Abstract
Severe reflux-induced esophagitis is a condition characterized by esophageal inflammation caused by acid and biliary reflux. The process leads to different degrees of esophageal damage with respective clinical presentations, which range from acute pain and severe debilitating dysphagia to life-threatening adenocarcinoma. Early intervention is essential in order to avoid irreversible damage, and since symptoms alone are not always reliable to identify progression of disease, it is important to monitor patients with predisposing risk factors. Depending on the severity of the disease, several options for treatment are available, ranging from medication to endoscopic and surgical therapy.
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References
Kauer WK, Stein HJ. Emerging concepts of bile reflux in the constellation of gastroesophageal reflux disease. J Gastrointest Surg. 2010;14(Suppl 1):S9–16. doi:10.1007/s11605-009-1014-4.
Dent J, El-Serag HB, Wallander MA, Johansson S. Epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut. 2005;54:710–7.
Peery AF, Dellon ES, Lund J, et al. Burden of gastrointestinal disease in the United States: 2012 update. Gastroenterology. 2012;143:1179–87.
Bredenoord AJ1, Pandolfino JE, Smout AJ. Gastro-oesophageal reflux disease. Lancet. 2013;381(9881):1933–42. doi:10.1016/S0140-6736(12)62171-0.
Society for Surgery of the Alimentary Tract. SSAT patient care guidelines. Surgical treatment of reflux esophagitis. J Gastrointest Surg. 2007;11(9):1207–9.
Liu JJ, Saltzman JR. Management of gastroesophageal reflux disease. South Med J. 2006;99(7):735–41; quiz 742, 752.
Ronkainen J, Aro P, Storskrubb T, Johansson SE, Lind T, Bolling-Sternevald E, et al. High prevalence of gastroesophageal reflux symptoms and esophagitis with or without symptoms in the general adult Swedish population: akalixanda study report. Scand J Gastroentero. 2005;40(3):275–85.
Carlsson R, Dent J, Watts R, et al. Gastro-oesophageal reflux disease in primary care: an international study of different treatment strategies with omeprazole. International GORD study group. Eur J Gastroenterol Hepatol. 1998;10:119–24.
Venables TL, Newland RD, Patel AC, et al. Omeprazole 10 milligrams once daily, 20 milligrams once daily, or ranitidine 150 milligrams twice daily, evaluated as initial therapy for the relief of symptoms of gastro-oesophageal reflux disease in general practice. Scand J Gastroenterol. 1997;32:965–73.
Souza RF. The role of acid and bile reflux in oesophagitis and Barrett’s metaplasia. Biochem Soc Trans. 2010;38(2):348–52. doi:10.1042/BST0380348.
Desai KM, Frisella MM, Soper NJ. Clinical outcomes after laparoscopic antireflux surgery in patients with and without preoperative endoscopic esophagitis. J Gastrointest Surg. 2003;7(1):44–51.Discussion 51–2.
Lundell LR, Dent J, Bennett JR, Blum AL, Armstrong D, Galmiche JP, Johnson F, Hongo M, Richter JE, Spechler SJ, Tytgat GN, Wallin L. Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification. Gut. 1999;45:172–80.
Genta RM, Spechler SJ, Kielhorn AF. The Los Angeles and Savary-Miller systems for grading esophagitis: utilization and correlation with histology. Dis Esophagus. 2011;24(1):10–7.
Westhoff B, Brotze S, Weston A, McElhinney C, Cherian R, Mayo MS, etal. The frequency of Barrett’s esophagus in high-risk patients with chronic GORD. Gastrointest Endosc. 2005;61(2):226–31.
Labenz J, Nocon M, Lind T, Leodolter A, Jaspersen D, Meyer-Sabellek W, etal. Prospective follow-up data from the ProGORD study suggest that GORD is not a categorical disease. Am J Gastroenterol. 2006;101(11):2457–62.
Orr WC. Review article: sleep-related gastro-oesophageal reflux as a distinct clinical entity. Aliment Pharmacol Ther. 2010;31:47–56.
Lagergren J, Bergstrom R, Lindgren A, Nyren O. Symptomatic gastroesophageal reflux as a risk factor for esophageal adenocarcinoma. N Engl J Med. 1999;340:825–31.
