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GERD
Reflux to Esophageal Adenocarcinoma
1st Edition - September 18, 2006
Authors: Parakrama T. Chandrasoma, Tom R. DeMeester
Language: English
Hardback ISBN:9780123694164
9 7 8 - 0 - 1 2 - 3 6 9 4 1 6 - 4
eBook ISBN:9780080464749
9 7 8 - 0 - 0 8 - 0 4 6 4 7 4 - 9
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…Read more
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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 esophagus
Brings together the pathogenesis of the disease in one source and applies it toward clinical treatment
Tom DeMeester is THE leading international expert on reflux disease; Parakrama Chandrasoma is one of the leading pathologists in the area
Book contains approximately 350 illustrations
Ancillary web site features color illustrations: www.chandrasoma.com
Gastroenterologists, esophageal surgeons and pathologists.
Preface
Chapter 1: Overview of Gastroesophageal Reflux Disease
Publisher Summary
PHYSIOLOGICAL VERSUS PATHOLOGICAL REFLUX
PREVALENCE OF GASTROESOPHAGEAL REFLUX DISEASE
HISTOLOGIC DEFINITION OF GASTROESOPHAGEAL REFLUX DISEASE
PREVALENCE OF BARRETT ESOPHAGUS
MANAGEMENT OF BARRETT ESOPHAGUS
PREVALENCE OF REFLUX-INDUCED ADENOCARCINOMA
Chapter 2: The Past, Present, and Future of Columnar-Lined (Barrett) Esophagus
Publisher Summary
THE HISTORY OF COLUMNAR-LINED ESOPHAGUS
Literature Review
Literature Review
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Literature Review
THE REASONS FOR CONFUSION
HISTORICAL EVOLUTION OF COLUMNAR-LINED (BARRETT) ESOPHAGUS (Table 2.2)
Literature Review
THE STATE OF THE ART AND TODAY’S PROBLEMS
SOLUTIONS TO THE PROBLEM AND WHAT WE HOPE TO SHOW
Chapter 3: Fetal Development of the Esophagus and Stomach
Publisher Summary
THE STUDY OF EMBRYOLOGY OF THE FOREGUT
EARLY DEVELOPMENT OF THE GASTROINTESTINAL TRACT
EARLY DEVELOPMENT OF THE FOREGUT
EPITHELIAL DEVELOPMENT IN THE FETAL ESOPHAGUS
Literature Review
EPITHELIAL DEVELOPMENT IN THE FETAL STOMACH
Literature Review
EPITHELIAL DEVELOPMENT IN THE FETAL GASTROESOPHAGEAL JUNCTION
Literature Review
SUMMARY OF EPITHELIAL DEVELOPMENT OF THE ESOPHAGUS
CONTROL OF FOREGUT EPITHELIAL DEVELOPMENT
Chapter 4: Normal Anatomy; Present Definition of the Gastroesophageal Junction
Publisher Summary
ANATOMY AND PHYSIOLOGY
ENDOSCOPIC/GROSS LANDMARKS
THE MEANING OF ENDOSCOPIC/GROSS LANDMARKS
PRESENT DEFINITION OF THE GASTROESOPHAGEAL JUNCTION
WHAT IS THE CARDIA? LET’S REMOVE THIS TERM FROM OUR VOCABULARY
THE LOGICAL CONCLUSION THAT SHOULD BE TESTED
Chapter 5: Histologic Definitions and Diagnosis of Epithelial Types
Publisher Summary
DEFINITIONS
PROBLEMS WITH THE DEFINITIONS
DIAGNOSIS OF DIFFERENT EPITHELIAL TYPES
Literature Review
Chapter 6: Cardiac Mucosa
Publisher Summary
WHAT IS CARDIAC MUCOSA?
WHERE IS CARDIAC MUCOSA LOCATED (Figure 6.1)?
IS CARDIAC MUCOSA PRESENT IN EVERYONE?
Literature Review
WHAT IS OXYNTOCARDIAC MUCOSA, AND WHERE IS IT?
HOW MUCH CARDIAC AND OXYNTOCARDIAC MUCOSA ARE PRESENT?
WHAT DOES THE PRESENCE/ABSENCE AND AMOUNT OF CARDIAC MUCOSA MEAN?
WHAT DOES INCREASING LENGTH OF CARDIAC MUCOSA MEAN?
