GERD: Reflux to Esophageal Adenocarcinoma

Gastroesophageal Reflux Disease (GERD) is one of the most common maladies of mankind. Approximately 40% of the adult population of the USA suffers from significant heartburn and the numerous antacids advertised incessantly on national television represents a $8 billion per year drug market. The ability to control acid secretion with the increasingly effective acid-suppressive agents such as the H2 blockers (pepcid, zantac) and proton pump inhibitors (nexium, prevacid) has given physicians an excellent method of treating the symptoms of acid reflux.

Unfortunately, this has not eradicated reflux disease. It has just changed its nature. While heartburn, ulceration and strictures have become rare, reflux-induced adenocarcinoma of the esophagus is becoming increasingly common. Adenocarcinoma of the esophagus and gastric cardia is now the most rapidly increasing cancer type in the Western world.

The increasing incidence of esophageal adenocarcinoma has created an enormous interest and stimulus for research in this area. GERD brings together a vast amount of disparate literature and presents the entire pathogenesis of reflux disease in one place. In addition to providing a new concept of how gastroesophageal reflux causes cellular changes in the esophagus, GERD also offers a complete solution to a problem that has confused physicians for over a century. Both clinical and pathological information about reflux disease and its treatment are presented. GERD is meant to be used as a comprehensive reference for gastroenterologists, esophageal surgeons, and pathologists alike.

Outlines how gastroesophageal reflux causes cellular changes in the esophagusBrings together the pathogenesis of the disease in one source and applies it toward clinical treatmentTom DeMeester is THE leading international expert on reflux disease; Parakrama Chandrasoma is one of the leading pathologists in the areaBook contains approximately 350 illustrationsAncillary web site features color illustrations: www.chandrasoma.com

Chapter 1: Overview of Gastroesophageal Reflux Disease

Chapter 2: The Past, Present, and Future of Columnar-Lined (Barrett) Esophagus

Chapter 3: Fetal Development of the Esophagus and Stomach

Chapter 4: Normal Anatomy; Present Definition of the Gastroesophageal Junction

Chapter 5: Histologic Definitions and Diagnosis of Epithelial Types

Chapter 6: Cardiac Mucosa

Chapter 7: New Histologic Definitions of Esophagus, Stomach, and Gastroesophageal Junction

Chapter 8: Pathology of Reflux Disease at a Cellular Level: Part 1—Damage to Squamous Epithelium and Transformation into Cardiac Mucosa

Chapter 9: The Pathology of Reflux Disease at a Cellular Level: Part 2—Evolution of Cardiac Mucosa to Oxyntocardiac Mucosa and Intestinal Metaplasia

Chapter 10: Pathology of Reflux Disease at a Cellular Level: Part 3—Intestinal (Barrett) Metaplasia to Carcinoma

Chapter 11: Pathology of Reflux Disease at an Anatomic Level

Chapter 12: Reflux Disease Limited to the Dilated End-Stage Esophagus: The Pathologic Basis of NERD

Chapter 13: Definition of Gastroesophageal Reflux Disease and Barrett Esophagus

Chapter 14: Diagnosis of Gastroesophageal Reflux Disease, Barrett Esophagus, and Dysplasia

Chapter 15: Research Strategies for Preventing Reflux-Induced Adenocarcinoma

Chapter 16: Rationale for Treatment of Reflux Disease and Barrett Esophagus

Chapter 17: Treatment Strategies for Preventing Reflux-Induced Adenocarcinoma

Index