Authors: Pisegna, J.¹; Holtmann, G.²; Howden, C. W.³; Katelaris, P. H.⁴; Sharma, P.⁵; Spechler, S⁶; Triadafilopoulos, G.⁷; Tytgat, G.⁸

Source: Alimentary Pharmacology & Therapeutics, Volume 20, Supplement 9, December 2004 , pp. 47-56(10)

Publisher: Wiley-Blackwell

Abstract:

Summary

The major oesophageal complications associated with persistent gastro-oesophageal reflux disease (GERD) include erosive oesophagitis, ulceration, strictures and gastrointestinal (GI) bleeding. Although the causes of these complications are uncertain, studies indicate that erosive oesophagitis may progress to the development of ulcers, strictures and GI bleeding. Pharmacological treatment with proton pump inhibitors is favoured over that with H₂-receptor antagonists for the treatment of strictures. The treatment of strictures is accomplished with dilation and many favour the concomitant use of proton pump inhibitors. Most gastroenterologists are seeing far fewer oesophageal strictures these days since the introduction of proton pump inhibitors. In addition, research has shown that oesophageal complications have a greater impact on patients suffering from night-time GERD than on those suffering from daytime GERD. Barrett's oesophagus is a significant complication associated with persistent GERD and those at risk generally experience a longer duration of symptoms, especially those with a high degree of severity. In addition, there is a strong relationship between Barrett's oesophagus and oesophageal adenocarcinoma. This is in part due to the association of obesity and the development of hiatal hernias. Furthermore, endoscopic screening is being used to detect Barrett's oesophagus and oesophageal adenocarcinoma in persons suffering from chronic GERD, even though screening may not have an impact on outcomes (Sharma P, McQuaid K, Dent J, et al. A critical review of the diagnosis and management of Barrett's esophagus: The AGA Chicago Workshop. Gastroenterology 2004; 127: 310-30.).

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1365-2036.2004.02240.x

Affiliations: 1: Division of Gastroenterology and Hepatology, VA Greater Los Angeles Health Care System, Los Angeles, CA, USA 2: Department of Gastroenterology, Hepatology and General Medicine, Royal Adelaide Hospital, Adelaide, South Australia, Australia 3: Division of Gastroenterology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA 4: Gastroenterology Department, Concord Hospital, University of Sydney, Sydney, New South Wales, Australia 5: University of Kansas School of Medicine, VA Medical Center, Kansas City, MO, USA 6: Division of Gastroenterology, The University of Texas South-western Medical Center at Dallas, Dallas, TX, USA 7: Division of Gastroenterology and Hepatology, Stanford University Medical Center, Menlo Park, CA, USA 8: Department of Gastroenterology, Academic Medical Center, Amsterdam, The Netherlands

Publication date: 2004-12-01

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• By this author: Pisegna, J. ;  Holtmann, G. ;  Howden, C. W. ;  Katelaris, P. H. ;  Sharma, P. ;  Spechler, S ;  Triadafilopoulos, G. ;  Tytgat, G.

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