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:
CreatorsEmailORCIDORCID Put Code
Fuchs, Karl-HermannUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lee, Arielle M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Breithaupt, WolframUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Varga, GaborUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Babic, BenjaminUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Horgan, SantiagoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
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:
KeywordsLanguage
LOWER ESOPHAGEAL SPHINCTER; LAPAROSCOPIC ANTIREFLUX SURGERY; BODY-MASS INDEX; HIATAL-HERNIA; CHICAGO CLASSIFICATION; FUNCTIONAL DYSPEPSIA; MOTILITY DISORDERS; NORMAL VALUES; FUNDOPLICATION; RELAXATIONSMultiple languages
Gastroenterology & HepatologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/58026

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