To whom and when the upper gastrointestinal endoscopy is indicated in gastroesophageal reflux disease? What is the role of routine esophageal biopsy? Which endoscopic esophagitis classification should be used?

2017 ◽  
Vol 28 (1) ◽  
pp. 22-25 ◽  
Author(s):  
Taylan Kav
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Gastrointestinal Endoscopy ◽  
Upper Gastrointestinal Endoscopy ◽  
Esophageal Biopsy ◽  
Upper Gastrointestinal ◽  
Endoscopic Esophagitis

scholarly journals THE ROLE OF THE TRANSDIAPHRAGMATIC PRESSURE GRADIENT IN THE PATHOPHYSIOLOGY OF GASTROESOPHAGEAL REFLUX DISEASE

2018 ◽  
Vol 55 (suppl 1) ◽  
pp. 13-17 ◽  
Author(s):  
Leonardo M DEL GRANDE ◽  
Fernando A M HERBELLA ◽  
Rafael C KATAYAMA ◽  
Francisco SCHLOTTMANN ◽  
Marco G PATTI
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Pressure Gradient ◽  
Reflux Disease ◽  
Pulmonary Diseases ◽  
Western World ◽  
Common Disease ◽  
Transdiaphragmatic Pressure ◽  
Upper Gastrointestinal

ABSTRACT Gastroesophageal reflux disease (GERD) is the most common disease of the upper gastrointestinal tract in the Western world. GERD pathophysiology is multifactorial. Different mechanisms may contribute to GERD including an increase in the transdiaphragmatic pressure gradient (TPG). The pathophysiology of GERD linked to TPG is not entirely understood. This review shows that TPG is an important contributor to GERD even when an intact esophagogastric barrier is present in the setting of obesity and pulmonary diseases.

scholarly journals Emerging dilemmas in the diagnosis and management of gastroesophageal reflux disease

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 1748 ◽  
Author(s):  
Peter Kahrilas ◽  
Rena Yadlapati ◽  
Sabine Roman
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Diagnostic Testing ◽  
Symptom Assessment ◽  
Upper Gastrointestinal Endoscopy ◽  
Diagnostic Dilemma ◽  
Risk Benefit Assessment ◽  
Improved Technology ◽  
Upper Gastrointestinal

Gastroesophageal reflux disease (GERD) is common, but less so than widely reported because of inconsistencies in definition. In clinical practice, the diagnosis is usually based on a symptom assessment without testing, and the extent of diagnostic testing pursued should be limited to that which guides management or which protects the patient from the risks of a potentially morbid treatment or an undetected early (or imminent) esophageal adenocarcinoma or which does both. When testing is pursued, upper gastrointestinal endoscopy is the most useful initial diagnostic test because it evaluates for the major potential morbidities (Barrett’s, stricture, and cancer) associated with GERD and facilitates the identification of some alternative diagnostic possibilities such as eosinophilic esophagitis. However, endoscopy is insensitive for diagnosing GERD because most patients with GERD have non-erosive reflux disease, a persistent diagnostic dilemma. Although many studies have tried to objectify the diagnosis of GERD with improved technology, this is ultimately a pragmatic diagnosis based on response to proton pump inhibitor (PPI) therapy, and, in the end, response to PPI therapy becomes the major indication for continued PPI therapy. Conversely, in the absence of objective criteria for GERD and the absence of apparent clinical benefit, PPI therapy is not indicated and should be discontinued. PPIs are well tolerated and safe, but nothing is perfectly safe, and in the absence of measurable benefit, even a miniscule risk dominates the risk-benefit assessment.

The Role of Laparoscopic Anti-Reflux Surgery in Obese Patients with Gastroesophageal Reflux Disease

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Flores Edgar Vargas ◽  
Cortez Juan Carlos Quintana ◽  
Contreras Jose Luis Ledesma ◽  
Medina Yazmin Berrones ◽  
Zhou Lucero Chao
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Obese Patients
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