GERD

A New Understanding of Pathology, Pathophysiology, and Treatment

Parakrama T. Chandrasoma

• Publisher: Academic Press
• Year: 2017
• ISBN:
  9780128098561
• Topic: Medicine
• Subtopic: Gastroenterology & Hepatology

GERD: A New Understanding of Pathology, Pathophysiology, and Treatment transforms the assessment of gastroesophageal reflux disease (GERD) from its present state, which is largely dependent on clinical definition and management, to a more objective scientific basis that depends on pathologic assessment. Sequential chapters in this single-author book describe the fetal development of the esophagus, the normal adult state, and the way exposure to gastric juice causes epithelial and lower esophageal sphincter damage at a cellular level. It allows recognition of the pathologic manifestations of lower esophageal sphincter damage and develops new histopathologic criteria for quantitating such damage. This understanding provides new pathologic criteria for definition and diagnosis of GERD from its earliest cellular stage. Algorithms based on measurement of sphincter damage can identify, even before the onset of clinical GERD, persons who will never develop GERD during life, those who develop GERD but remain with mild and easily controlled disease, and those who will progress to severe GERD with failure to control symptoms, Barrett esophagus and adenocarcinoma. Aggressive early intervention in the last group with the objective of preventing disease progression to its end points of uncontrolled symptoms and adenocarcinoma becomes feasible.

• Provides a new method of assessment of GERD that has never previously been presented, creating a pathway to control
• Describes a new pathologic test based on standard histology that can define lower esophageal sphincter damage
• Sequential chapters outline the way GERD progresses from the perspective of the amount of damage to the lower esophageal sphincter
• Provides new avenues of clinical research and technologic innovations in pathology and treatment aimed at preventing esophageal adenocarcinoma

Table of contents

• Cover image
• Title page
• Table of Contents
• Dedication
• Copyright
• Acknowledgments
• Introduction: Discovery: A Path to a New Solution for Gastroesophageal Reflux Disease
• Chapter 1. Definition of Gastroesophageal Reflux Disease: Past, Present, and Future
• Chapter 2. Present Diagnosis and Management of Gastroesophageal Reflux Disease: The Good, Bad, and Ugly
• Chapter 3. Fetal and Postnatal Development of the Esophagus and Proximal Stomach
• Chapter 4. Histologic Definition and Diagnosis of Epithelia in the Esophagus and Proximal Stomach
• Chapter 5. Definition of the Normal State—A Yet Unfinished Saga
• Chapter 6. Definition of the Gastroesophageal Junction
• Chapter 7. The Normal Lower Esophageal Sphincter
• Chapter 8. The Pathogenesis of Early GERD
• Chapter 9. Correlation of LES Damage and GERD
• Chapter 10. The Effect of Damage to the Abdominal Segment of the LES: The Dilated Distal Esophagus
• Chapter 11. Columnar-Lined Esophagus (Microscopic and Visible) and Barrett Esophagus
• Chapter 12. Esophageal Adenocarcinoma
• Chapter 13. Progression of GERD at the Clinical Level
• Chapter 14. Progression of GERD at a Pathological Level
• Chapter 15. Molecular Evolution of Esophageal Epithelial Metaplasia
• Chapter 16. Progression of GERD From the Perspective of LES Damage
• Chapter 17. New Pathologic Test of LES Damage
• Chapter 18. New Method of Functional Assessment of the LES
• Chapter 19. Prediction of Future Progression of LES Damage
• Chapter 20. Proof of Concept of the New Diagnostic Method
• Chapter 21. Application of the New Method to Present and Future Management of GERD
• Author Index
• Subject Index