eMedicine Specialties > Gastroenterology > Esophagus

Gastroesophageal Reflux Disease: Multimedia

Author: Piero Marco Fisichella, MD, Assistant Professor of Surgery, Stritch School of Medicine, Loyola University; Director, Esophageal Motility Center, Loyola University Medical Center
Coauthor(s): Marco G Patti, MD, Professor of Surgery, Director, Center for Esophageal Diseases, University of Chicago Pritzker School of Medicine
Contributor Information and Disclosures

Updated: Apr 28, 2009

Multimedia

Esophagogastroduodenoscopy indicating Barrett eso...Media file 1: Esophagogastroduodenoscopy indicating Barrett esophagus.
Esophagogastroduodenoscopy indicating Barrett eso...

Esophagogastroduodenoscopy indicating Barrett esophagus.

Gastroesophageal reflux disease (GERD)/Barrett es...Media file 2: Gastroesophageal reflux disease (GERD)/Barrett esophagus/adenocarcinoma sequence.
Gastroesophageal reflux disease (GERD)/Barrett es...

Gastroesophageal reflux disease (GERD)/Barrett esophagus/adenocarcinoma sequence.

Barium swallow indicating hiatal hernia.Media file 3: Barium swallow indicating hiatal hernia.
Barium swallow indicating hiatal hernia.

Barium swallow indicating hiatal hernia.

Ambulatory pH monitoring indicating episodes of r...Media file 4: Ambulatory pH monitoring indicating episodes of reflux correlating with the heartburn experienced by the patient.
Ambulatory pH monitoring indicating episodes of r...

Ambulatory pH monitoring indicating episodes of reflux correlating with the heartburn experienced by the patient.

Laparoscopic Nissen fundoplication.Media file 5: Laparoscopic Nissen fundoplication.
Laparoscopic Nissen fundoplication.

Laparoscopic Nissen fundoplication.

Peptic esophagitis. A rapid urease test (RUT) is ...Media file 6: Peptic esophagitis. A rapid urease test (RUT) is performed on the esophageal biopsy sample. The result is positive for esophagitis.
Peptic esophagitis. A rapid urease test (RUT) is ...

Peptic esophagitis. A rapid urease test (RUT) is performed on the esophageal biopsy sample. The result is positive for esophagitis.

Endoscopy demonstrating intraluminal esophageal c...Media file 7: Endoscopy demonstrating intraluminal esophageal cancer.
Endoscopy demonstrating intraluminal esophageal c...

Endoscopy demonstrating intraluminal esophageal cancer.

More on Gastroesophageal Reflux Disease

Overview: Gastroesophageal Reflux Disease
Differential Diagnoses & Workup: Gastroesophageal Reflux Disease
Treatment & Medication: Gastroesophageal Reflux Disease
Follow-up: Gastroesophageal Reflux Disease
Multimedia: Gastroesophageal Reflux Disease
References
Further Reading

References

  1. [Best Evidence] Hampel H, Abraham NS, El-Serag HB. Meta-analysis: obesity and the risk for gastroesophageal reflux disease and its complications. Ann Intern Med. Aug 2 2005;143(3):199-211. [Medline][Full Text].

  2. Herbella FA, Sweet MP, Tedesco P, Nipomnick I, Patti MG. Gastroesophageal reflux disease and obesity. Pathophysiology and implications for treatment. J Gastrointest Surg. Mar 2007;11(3):286-90. [Medline].

  3. Merrouche M, Sabate JM, Jouet P, et al. Gastro-esophageal reflux and esophageal motility disorders in morbidly obese patients before and after bariatric surgery. Obes Surg. Jul 2007;17(7):894-900. [Medline].

  4. Murray L, Johnston B, Lane A, et al. Relationship between body mass and gastro-oesophageal reflux symptoms: The Bristol Helicobacter Project. Int J Epidemiol. Aug 2003;32(4):645-50. [Medline][Full Text].

  5. Pandolfino JE, El-Serag HB, Zhang Q, et al. Obesity: a challenge to esophagogastric junction integrity. Gastroenterology. Mar 2006;130(3):639-49. [Medline].

  6. El-Serag HB, Graham DY, Satia JA, Rabeneck L. Obesity is an independent risk factor for GERD symptoms and erosive esophagitis. Am J Gastroenterol. Jun 2005;100(6):1243-50. [Medline].

  7. Yang YX, Lewis JD, Epstein S, Metz DC. Long-term proton pump inhibitor therapy and risk of hip fracture. JAMA. Dec 27 2006;296(24):2947-53. [Medline][Full Text].

