## Gastro-oesophageal reflux disease The innovations of recent years, chiefly more powerful antisecretory drugs and minimally invasive surgery, have produced major changes in the treatment of upper gastrointestinal disease, in particular of acid-related disorders. Gastro-oesophageal reflux disease
Gastro-oesophageal reflux disease and motility disorders
โ Scribed by Sylvia Salvatore; Yvan Vandenplas
- Publisher
- Elsevier Science
- Year
- 2003
- Tongue
- English
- Weight
- 167 KB
- Volume
- 17
- Category
- Article
- ISSN
- 1521-6918
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โฆ Synopsis
Gastro-oesophageal reflux (GOR) is a common phenomenon occurring at any age with a benign prognosis in the majority of cases, but requiring prompt evaluation and treatment when presenting with alarm symptoms or when persisting. Complications of GOR disease (GORD) may be severe. This chapter will discuss the epidemiology, natural course, pathophysiology, clinical presentation, diagnostic and therapeutic approach towards GORD and motility disorders according to different ages. Similarities and differences between infants, children and adults will be highlighted. The superior efficacy and safety of proton pump inhibitors have recently changed the diagnostic and therapeutic recommendations in adults, and possible indications in children are discussed. Only in patients unresponsive to optimal medical treatment are further investigations to exclude other aetiologies for GORD needed (e.g. eosinophilic oesophagitis in infants, scleroderma in adults). Special patient groups such as those with congenital malformations (e.g. oesophageal atresia) are not considered, whereas neurological, respiratory and allergy-affected patients as well as Helicobacter pylori infection are briefly discussed.
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## Abstract ## Background Bile in the oesophagus occurs frequently in patients with gastro-oesophageal reflux disease (GORD) and has been linked to Barrett's metaplasia and cancer. Although duodenogastric reflux is a prerequisite for bile in the oesophagus, little is known about its importance in