Gastro-oesophageal Reflux Disease
Mohamad Abdalla Saleh;
Abstract
Gastro-oesophageal reflux disease is a very common chronic relapsing condition which affects bo.th sexes. It is due to disturbance in the factors of antireflux mechanism (such as lower oesophageal sphincter, intra-abdominal part of the oesophagus, diaphragmatic crural sling, the angle ofHis, and mucosal rosette) and decreased oesophageal mucosal resistance to refluxed gastric acid and weak oesophageal clearance.
Pathophysiology of gastro-oesophageal reflux has been investigated, and the precise nature of continence mechanism of the cardia is still a matter of debate. At present the pressure and intra-abdominal length of lower oesophageal sphincter are thought to be important factors that prevent the gastro oesophageal reflux. Transient lower oesophageal sphincter relaxation has been suggested as the only mechanism of physiological acid reflux in normal subjects and is said to account for 40-70% of reflux episodes in patients with gastro oesophageal reflux.
The condition usually presents with classical symptoms • but the diagnostic challenge arises when symptoms of reflux mimic cardiac and pulmonary diseases. The diagnosis is made sure by prolonged oesophageal PH monitoring and manometry is used to assess the lower oesophageal sphincter function. Endoscopy is the first line and most cost effective investigation and is necessary to identify complications such as oesophagitis, ulceration, and Barrett's oesophagus. Barium swallow
Pathophysiology of gastro-oesophageal reflux has been investigated, and the precise nature of continence mechanism of the cardia is still a matter of debate. At present the pressure and intra-abdominal length of lower oesophageal sphincter are thought to be important factors that prevent the gastro oesophageal reflux. Transient lower oesophageal sphincter relaxation has been suggested as the only mechanism of physiological acid reflux in normal subjects and is said to account for 40-70% of reflux episodes in patients with gastro oesophageal reflux.
The condition usually presents with classical symptoms • but the diagnostic challenge arises when symptoms of reflux mimic cardiac and pulmonary diseases. The diagnosis is made sure by prolonged oesophageal PH monitoring and manometry is used to assess the lower oesophageal sphincter function. Endoscopy is the first line and most cost effective investigation and is necessary to identify complications such as oesophagitis, ulceration, and Barrett's oesophagus. Barium swallow
Other data
| Title | Gastro-oesophageal Reflux Disease | Other Titles | مرض ارتجاع المرئ المعدى | Authors | Mohamad Abdalla Saleh | Issue Date | 2000 |
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