Universität zu Köln

Fuchs, Karl-Hermann, Lee, Arielle M., Breithaupt, Wolfram, Varga, Gabor, Babic, Benjamin and Horgan, Santiago (2021). Pathophysiology of gastroesophageal reflux disease-which factors are important? Transl. Gastroenterol. Hepatol., 6. SHATIN: AME PUBL CO. ISSN 2415-1289

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Abstract

Background: Pathophysiology of gastroesophageal reflux disease (GERD) shows a multifactorial background. Different anatomical and functional alterations can be determined such as weakness of the lower esophageal sphincter (LES), changes in anatomy by a hiatal hernia (HH), an impaired esophageal motility (IEM) and/or an associated gastric motility problem with either duodeno-gastro-esophageal reflux (DGER) or delayed gastric emptying (DGE). The purpose of this study is to assess a large GERD-patient population to quantitatively determine different pathophysiologic factors contributing to the disease. Methods: For this analysis only patients with documented GERD (pathologic esophageal acid exposure) were selected from a prospectively maintained databank. Investigations: history and physical, body mass index, endoscopy, esophageal manometry, 24 h-pH-monitoring, 24 h-bilirbine-monitoring, radiographicgastric-emptying or scintigraphy, gastrointestinal quality of life index (GIQLI). Results: In total, 728 patients (420 males; 308 females) were selected for this analysis. Moan age: 49.9 years; mean BMI: 27.2 kg/m(2) (range, 20-45 kg/m(2)); mean GIQLI of 91 (range: 43-138; normal level: 121); no esophagitis: 30.6%; minor esophagitis (Savary-Miller type I or Los Angeles Grade A): 22.4%; esophagitis [2-4]/B-D: 36.2%; Barrett's esophagus 10%. Presence of pathophysiologic factors: HH 95.4%; LES-incompetence 88%, DGER 55%, obesity 25.6%, IEM 8.8%, DGE 6.8%. Conclusions: In our evaluation of GERD patients, the most important pathophysiologic components are anatomical alterations (HH), LES-incompetence and DGER.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Fuchs, Karl-Hermann UNSPECIFIED UNSPECIFIED UNSPECIFIED Lee, Arielle M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Breithaupt, Wolfram UNSPECIFIED UNSPECIFIED UNSPECIFIED Varga, Gabor UNSPECIFIED UNSPECIFIED UNSPECIFIED Babic, Benjamin UNSPECIFIED UNSPECIFIED UNSPECIFIED Horgan, Santiago UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-580261
DOI:	10.21037/tgh.2020.02.12
Journal or Publication Title:	Transl. Gastroenterol. Hepatol.
Volume:	6
Date:	2021
Publisher:	AME PUBL CO
Place of Publication:	SHATIN
ISSN:	2415-1289
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language LOWER ESOPHAGEAL SPHINCTER; LAPAROSCOPIC ANTIREFLUX SURGERY; BODY-MASS INDEX; HIATAL-HERNIA; CHICAGO CLASSIFICATION; FUNCTIONAL DYSPEPSIA; MOTILITY DISORDERS; NORMAL VALUES; FUNDOPLICATION; RELAXATIONS Multiple languages Gastroenterology & Hepatology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/58026