Abstract
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.
MeSH terms
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Adenocarcinoma / etiology
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Adenocarcinoma / physiopathology
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Adenocarcinoma / therapy
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Barrett Esophagus / etiology
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Barrett Esophagus / physiopathology
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Barrett Esophagus / therapy
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Esophageal Neoplasms / etiology
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Esophageal Neoplasms / physiopathology
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Esophageal Neoplasms / therapy
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Esophageal Sphincter, Lower / physiopathology*
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Esophagitis / etiology
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Esophagitis / physiopathology
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Esophagitis / therapy
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Gastroesophageal Reflux / etiology
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Gastroesophageal Reflux / physiopathology*
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Gastroesophageal Reflux / therapy*
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Helicobacter Infections / microbiology
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Helicobacter pylori / pathogenicity
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Hernia, Hiatal / complications
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Humans
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Precancerous Conditions / etiology
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Precancerous Conditions / physiopathology
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Precancerous Conditions / therapy
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Risk Factors
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Treatment Outcome