disease pathogenesis over the last few years which are summarized in this article.


RESULTS
With improved understanding of gastroesophageal reflux disease, newer developments in diagnostic techniques have evolved. The proton pump inhibitor test has been formally described as one of the initial diagnostic tests. Other new tests include multiple channel impedance monitoring, bilirubin reflux monitoring, Barostat measurements and intraluminal ultrasounds which, along with other newer technologies, are described in this review.


CONCLUSIONS
The mechanisms involved in the pathogenesis of gastroesophageal reflux disease are complex and multifactorial. The lower esophageal sphincter pressure, the motility of the esophageal body and the stomach, the composition of the reflux material and the sensitivity or resistance of the esophageal mucosa to the reflux material are important factors involved in the pathogenesis of disease-related symptoms and lesions. Based on our improving understanding, novel diagnostic tools are available to improve investigation of the disease.
Ali
Tauseef
T
Department of Gastroenterology and Hepatology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA. tauseef-ali@ouhsc.edu
Miner
Philip B
PB
D000465:Algorithms; D017097:Electric Impedance; D050782:Esophageal pH Monitoring; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D006801:Humans; D011312:Pressure; D054328:Proton Pump Inhibitors / Q000627:therapeutic use
D054328:Proton Pump Inhibitors