Armstrong D, Marshall JK, Chiba N, et al. Canadian consensus conference on the management of gastroesophageal reflux dis-ease in adults—update 2004. Can J Gastroenterol. 2005;19:15–35.
Vakil N, Moayyedi P, Fennerty MB, et al. Limited value of alarm features in the diagnosis of upper gastrointestinal malignancy: systematic review and meta-analysis. Gastroenterology. 2006;131:390–401.
Rantanen TK, Sihvo EI, Rasanen JV, et al. Gastroesophageal reflux disease as a cause of death is increasing: analysis of fatal cases after medical and surgical treatment. Am J Gastroenterol. 2007;102:246–53.
GralnekI M, Dulai GS, Fennerty MB, et al. Esomeprazole versus other proton pump inhibitors in erosive esophagitis: a meta-analysis of randomized clinical trials. Clin Gastroenterol Hepatol. 2006;4:1452–8.
Vela MF, Camacho-Lobato L, Srinivasan R, et al. Simultaneous intraesophageal impedance and pH measurement of acid and nonacid gastroesophageal reflux: effect of omeprazole. Gastroenterology. 2001;120:1599–606.
Stein HJ, Kauer WKH, Feussner H, et al. Bile acids as components of the duodenogastric refluxate: detection, relationship to bilirubin, mechanism of injury and clinical relevance. Hepato.Gastroenterol. 1999;46:66–7.
Kauer WKH, Burdiles P, Ireland A, et al. Does duodenal juice reflux into the esophagus of patients with complicated GERD. Am J Surg. 1995;169:98–104.
Stein HJ, Kauer WKH, Feussner H, et al. Bile reflux in benign and malignant Barrett’s esophagus. Effect of medical acid suppression and fundoplication. J Gastrointest Surg. 1998;2:233–41.
Kaltenbach T, Crockett S, Gerson LB. Are lifestyle measures effective in patients with gastroesophageal reflux disease? An evidence-based approach. Arch Intern Med. 2006;166:965–71
Kahrilas PJ, Shaheen NJ, Vaezi MF. American gastroenterological association institute technical review on the management of gastroesophageal reflux disease. Gastroenterology. 2008;135:1392–413.
Tytgat GNJ. Review article: management of mild and severe gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2003; 17(Suppl 2):52–6.
Chubineh S1, Birk J. Proton pump inhibitors: the good, the bad, and the unwanted. South Med J. 2012;105(11):613–8. doi:10.1097/SMJ.0b013e31826efbea.
Spechler SJ, Sharma P, Souza RF, Inadomi JM, Shaheen NJ. American gastroenterological association medical position statement on the management of Barrett’s esophagus. Gastroenterology. 2011;140(3):1084–91.
Vela MF, Camacho-Lobato L, Srinivasan R, et al. Intraesophageal impedance and pH measurement of acid and non-acid reflux: effect of omeprazole. Gastroenterology. 2001;120:1599–606.
Ghatak S, Reveiller M, Toia L, Ivanov A, Godfrey TE, Peters JH. Bile acid at low pH reduces squamous differentiation and activates EGFR signaling in esophageal squamous cells in 3-D culture. J Gastrointest Surg. 2013;17(10):1723–31. doi:10.1007/s11605-013-2287-1.
Kahrilas PJ1, Shaheen NJ, Vaezi MF. American gastroenterological association institute technical review on the management of gastroesophageal reflux disease. Gastroenterology. 2008;135(4):1392–1413, 1413.e1–5. doi:10.1053/j.gastro.2008.08.044.
Bavishi C, Dupont HL. Systematic review: the use of proton pump inhibitors and increased susceptibility to enteric infection. Aliment Pharmacol Ther. 2011;34:1269–81.
Laheij RJ, Sturkenboom MC, Hassing JR, et al. Risk of community- acquired pneumonia and use of gastric acid-suppressive drugs. JAMA. 2004;292:1955–60.
Campos GM1, Peters JH, DeMeester TR, Oberg S, Crookes PF, Tan S, DeMeester SR, Hagen JA, Bremner CG. Multivariate analysis of factors predicting outcome after laparoscopic Nissen fundoplication. J Gastrointest Surg. 1999;3(3):292–300.
Parasa S, Sharma P. Complications of gastro-oesophageal reflux disease. Best Pract Res Clin Gastroenterol. 2013;27(3):433–42. doi:10.1016/j.bpg.2013.07.002.
