Document Detail


Treatment of GERD complications (Barrett's, peptic stricture) and extra-oesophageal syndromes.
MedLine Citation:
PMID:  21126707     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Apart from typical reflux symptoms and oesophagitis, the clinical presentation of GERD can be dominated by mucosal complications of reflux (Barrett's oesophagus, oesophageal adenocarcinoma, Peptic structure) or by extra-oesophageal syndromes, most notably asthma, laryngitis, or chronic cough. Managing these entities is much less straightforward than with oesophagitis. With respect to adenocarcinoma, metaplasia and dysplasia are recognised precursors, but the potential of these lesions to evolve to cancer has not been shown to lessen as a result of treatment, medical or surgical. Consequently, management focuses on strategies to identify and eliminate high-grade dysplasia and intramucosal cancer, lesions that are potentially curable by endoscopic ablation or surgical resection. With respect to the extra-oesophageal GERD syndromes, these are increasingly recognised as multifactorial conditions with reflux as an exacerbating factor. Treatment trials have been generally disappointing and the clinical challenge remains in accurately identifying afflicted patients who might benefit from more intensive medical or surgical reflux treatment.
Authors:
Ajay Bansal; Peter J Kahrilas
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.; Review    
Journal Detail:
Title:  Best practice & research. Clinical gastroenterology     Volume:  24     ISSN:  1532-1916     ISO Abbreviation:  Best Pract Res Clin Gastroenterol     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-03     Completed Date:  2011-03-21     Revised Date:  2011-12-21    
Medline Journal Info:
Nlm Unique ID:  101120605     Medline TA:  Best Pract Res Clin Gastroenterol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  961-8     Citation Subset:  IM    
Copyright Information:
Published by Elsevier Ltd.
Affiliation:
Department of Medicine, Veterans Affairs Medical Center, University of Kansas, MO, USA.
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / etiology,  therapy*
Asthma / etiology,  therapy
Barrett Esophagus / etiology,  therapy*
Cough / etiology,  therapy
Dilatation
Esophageal Neoplasms / etiology,  therapy*
Esophageal Stenosis / etiology,  therapy*
Esophagoscopy
Gastroesophageal Reflux / complications,  therapy*
Humans
Laryngitis / etiology,  therapy
Proton Pump Inhibitors / therapeutic use
Stents
Treatment Outcome
Grant Support
ID/Acronym/Agency:
R01 DK056033-09/DK/NIDDK NIH HHS; R01 DK56033/DK/NIDDK NIH HHS
Chemical
Reg. No./Substance:
0/Proton Pump Inhibitors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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