tissue disorders Endocrine disorders Genetic syndromes Infiltrative disorders Inflammatory disorders Neuromuscular disorders Conclusion References
11 PART IV: Gastroesophageal Reflux Disease 19 Clinical Spectrum and Diagnosis of GERD Phenotypes Introduction The current paradigm of gastroesophageal reflux disease Clinical spectrum of GERD Further esophageal physiologic testing Conclusion References 20 Hiatus Hernia and Gastroesophageal Reflux Disease Introduction Anatomy of the diaphragm and the esophagogastric junction Physiology of the esophagogastric junction Hiatus hernia Congenital diaphragmatic hernias Sliding hiatus hernia and reflux disease Diagnosis Therapy Conclusions References 21 Pathophysiology of Gastroesophageal Reflux Disease: Motility Factors Introduction Sphincter mechanism at the esophagogastric junction (EGJ) Gastroesophageal junction pressure under various physiologic conditions Mechanisms of gastroesophageal reflux Hiatus hernia and reflux disease Compliance/opening function of LES and EGJ in GER disease Role of esophageal peristalsis in reflux disease Conclusions References 22 Pathophysiology of Gastroesophageal Reflux Disease: Epithelial Factors Introduction Acid, pepsin, and bile acids: the epithelial triple threat Development of the esophagus and its defensive players Esophageal tissue resistance: epithelial factors and beyond Assessing the epithelial barrier: measurements of resistance, permeability, and intercellular spaces Pathophysiology of GERD and reflux esophagitis: acid burn or cytokine sizzle? Conclusions and future directions References 23 Duodenogastroesophageal Reflux Introduction The role of acid and pepsin The role of duodenal contents Detection of DGER in humans Medical and surgical treatment Conclusion References 24 Helicobacter pylori and GERD Introduction Epidemiology of H. pylori and GERD Pathobiology of H. pylori and GERD Implication of eradication of H. pylori on de novo GERD Implication of H. pylori eradication on patients with known GERD H. pylori and Barrett’s esophagus H. pylori and esophageal adenocarcinoma and gastroesophageal junction adenocarcinoma Professional guidelines, recommendations, and updates Conclusions References 25 Medical Management of Gastroesophageal Reflux Disease Introduction Lifestyle modifications Pharmacologic therapy Long‐term management References 26 Refractory Heartburn: Reflux Hypersensitivity and Functional Heartburn Introduction Functional heartburn Reflux hypersensitivity Overlap