Galmiche JP, Hatlebakk J, Attwood S, et al. Laparoscopic antireflux surgery vs esomeprazole treatment for chronic GERD: the lotus randomized clinical trial. JAMA. 2011;305:1969–77.
Parrilla P, Martinezde Haro LF, Ortiz A, et al. Long-term results of a randomized prospective study comparing medical and surgical treatment of Barrett’s esophagus. Ann Surg. 2003;237:291–8.
Gurski RR, Peters JH, Hagen JA, et al. Barrett’s esophagus can and does regress after antireflux surgery: a study of prevalence and predictive features. J Am Coll Surg. 2003;196:706–12.
Zaninotto G, Parente P, Salvador R, et al. Long-term follow-up of Barrett’s epithelium: medical versus antireflux surgical therapy. J Gastrointest Surg. 2012;16:7–14.
Horvath KD, Jobe BA, Herron Dm, Swanstrom LL. Laparoscopic toupet fundoplication is an inadequate procedure for patients with severe reflux disease. J Gastrointest Surg. 1999;3:583–91.
Patti MG, Robinson T, Galvani C, Gorodner MV, Fisichella PM, Way LW. Total fundoplication is superior to partial fundoplication even when esophageal peristalsis is weak. J Am Coll Surg. 2004;198:863–70.
Society for Surgery of the Alimentary Tract. SSAT patient care guidelines. Management of Barrett’s esophagus. J Gastrointest Surg. 2007;11(9):1213–5.
Broeders JA1, Draaisma WA, Bredenoord AJ, Smout AJ, Broeders IA, Gooszen HG. Long-term outcome of Nissen fundoplication in non-erosive and erosive gastro-oesophageal reflux disease. Br J Surg. 2010;97(6):845–52. doi:10.1002/bjs.7023.
Braghetto I1, Csendes A, Burdiles P, Botero F, Korn O. Results of surgical treatment for recurrent postoperative gastroesophageal reflux. Dis Esophagus. 2002;15(4):315–22.
Catarci M, Gentileschi P, Papi C, Carrara A, Marrese R, Gaspari AL, et al. Evidence-based appraisal of antireflux fundoplication. Ann Surg. 2004;239:325–37.
Grant AM, Cotton SC, Boachie C, Ramsay CR, Krukowski ZH, Heading RC, Campbell MK. Minimal access surgery compared with medical management for gastro-oesophageal reflux disease: five year follow-up of a randomised controlled trial (REFLUX). BMJ. 2013;346:f1908. doi:10.1136/bmj.f1908.
Faria R, Bojke L, Epstein D, Corbacho B, Sculpher M.REFLUX trial group. Cost-effectiveness of laparoscopic fundoplication versus continued medical management for the treatment of gastro-oesophageal reflux disease based on long-term follow-up of the REFLUX trial. Br J Surg. 2013;100(9):1205–13.
Rossi M1, Barreca M, deBortoli N, Renzi C, Santi S, Gennai A, Bellini M, Costa F, Conio M, Marchi S. Efficacy of Nissen fundoplication versus medical therapy in the regression of low grade dysplasia in patients with Barrett esophagus: a prospective study. Ann Surg. 2006;243(1):58–63.
Lipham JC, Demeester TR, Ganz RA, et al. â£e LINX(®) reflux management system: confirmed safety and efficacy now at 4 years. Surg Endosc. 2012;26:2944–9.
Locke GR, Horwhat J, Mashimo H, Savarino E, Zentilin P, Savarino V, Zerbib F, Armbruster SP, Wong RK, Moawad F. Endotherapy for and tailored approaches to treating GERD, and refractory GERD. Ann N Y Acad Sci. 2013;1300:166–86. doi:10.1111/nyas.12240.
Pisegna J, Holtmann G, Howden CW, Katelaris PH, Sharma P, Spechler S, Triadafilopoulos G, Tytgat G. Review article: oesophageal complications and consequences of persistent gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2004; 20(Suppl 9):47–56.
Awad ZT1, Filipi CJ, Mittal SK, Roth TA, Marsh RE, Shiino Y, Tomonaga T. Left side thoracoscopically assisted gastroplasty: a new technique for managing the shortened esophagus. Surg Endosc. 2000;14(5):508–12.
