Gastroesophageal reflux disease: From pathophysiology to treatment.
This review focuses on the pathophysiology of gastroesophageal reflux disease (GERD) and its implications for treatment. The role of the natural anti-reflux mechanism (lower esophageal sphincter, esophageal peristalsis, diaphragm, and trans-diaphragmatic pressure gradient), mucosal damage, type of refluxate, presence and size of hiatal hernia, Helicobacter pylori infection, and Barrett's esophagus are reviewed. The conclusions drawn from this review are: (1) the pathophysiology of GERD is multifactorial; (2) because of the pathophysiology of the disease, surgical therapy for GERD is the most appropriate treatment; and (3) the genesis of esophageal adenocarcinoma is associated with GERD.
Herbella
Fernando A
FA
Department of Surgery, University of Chicago Pritzker School of Medicine, Chicago, IL 60637, United States.
Patti
Marco G
MG
D000230:Adenocarcinoma / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D001471:Barrett Esophagus / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D004938:Esophageal Neoplasms / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D049630:Esophageal Sphincter, Lower / Q000503:physiopathology*; D004941:Esophagitis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D005764:Gastroesophageal Reflux / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy*; D016481:Helicobacter Infections / Q000382:microbiology; D016480:Helicobacter pylori / Q000472:pathogenicity; D006551:Hernia, Hiatal / Q000150:complications; D006801:Humans; D011230:Precancerous Conditions / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D012307:Risk Factors; D016896:Treatment Outcome