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Gastroesophageal Reflux
Pathogenesis, Diagnosis, and Therapy
Abstract
In recent years, considerable new information has become available on the pathogenesis, diagnosis and therapy of gastroesophageal reflux. Gastric contents, mucosal resistance, esophageal acid clearance, and gastric emptying are now recognized, along with incompetency of the lower esophageal sphincter, as contributing factors to gastroesophageal reflux disease. The potential tests for reflux are reviewed and the diagnostic accuracy of each is evaluated. A diagnostic approach to the patient with reflux symptoms is outlined that considers the sensitivity and specificity of these various tests as well as their availability to the generalist and gastrointestinal specialist. Finally, an overview of the current therapy for reflux disease summarizes the controlled studies in the medical literature.
Article and Author Information
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▸From the Gastroenterology Branch, Internal Medicine Service, National Naval Medical Center; and the Digestive Diseases Division, Department of Medicine, Uniformed Services University of the Health Sciences; Bethesda, Maryland.
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Grant support: Uniform Services University of the Health Sciences (USUHS) Grant #R08136, and the Department of the Navy Clinical In vestigation Program #CI-0-06-1398.
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The opinions and assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Navy or the Department of Defense.
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▸Requests for reprints should be addressed to Donald O. Castell, M.D.; Digestive Diseases Division, Uniformed Services University, 4301 Jones Bridge Road; Bethesda, MD 20814.
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