  8. Agency for Healthcare Research and Quality. Comparative Effectiveness of Management Strategies for Gastroesophageal Reflux Disease - Executive Summary. AHRQ pub. no. 06-EHC003-1. December 2005. Available at http://effectivehealthcare.ahrq.gov/healthInfo.cfm?infotype=rr&ProcessID=1&DocID=42. Accessed April 21, 2009.

  9. Lundell L, Miettinen P, Myrvold HE, et al. Continued (5-year) followup of a randomized clinical study comparing antireflux surgery and omeprazole in gastroesophageal reflux disease. J Am Coll Surg. Feb 2001;192(2):172-9; discussion 179-81. [Medline].

  10. Spechler SJ. Epidemiology and natural history of gastro-oesophageal reflux disease. Digestion. 1992;51 suppl 1:24-9. [Medline].

  11. Anvari M, Allen C, Marshall J, et al. A randomized controlled trial of laparoscopic nissen fundoplication versus proton pump inhibitors for treatment of patients with chronic gastroesophageal reflux disease: One-year follow-up. Surg Innov. Dec 2006;13(4):238-49. [Medline].

  12. [Best Evidence] Grant AM, Wileman SM, Ramsay CR, et al. Minimal access surgery compared with medical management for chronic gastro-oesophageal reflux disease: UK collaborative randomised trial. BMJ. Dec 15 2008;337:a2664. [Medline][Full Text].

  13. El-Serag HB. Time trends of gastroesophageal reflux disease: a systematic review. Clin Gastroenterol Hepatol. Jan 2007;5(1):17-26. [Medline].

  14. Anvari M, Allen C. Five-year comprehensive outcomes evaluation in 181 patients after laparoscopic Nissen fundoplication. J Am Coll Surg. Jan 2003;196(1):51-7; discussion 57-8; author reply 58-9. [Medline].

  15. Armstrong D, Kazim F, Gervais M, Pyzyk M. Early relief of upper gastrointestinal dyspeptic symptoms: a survey of empirical therapy with pantoprazole in Canadian clinical practice. Can J Gastroenterol. Jul 2002;16(7):439-50. [Medline].

  16. Bianchi Porro G, Pace F, Peracchia A, et al. Short-term treatment of refractory reflux esophagitis with different doses of omeprazole or ranitidine. J Clin Gastroenterol. Oct 1992;15(3):192-8. [Medline].

  17. Bowers SP, Mattar SG, Smith CD, Waring JP, Hunter JG. Clinical and histologic follow-up after antireflux surgery for Barrett's esophagus. J Gastrointest Surg. Jul-Aug 2002;6(4):532-8; discussion 539. [Medline].

  18. Bremner RM, Bremner CG, DeMeester TR. Gastroesophageal reflux: the use of pH monitoring. Curr Probl Surg. Jun 1995;32(6):429-558. [Medline].

  19. Broussard CN, Richter JE. Treating gastro-oesophageal reflux disease during pregnancy and lactation: what are the safest therapy options?. Drug Saf. Oct 1998;19(4):325-37. [Medline].

  20. Bytzer P, Havelund T, Hansen JM. Interobserver variation in the endoscopic diagnosis of reflux esophagitis. Scand J Gastroenterol. Feb 1993;28(2):119-25. [Medline].

  21. Campos GM, Peters JH, DeMeester TR, et al. Multivariate analysis of factors predicting outcome after laparoscopic Nissen fundoplication. J Gastrointest Surg. May-Jun 1999;3(3):292-300. [Medline].

  22. Costantini M, Crookes PF, Bremner RM, et al. Value of physiologic assessment of foregut symptoms in a surgical practice. Surgery. Oct 1993;114(4):780-6; discussion 786-7. [Medline].

  23. Dallemagne B, Weerts J, Markiewicz S, et al. Clinical results of laparoscopic fundoplication at ten years after surgery. Surg Endosc. Jan 2006;20(1):159-65. [Medline].

  24. El-Serag HB, Tran T, Richardson P, Ergun G. Anthropometric correlates of intragastric pressure. Scand J Gastroenterol. Aug 2006;41(8):887-91. [Medline].

  25. Fernando HC, Schauer PR, Rosenblatt M, et al. Quality of life after antireflux surgery compared with nonoperative management for severe gastroesophageal reflux disease. J Am Coll Surg. Jan 2002;194(1):23-7. [Medline].

  26. Fuchs KH, DeMeester TR, Albertucci M. Specificity and sensitivity of objective diagnosis of gastroesophageal reflux disease. Surgery. Oct 1987;102(4):575-80. [Medline].

  27. Harding SM, Richter JE, Guzzo MR, et al. Asthma and gastroesophageal reflux: acid suppressive therapy improves asthma outcome. Am J Med. Apr 1996;100(4):395-405. [Medline].

