The New Landscape of Gastroesophageal Reflux Disease Management: 2020 and Beyond

The landscape of gastroesophageal reflux disease (GERD) management is changing, in a good way. Several key forces have converged (Box  1), propelling us to see GERD with a new perspective. One of these forces is the expanding role of the interventional gastrointestinal endoscopist in foregut diseases, including GERD, Barrett’s and early esophageal cancer, achalasia, Zenker diverticulum, early gastric cancer, gastric outlet obst ruction, and obesity. Accordingly, when tapped by Dr Lightdale to be the editor of this issue devoted to GERD management, I had the privilege of assembling some of the top GERD authorities, including esophagologists, interventional endoscopists, and foregut surgeons.
Source: Gastrointestinal Endoscopy Clinics of North America - Category: Gastroenterology Authors: Tags: Preface Source Type: research

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Endoscopy DOI: 10.1055/a-1104-5245In Europe at present, but also in 2040, 1 in 3 cancer-related deaths are expected to be caused by digestive cancers. Endoscopic technologies enable diagnosis, with relatively low invasiveness, of precancerous conditions and early cancers, thereby improving patient survival. Overall, endoscopy capacity must be adjusted to facilitate both effective screening programs and rigorous control of the quality assurance and surveillance systems required. 1 For average-risk populations, ESGE recommends the implementation of organized population-based screening programs for colorectal cancer, based...
Source: Endoscopy - Category: Gastroenterology Authors: Tags: Position Statement Source Type: research
Laparoscopic sleeve gastrectomy (LSG) affords patients excellent long term excess weight loss; however, one of the primary problems reported with this procedure is new onset or worsening gastro-esophageal reflux (GERD). Studies show the rate of de novo reflux after LSG to be 47.8%. Long-term GERD portends poor quality of life and increases the risk of esophageal cancer. We propose modifying the LSG by reattaching the omentum to the “new” greater portion of the sleeve stomach reduces the incidence of GERD by restoring natural anatomy.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research
Incidence of gastroesophageal reflux (GER) after sleeve gastrectomy (SG) is a concern considering the popularity of this procedure, lack of long-term data and theoretical risk of esophageal cancer development. Gastric bypass is considered the best therapeutic option for persisting reflux after SG. However up to 30% of patients suffer from post-operative GER.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research
Conclusions: The expression of MMP-9 is most common in severe forms compared to the mild forms of GRD. PMID: 31264989 [PubMed - in process]
Source: Cirugia y Cirujanos - Category: Surgery Authors: Tags: Cir Cir Source Type: research
AbstractIn the West, the incidence of esophageal adenocarcinoma, which is a long-term complication of damage by gastroesophageal reflux, has been rising over recent decades. Two main factors are likely to account for this increase. The first is the rising incidence of central obesity which promotes gastroesophageal reflux. The second is the falling incidence ofH. pylori infection and associated atrophic gastritis which reduces the acidity and peptic activity of gastric juice, the main factors damaging to the esophageal mucosa. The rise in esophageal adenocarcinoma has been mirrored by a fall in gastric cancer consistent wi...
Source: Journal of Gastroenterology - Category: Gastroenterology Source Type: research
This article summarizes the available evidence on this topic, and highlights specific areas for further research. PMID: 31047035 [PubMed - in process]
Source: The Surgical Clinics of North America - Category: Surgery Authors: Tags: Surg Clin North Am Source Type: research
Abstract In this paper, I reviewed the emerging field of endoscopic surgery and present data supporting the contention that endoscopy can now be used to treat many foregut diseases that have been traditionally treated surgically. Within each topic, the content will progress as follows: "lessons learned", "technical considerations" and "future opportunities". Lessons learned will provide a brief background and update on the most current literature. Technical considerations will include my personal experience, including tips and tricks that I have learned over the years. Finally, future...
Source: World Journal of Gastroenterology : WJG - Category: Gastroenterology Authors: Tags: World J Gastroenterol Source Type: research
Authors: Kim JJ Abstract The incidence of gastroesophageal junction adenocarcinoma (GEJAC) in Western countries has increased in recent decades, in addition to a rise in the incidence of esophageal adenocarcinoma (EAC). Gastroesophageal reflux disease (GERD), obesity, smoking, alcohol consumption, and low Helicobacter pylori (HP) infection rate have been nominated as risk factors for such cancers. Among these risk factors, the increased prevalence of GERD and obesity and the decreased prevalence of HP infection are of special interest owing to the currently increasing prevalence of GEJAC in Western countries. Altho...
Source: Journal of Gastric Cancer - Category: Gastroenterology Tags: J Gastric Cancer Source Type: research
When I was a kid, grasshoppers were everywhere. I walked through a field every day to get to school and grasshoppers were everywhere, jumping back and forth across my path, frequently banging off my legs. At night in summer, the backyard was filled with fireflies that we’d chase and capture in jars to watch up close. And there were butterflies of many colors and varieties everywhere, flitting from flower to flower. Today, I don’t see any grasshoppers. In fact, I haven’t seen one in over 40 years. I saw one—just one—firefly this past summer in my backyard. And I can count the number of butterie...
Source: Wheat Belly Blog - Category: Cardiology Authors: Tags: Agribusiness bowel flora Inflammation microbiota prebiotic probiotic wheat belly Source Type: blogs
Authors: Elliott JA, Donohoe CL, Reynolds JV Abstract There has been a substantial increase in the incidence of esophageal adenocarcinoma over the past 40 years. Meta-analyses of large prospective cohorts and population-based case-control studies demonstrate consistent associations between obesity and the development of adenocarcinoma of the esophagus and esophago-gastric junction, with an approximate doubling of risk of esophageal adenocarcinoma among patients who are obese, and an almost five-fold increased risk among those with BMI>40 kg/m2. The pathologic precursor, specialized intestinal metaplasia in Barre...
Source: Expert Review of Endocrinology and Metabolism - Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research
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