A HUMAN EXPERIMENT
Literature Review
SUMMARY STATEMENT REGARDING CARDIAC MUCOSA
Chapter 7: New Histologic Definitions of Esophagus, Stomach, and Gastroesophageal Junction
Publisher Summary
LET US ESTABLISH COMMON GROUND IN HISTOLOGY
Literature Review
LET US UNDERSTAND THE PROBLEM
NORMAL HISTOLOGY OF THE ESOPHAGUS AND STOMACH: A STATEMENT OF FACT AND NEW HISTOLOGIC DEFINITIONS
APPLICATION OF THESE DEFINITIONS TO PRACTICE
Chapter 8: Pathology of Reflux Disease at a Cellular Level: Part 1—Damage to Squamous Epithelium and Transformation into Cardiac Mucosa
Publisher Summary
REFLUX-INDUCED DAMAGE OF THE SQUAMOUS EPITHELIUM
COLUMNAR METAPLASIA OF THE SQUAMOUS EPITHELIUM
SUMMARY
Chapter 9: The Pathology of Reflux Disease at a Cellular Level: Part 2—Evolution of Cardiac Mucosa to Oxyntocardiac Mucosa and Intestinal Metaplasia
Publisher Summary
HISTOLOGIC COMPOSITION OF COLUMNAR-LINED ESOPHAGUS
CARDIAC TO OXYNTOCARDIAC MUCOSA: THE BENIGN GENETIC SWITCH
CARDIAC MUCOSA TO INTESTINAL METAPLASIA: THE SECOND GENETIC SWITCH
Literature Review
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Chapter 10: Pathology of Reflux Disease at a Cellular Level: Part 3—Intestinal (Barrett) Metaplasia to Carcinoma
Publisher Summary
CARCINOGENESIS IN INTESTINAL METAPLASIA
DOES ADENOCARCINOMA ARISE IN ESOPHAGUS WITHOUT INTESTINAL (BARRETT) METAPLASIA?
Literature Review
NATURAL HISTORY OF DYSPLASIA: SURVEILLANCE FOR BARRETT ESOPHAGUS
Literature Review
Literature Review
Literature Review
DOES DYSPLASIA REVERSE?
THEORETICAL CONSIDERATIONS RELATING TO ADENOCARCINOMA DISTRIBUTION IN THE COLUMNAR-LINED ESOPHAGUS
ASSESSMENT OF CANCER RISK IN BARRETT ESOPHAGUS
Literature Review
CLINICALLY USEFUL MOLECULAR TESTS
Literature Review
CAUSE OF CARCINOGENESIS IN BARRETT ESOPHAGUS
Chapter 11: Pathology of Reflux Disease at an Anatomic Level
Publisher Summary
Literature Review
IDENTIFICATION AND VALIDATION OF THE TRUE GASTROESOPHAGEAL JUNCTION
Literature Review
THE ANATOMIC CHANGES ASSOCIATED WITH SLIDING HIATAL HERNIA
STAGES BETWEEN NORMAL AND SLIDING HIATAL HERNIA: THE REFLUX-DAMAGED DISTAL ESOPHAGUS—DEFINING THE END-STAGE ESOPHAGUS
Literature Review
RELATIONSHIP OF THE DILATED END-STAGE ESOPHAGUS TO COLUMNAR-LINED ESOPHAGUS
THE DISCREPANCY HAS NOW DISAPPEARED
ANATOMY AND HISTOLOGY OF A SLIDING HIATAL HERNIA
THE GREAT HISTORICAL MISUNDERSTANDING CONTINUES TO THE PRESENT
Chapter 12: Reflux Disease Limited to the Dilated End-Stage Esophagus: The Pathologic Basis of NERD
Publisher Summary
GASTROESOPHAGEAL REFLUX VERSUS REFLUX DISEASE
REFLUX DISEASE LIMITED TO THE DILATED END-STAGE ESOPHAGUS
A NEW LOOK AT INTESTINAL METAPLASIA OF THE GASTRIC CARDIA
Literature Review
Literature Review
Literature Review
A NEW LOOK AT ADENOCARCINOMA OF THE GASTRIC CARDIA
Literature Review
Chapter 13: Definition of Gastroesophageal Reflux Disease and Barrett Esophagus
Publisher Summary
PRESENTLY USED CRITERIA FOR DEFINING GASTROESOPHAGEAL REFLUX DISEASE
DEFINITIONS BASED ON QUANTITATING GASTROESOPHAGEAL REFLUX
PROPOSED NEW CRITERION FOR DEFINING GASTROESOPHAGEAL REFLUX DISEASE
REFLUX CARDITIS: A NEW ENTITY THAT DEFINES GASTROESOPHAGEAL REFLUX DISEASE WITH PERFECTION
Literature Review
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A NEW DEFINITION OF BARRETT ESOPHAGUS
Literature Review
Chapter 14: Diagnosis of Gastroesophageal Reflux Disease, Barrett Esophagus, and Dysplasia
Publisher Summary
A NEW DIAGNOSTIC METHOD FOR REFLUX DISEASE
THE DIAGNOSIS OF REFLUX CARDITIS AND BARRETT ESOPHAGUS
THE DIAGNOSIS OF DYSPLASIA IN BARRETT ESOPHAGUS
Literature Review
Literature Review
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Literature Review
