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Gastro-oesophageal reflux disease
Published in Samar Razaq, Difficult Cases in Primary Care, 2021
GERD refers to the involuntary reflux of stomach contents into the oesophagus, causing irritation and damage. Whereas an adult may complain of heartburn, chest pain or burning, bloating, nausea and an acidic taste in the mouth, the presentation in children and infants is less likely to be so obvious. In most cases the reflux is minor and is an annoyance. It causes irritation in the child and may be responsible for unexplained bouts of vomiting. When reflux is suspected in a child, the important differentiation to be made is whether it is simple physiological reflux that is likely to self-resolve or whether complications of GERD are developing. Whereas the former can be managed by reassurance and conservative measures, the latter is likely to require treatment. Figure 3 may be useful in helping differentiate between mild and severe disease.
Esophageal Cancer
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Jennifer Kahan, Carys Morgan, Kieran Foley, Thomas Crosby
The two main histological subtypes of esophageal cancer are adenocarcinoma seen in the distal esophagus, GEJ, and gastric cardia and SCC of the thoracic and cervical esophagus. During the past 50 years, there has been a change in the incidence of the two common histological subtypes in western populations. In the 1960s, 90% of cases were squamous carcinomas; but the rapid rise in adenocarcinomas of the lower esophagus and gastric cardia has reversed this.
Endoscopic Biopsy Demonstrating High-Grade Dysplasia in Barrett’s Esophagus
Published in Savio George Barreto, Shailesh V. Shrikhande, Dilemmas in Abdominal Surgery, 2020
Traditionally, the treatment for Barrett’s esophagus entailed an esophagectomy for individuals with high-grade dysplasia or early stage cancer. However, comorbidities and advancing age have limited esophagectomy to a subset of younger and fitter individuals. The development of endoscopic interventions over the last two decades offers the option of lower risk interventions which can be applied to a wider population, including elderly and less fit patients. Current management now prioritizes endoscopic therapy as the first choice in patients diagnosed with high-grade dysplasia.
Current status and advances in esophageal drug delivery technology: influence of physiological, pathophysiological and pharmaceutical factors
Published in Drug Delivery, 2023
Ai Wei Lim, Nicholas J. Talley, Marjorie M. Walker, Gert Storm, Susan Hua
The esophagus is a part of the gastrointestinal tract (GI tract) that connects the pharynx to the stomach. It is a hollow, muscular channel that delivers swallowed food bolus to the stomach. The thickness of the esophageal wall in healthy individuals varies depending on the section of the esophagus, with the largest wall thickness during esophageal contraction of 4.70 mm (95%CI: 4.44-4.95) and during esophageal dilation of 2.11 mm (95%CI: 2.00-2.23) (Xia et al., 2009). The esophagus begins at the upper esophageal sphincter that is formed by the cricopharyngeal muscle and ends with the lower esophageal sphincter, which is surrounded by the crural diaphragm (Standring, 2020). While the average length of the esophagus in an adult is between 23 to 25 cm, the length in children at birth varies between 8 to 10 cm (Standring, 2020; Scott-Brown et al., 2008). The esophagus is lined with non-keratinized squamous epithelium in humans and the muscular elements are smooth muscle (Standring, 2020).
Cost-effectiveness of a novel, non-active implantable device as a treatment for refractory gastro-esophageal reflux disease
Published in Journal of Medical Economics, 2023
Sam Harper, Lukasz Grodzicki, Stuart Mealing, Liz Gemmill, Paul J. Goldsmith, Ahmed R. Ahmed
Gastro-esophageal reflux disease (GERD) is a chronic gastrointestinal condition characterized by retrograde flow of gastric contents into the esophagus1. Common symptoms include heartburn, chest pain, regurgitation, bloating, excessive salivation, and impaired sleep1. GERD is a common disorder; its age-standardized prevalence was recently estimated at 8,819 (95% uncertainty interval [UI]: 7,781–9,863) cases per 100,000 population globally and 9,920 (95% UI: 8,721–11,140) per 100,000 population in the UK2. Patients with GERD are at an increased risk of developing esophageal adenocarcinoma and its precursor lesion, Barrett’s esophagus, defined by a change in the lining of the esophagus from squamous to columnar epithelium3. In a recent meta-analysis, the prevalence of histologically confirmed Barrett’s esophagus in patients with GERD was 7.2%, while esophageal adenocarcinoma was rare, affecting 1.2% of patients with histologically confirmed Barrett’s esophagus and 0.1% of the broader population of patients with GERD4.
Investigation of the potential relationship between gastroesophageal reflux disease and laryngopharyngeal reflux disease in symptomatology – a prospective study based on a multidisciplinary outpatient
Published in Scandinavian Journal of Gastroenterology, 2023
Xiaoyu Wang, Zhi Liu, Jinhong Zhang, Chun Zhang, Jing Zhao, Lianlian Liu, Shizhen Zou, Xin Ma, Jinrang Li
Gastroesophageal reflux disease (GERD) means symptoms or complications caused by the reflux of the gastric contents into the esophagus, mouth (including the larynx) or lungs, and its main typical symptoms include heartburn, regurgitation, belching, dysphagia, reflux cough, reflux chest pain and so on [1,2]. Laryngopharyngeal reflux disease (LPRD) is an infectious disease of the tissues of the upper aerodigestive tract caused by the direct or indirect effects associated with the reflux of gastroduodenal contents, which can cause morphological changes in the upper aerodigestive tract [3]. Common symptoms of LPRD include hoarseness, vocal fatigue, excessive throat clearing, globus pharyngeal, chronic cough, postnasal drip, dysphagia, etc. [4]. Common signs of LPRD include subglottic edema, ventricular obliteration, erythema/hyperemia, vocal fold edema, diffuse laryngeal edema, posterior commissure hypertrophy, granuloma/granulation tissue, excessive endolaryngeal mucus, etc. [5].