  28. Hetzel DJ, Dent J, Reed WD, et al. Healing and relapse of severe peptic esophagitis after treatment with omeprazole. Gastroenterology. Oct 1988;95(4):903-12. [Medline].

  29. Hinder RA, Stein HJ, Bremner CG, DeMeester TR. Relationship of a satisfactory outcome to normalization of delayed gastric emptying after Nissen fundoplication. Ann Surg. Oct 1989;210(4):458-64; discussion 464-5. [Medline][Full Text].

  30. Hunter JG, Trus TL, Branum GD, Waring JP, Wood WC. A physiologic approach to laparoscopic fundoplication for gastroesophageal reflux disease. Ann Surg. Jun 1996;223(6):673-85; discussion 685-7. [Medline][Full Text].

  31. Kauer WK, Peters JH, DeMeester TR, et al. Mixed reflux of gastric and duodenal juices is more harmful to the esophagus than gastric juice alone. The need for surgical therapy re-emphasized. Ann Surg. Oct 1995;222(4):525-31; discussion 531-3. [Medline][Full Text].

  32. Koelz HR, Birchler R, Bretholz A, et al. Healing and relapse of reflux esophagitis during treatment with ranitidine. Gastroenterology. Nov 1986;91(5):1198-205. [Medline].

  33. Locke GR 3rd, Talley NJ, Fett SL, Zinsmeister AR, Melton LJ 3rd. Risk factors associated with symptoms of gastroesophageal reflux. Am J Med. Jun 1999;106(6):642-9. [Medline].

  34. McCallum RW, Berkowitz DM, Lerner E. Gastric emptying in patients with gastroesophageal reflux. Gastroenterology. Feb 1981;80(2):285-91. [Medline].

  35. Monnier P, Ollyo JP, Fontolliet C, Savary M. Epidemiology and natural history of reflux esophagitis. Semin Laparosc Surg. 1995;2:2-9.

  36. Oelschlager BK, Barreca M, Chang L, Oleynikov D, Pellegrini CA. Clinical and pathologic response of Barrett's esophagus to laparoscopic antireflux surgery. Ann Surg. Oct 2003;238(4):458-64; discussion 464-6. [Medline][Full Text].

  37. Ollyo JB, Lang F, Fontolliet CH. Savary-Miller's new endoscopic grading of reflux-esophagitis: a simple, reproducible, logical, complete, and useful classification. Gastroenterology. 1990;98:A100.

  38. Patti MG, Arcerito M, Feo CV, et al. An analysis of operations for gastroesophageal reflux disease: identifying the important technical elements. Arch Surg. Jun 1998;133(6):600-6; discussion 606-7. [Medline][Full Text].

  39. Patti MG, Arcerito M, Feo CV, et al. Barrett's esophagus: a surgical disease. J Gastrointest Surg. Jul-Aug 1999;3(4):397-403; discussion 403-4. [Medline].

  40. Patti MG, Feo CV, De Pinto M, et al. Results of laparoscopic antireflux surgery for dysphagia and gastroesophageal reflux disease. Am J Surg. Dec 1998;176(6):564-8. [Medline].

  41. Patti MG, Robinson T, Galvani C, et al. Total fundoplication is superior to partial fundoplication even when esophageal peristalsis is weak. J Am Coll Surg. Jun 2004;198(6):863-9; discussion 869-70. [Medline].

  42. Peghini PL, Katz PO, Castell DO. Ranitidine controls nocturnal gastric acid breakthrough on omeprazole: a controlled study in normal subjects. Gastroenterology. Dec 1998;115(6):1335-9. [Medline].

  43. Pessaux P, Arnaud JP, Delattre JF, et al. Laparoscopic antireflux surgery: five-year results and beyond in 1340 patients. Arch Surg. Oct 2005;140(10):946-51. [Medline][Full Text].

  44. Peters JH, DeMeester TR, Crookes P, et al. The treatment of gastroesophageal reflux disease with laparoscopic Nissen fundoplication: prospective evaluation of 100 patients with "typical" symptoms. Ann Surg. Jul 1998;228(1):40-50. [Medline][Full Text].

  45. Richter JE. Extraesophageal presentations of gastroesophageal reflux disease. Semin Gastrointest Dis. Apr 1997;8(2):75-89. [Medline].

  46. Schillinger W, Teucher N, Sossalla S, et al. Negative inotropy of the gastric proton pump inhibitor pantoprazole in myocardium from humans and rabbits: evaluation of mechanisms. Circulation. Jul 3 2007;116(1):57-66. [Medline][Full Text].

  47. Spechler SJ. The columnar-lined esophagus. History, terminology, and clinical issues. Gastroenterol Clin North Am. Sep 1997;26(3):455-66. [Medline].

