By Michael F. Vaezi
This quantity provides the latest advancements in analysis and therapy of sufferers with gastroesophageal reflux illness (GERD) and people who remain refractory to traditional GERD cures. The booklet delineates the position of newly built endoscopic treatments in GERD and descriptions the simplest applicants for surgical fundoplication. issues because the dangers linked to GERD, way of life amendment in GERD and the position of H2RA and proton pump inhibitor remedy in treating reflux affliction also are explored.
Written by means of professionals within the box, Diagnosis and therapy of Gastroesophageal Reflux ailment is a concise but finished source that's worthwhile for basic care prone, gastroenterologists, pulmonologists, surgeons and ENT specialists.
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Additional info for Diagnosis and Treatment of Gastroesophageal Reflux Disease
Cross-sectional studies of patients undergoing endoscopy have suggested that approximately 20 % of patients with upper gastrointestinal symptoms have esophagitis, 20 % have endoscopy-negative reflux disease, 10 % have peptic ulcer disease, 2 % have Barrett’s esophagus, and 1 % may have malignancy . Findings related to a diagnosis of GERD include the presence of erosive esophagitis, peptic strictures, and a columnar-lined esophagus (Barrett’s esophagus) . Reflux esophagitis is present when erosions or ulcerations are present at the squamocolumnar junction (SCJ; interface between the light pink esophageal squamous mucosa and the red columnar gastric mucosa).
1 N hydrochloric acid solution for 30 min or until symptoms are produced. 5 mL) per minute, and the test is considered positive when the patient’s symptoms or substernal burning is reported twice during acid perfusion and relieved by saline . While the original description reported 19 of 22 patients with gastroesophageal reflux having a positive test (86 % sensitivity) and 20 of 21 controls having a negative test (95 % specificity), subsequent studies have demonstrated lower sensitivities, especially in comparison with 24-h esophageal pH monitoring as the reference standard, making for the Bernstein test to be now rarely used [13, 15, 16].
The likelihood of lymph node involvement is low (less than 2 %) for T1a (intramucosal) EAC . In many instances, therefore, patients with T1a EAC may undergo endoscopic therapy with reasonable expectation of complete cancer eradication and durable disease remission. The likelihood of lymph node involvement increases considerably, however, for patients with T1b (submucosal invasive) EAC . Current guidelines recommend endoscopic staging with EMR for dysplasia associated with focal endoscopic abnormalities within a BE segment [9, 10].
Diagnosis and Treatment of Gastroesophageal Reflux Disease by Michael F. Vaezi