Chapter 15: Research Strategies for Preventing Reflux-Induced Adenocarcinoma
Publisher Summary
MECHANISMS OF CELLULAR CHANGES IN REFLUX DISEASE
THE MECHANISM OF METAPLASIA: EPITHELIA DO NOT “MOVE”
THE REFLUX-ADENOCARCINOMA SEQUENCE
RECOGNITION OF DIFFERENT RISK LEVELS IN THE EPITHELIA OF COLUMNAR-LINED ESOPHAGUS
THE STATE OF PRESENT PHARMACEUTICAL INTERVENTION IN REFLUX DISEASE
PROPOSED NEW PHARMACEUTICAL RESEARCH TARGETS AIMED AT PREVENTING ADENOCARCINOMA
RESEARCH INTO SURGICAL METHODS OF PREVENTING ADENOCARCINOMA
IDENTIFYING FACTORS IN GASTRIC JUICE RESPONSIBLE FOR MOLECULAR EVENTS
MOLECULAR RESEARCH INTO CARCINOGENESIS
Chapter 16: Rationale for Treatment of Reflux Disease and Barrett Esophagus
Publisher Summary
THE PRESENT RATIONALE FOR TREATMENT OF REFLUX DISEASE
ACID SUPPRESSION WITH DRUGS AS TREATMENT FOR REFLUX DISEASE
Literature Review
Literature Review
Literature Review
DOES ACID SUPPRESSIVE DRUG THERAPY INCREASE THE RISK OF ADENOCARCINOMA?
Literature Review
ANTIREFLUX SURGERY AS TREATMENT FOR REFLUX DISEASE
Literature Review
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ABLATION AS TREATMENT FOR BARRETT ESOPHAGUS
Chapter 17: Treatment Strategies for Preventing Reflux-Induced Adenocarcinoma
Publisher Summary
ASYMPTOMATIC VERSUS SYMPTOMATIC PATIENTS
Literature Review
PRESENT TREATMENT OF REFLUX DISEASE
OUTCOME OF PRESENT TREATMENT REGIMENS
REFLUX DISEASE IS THE PREMALIGNANT PHASE OF CANCER
ANTIREFLUX SURGERY CAN PREVENT PROGRESSION IN THE REFLUX TO ADENOCARCINOMA SEQUENCE; CANCER CAN BE PREVENTED
DEFINITION OF THE BIOPSY PROTOCOL FOR INDEX DIAGNOSIS
CLASSIFICATION OF RISK BASED ON BIOPSY RESULTS
RECOMMENDATIONS FOR TREATMENT OF BIOPSY-DEFINED GROUPS
RECOMMENDED CHANGES IN THE TREATMENT OF DEFINED PATIENT GROUPS
Literature Review
Literature Review
COST OF ANTIREFLUX SURGERY
Literature Review
Literature Review
RESOURCES NEEDED TO IMPLEMENT RECOMMENDED CHANGES
SUMMARY OF RECOMMENDED CHANGES
Index
No. of pages: 464
Language: English
Edition: 1
Published: September 18, 2006
Imprint: Elsevier Science
Hardback ISBN: 9780123694164
eBook ISBN: 9780080464749
PC
Parakrama T. Chandrasoma
Dr. Parakrama Chandrasoma was born in Sri Lanka and received his medical education and initial pathology training in the Medical School of the University of Sri Lanka. He has postgraduate degrees in internal medicine, including the M.D. (Sri Lanka) and Membership of the Royal College of Physicians (UK). He immigrated to the United States in 1978. Upon completing his pathology residency, he assumed duties as Chief of Surgical Pathology at the Los Angeles County + University of Southern California Medical Center He has held this position since. After an initial interest in neuropathology, Dr. Chandrasoma joined Dr. Tom DeMeester’s Foregut Surgery team as pathologist in 1991. This led to a productive study of gastroesophageal reflux disease spanning 16 years and resulting in the development of numerous original concepts relating to the pathogenesis of gastroesophageal reflux disease. Dr. Chandrasoma has written over 140 peer reviewed papers and 6 previous pathology textbooks, including a general text on Gastrointestinal Pathology and a text on Gastroesophageal Reflux Disease, and is a Professor of Pathology at the Keck School of Medicine at the University of Southern California. He is married with three children and lives in Pasadena, California.
Affiliations and expertise
Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
TD
Tom R. DeMeester
Professor of Clinical Surgery and Chair of the Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Affiliations and expertise
University of Southern California, Keck School of Medicine, Los Angeles, California, USA