  48. Spechler SJ, Lee E, Ahnen D, et al. Long-term outcome of medical and surgical therapies for gastroesophageal reflux disease: follow-up of a randomized controlled trial. JAMA. May 9 2001;285(18):2331-8. [Medline][Full Text].

  49. Streitz JM Jr, Andrews CW Jr, Ellis FH Jr. Endoscopic surveillance of Barrett's esophagus. Does it help?. J Thorac Cardiovasc Surg. Mar 1993;105(3):383-7; discussion 387-8. [Medline].

  50. Streitz JM Jr, Williamson WA, Ellis FH Jr. Current concepts concerning the nature and treatment of Barrett's esophagus and its complications. Ann Thorac Surg. Sep 1992;54(3):586-91. [Medline].

  51. Vigneri S, Termini R, Leandro G, et al. A comparison of five maintenance therapies for reflux esophagitis. N Engl J Med. Oct 26 1995;333(17):1106-10. [Medline][Full Text].

  52. Zaninotto G, Portale G, Costantini M, et al. Long-term results (6-10 years) of laparoscopic fundoplication. J Gastrointest Surg. Sep 2007;11(9):1138-45. [Medline].

  53. [Best Evidence] Hemmink GJ, Bredenoord AJ, Weusten BL, et al. Esophageal pH-impedance monitoring in patients with therapy-resistant reflux symptoms: 'on' or 'off' proton pump inhibitor?. Am J Gastroenterol. Oct 2008;103(10):2446-53. [Medline].

  54. [Best Evidence] Horvath A, Dziechciarz P, Szajewska H. The effect of thickened-feed interventions on gastroesophageal reflux in infants: systematic review and meta-analysis of randomized, controlled trials. Pediatrics. Dec 2008;122(6):e1268-77. [Medline][Full Text].

Further Reading

Additional resources on asthma are available at Medscape’s Gastroesophageal Reflux Disease Resource Center.

Related eMedicine Topics

Clinical Trials

National Guidelines Clearinghouse

Keywords

gastroesophageal reflux disease, GERD, reflux, heartburn, esophagitis, gastritis, peptic ulcer disease, PUD, lower esophageal sphincter, LES, hiatal hernia, obesity, regurgitation, dysphagia, Barrett esophagus, adenocarcinoma, laryngitis, proton pump inhibitor, PPI, esophagogastroduodenoscopy, EGD, laparoscopic fundoplication, Nissen fundoplication

Contributor Information and Disclosures

Author

Piero Marco Fisichella, MD, Assistant Professor of Surgery, Stritch School of Medicine, Loyola University; Director, Esophageal Motility Center, Loyola University Medical Center
Piero Marco Fisichella, MD is a member of the following medical societies: American College of Surgeons, American Medical Association, Association for Academic Surgery, Society for Surgery of the Alimentary Tract, and Society of American Gastrointestinal and Endoscopic Surgeons
Disclosure: Nothing to disclose.

Coauthor(s)

Marco G Patti, MD, Professor of Surgery, Director, Center for Esophageal Diseases, University of Chicago Pritzker School of Medicine
Marco G Patti, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Surgeons, American Gastroenterological Association, American Medical Association, American Surgical Association, Association for Academic Surgery, Pan-Pacific Surgical Association, Society for Surgery of the Alimentary Tract, Society of American Gastrointestinal and Endoscopic Surgeons, Southwestern Surgical Congress, and Western Surgical Association
Disclosure: Nothing to disclose.

Medical Editor

John Gunn Lee, MD, Director of Pancreaticobiliary Service, Associate Professor, Department of Internal Medicine, Division of Gastroenterology, University of California at Irvine School of Medicine
John Gunn Lee, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, and American Society for Gastrointestinal Endoscopy
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Noel Williams, MD, Professor Emeritus, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; Professor, Department of Internal Medicine, Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada
Noel Williams, MD is a member of the following medical societies: Royal College of Physicians and Surgeons of Canada
Disclosure: Nothing to disclose.

CME Editor

Alex J Mechaber, MD, FACP, Associate Dean for Undergraduate Medical Education, Associate Professor of Medicine, University of Miami Miller School of Medicine
Alex J Mechaber, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, and Society of General Internal Medicine
Disclosure: Nothing to disclose.

Chief Editor

Julian Katz, MD, Clinical Professor of Medicine, Drexel University College of Medicine; Consulting Staff, Department of Medicine, Section of Gastroenterology and Hepatology, Hospital of the Medical College of Pennsylvania
Julian Katz, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Geriatrics Society, American Medical Association, American Society for Gastrointestinal Endoscopy, American Society of Law Medicine and Ethics, American Trauma Society, Association of American Medical Colleges, and Physicians for Social Responsibility
Disclosure: Nothing to disclose.

 
 
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