Urbach DR, Khajanchee YS, Glasgow RE, Hansen PD, Swan-strom LL. Preoperative determinations of an esophageal-length-ening procedure in laparoscopic antireflux surgery. Surg Endosc.
Pregun I, Hritz I, Tulassay Z, Herszényi L. Peptic esophageal stricture: medical treatment. Dig Dis. 2009;27(1):31–7. doi:10.1159/000210101. Epub 2009 May 8. Review.
Spechler SJ. Clinical manifestations and esophageal complications of GORD. Am J Med Sci. 2003;326(5):279–84.
Braghetto I, Csendes A, Burdiles P, Korn O, Compan A, Guerra JF. Barrett’s esophagus complicated with stricture: correlation be-tween classification and the results of the different therapeutic options. World J Surg. 2002;26:1228–33.
Ferguson DD. Evaluation and management of benign esophageal strictures. Dis Esophagus. 2005;18(6):359–64.
Dakkak M, Hoare RC, Maslin SC, et al. Oesophagitis is as important as oesophageal stricture diameter in determining dysphagia. Gut.1993;34:152–5.
Watson A. Reflux stricture of the oesophagus. Br J Surg. 1987;74:443–8.
Kochhar R, Ray JD, Sriram PV, Kumar S, Singh K. Intralesional steroids augment the effects of endoscopic dilation in corrosive esophageal strictures. Gastrointest Endosc. 1999;49(4 Pt 1):509–13.
Bender EM, Walbaum PR. Esophagogastrectomy for benign esophageal stricture. Fate of the esophagogastric anastomosis. Ann Surg. 1987;205:385–8.
Buttar NS, Falk GW. Pathogenesis of gastroesophageal reflux and Barrett esophagus. Mayo Clin Proc. 2001;76:226–34.
Lieberman DA, Oehlke M, Helfand M. Risk factors for Barrett’s esophagus in community-based practice. Gorge consortium. Gastroenterology outcomes research group in endoscopy. Am J Gastroenterol. 1997;92:1293–7.
Modiano N, Gerson LB. Risk factors for the detection of Barrett’s esophagus in patients with erosive esophagitis. Gastrointest Endosc. 2009;69(6):1014–20. doi:10.1016/j.gie.2008.07.024.
Inadomi JM, Sampliner R, Lagergren J, et al. Screening and surveillance for Barrett esophagus in high risk groups: a cost-utility analysis. Ann Intern Med. 2003;138:176–86.
Prasad GA, Bansal A, Sharma P, Wang KK. Predictors of progression in Barrett’s esophagus: current knowledge and future directions. Am J Gastroentero. 2010;105(7):1490–502.
Leodolter A, Nocon M, Vieth M, Lind T, Jaspersen D, Richter K, et al. Progression of specialized intestinal metaplasia at the cardia to macroscopically evident Barrett’s esophagus: an entity of concern in the Progord study. Scand J Gastroentero. 2012;47(12):1429–35.
Shaheen NJ, Sharma P, Overholt BF, et al. Radiofrequency ablation in Barrett’s esophagus with dysplasia. N Engl J Med. 2009;360:2277–88.
Shaheen NJ, Crosby MA, Bozymski EM, et al. Is there publication bias in the reporting of cancer risk in Barrett’s esophagus?.Gastroenterology. 2000;119:333–8.
Rastogi A, Puli S, El-Serag HB, et al. Incidence of esophageal adenocarcinoma in patients with Barrett's esophagus and high-grade dysplasia: a meta-analysis. Gastrointest Endosc. 2008;67:394–8.
Falk GW, Jacobson BC, Riddell RH, Rubenstein JH, El-Zimaity H, Drewes AM, et al. Barrett’s esophagus: prevalence- incidence and etiology-origins. Ann N Y Acad Sci. 2011;1232:1–17.
Mori H1, Kobara H, Fujihara S, Nishiyama N, Nomura T, Kobayashi M, Hagiike M, Izuishi K, Suzuki Y, Masaki T. Simultaneous resection of Barrett’s esophageal cancer and severe stenosis caused by reflux esophagitis. Gastrointest Endosc. 2012;76(3):689–90. doi:10.1016/j.gie.2011.08.035.
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Barbon, C., Mungo, B., Molena, D., Yang, S. (2015). Severe Reflux-Induced Esophagitis. In: Pawlik, T., Maithel, S., Merchant, N. (eds) Gastrointestinal Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2223-9_7
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