Some new clinical and experimental aspects of the etiology and treatment of esophageal diseases

Abstract

The esophagus is one of the most inscrutable organs of the gastrointestinal tract, hereby it challenges all physicians who specialize on it, including gastroenterologists, surgeons and also primary care physicians. The complexity of the esophagus manifests itself on the colorful spectrum of complications that develop on the ground of gastroesophageal reflux disease (GERD). It is already unexplainable why chronic acid regurgitation provokes reflux esophagitis in some patients, while in others no endoscopic or histologic sign of inflammation can be detected, yet patients have severe complains. Development of diverse functional and structural esophageal disorders have been described in association with gastroesophageal reflux disease, but to date, it is unclear whether these secondary pathologies are simple consequences of GERD or is it possible that some of them are defensive reactions? Is there an expediency in their development or is it mere coincidence? Do the presumed adaptive esophageal changes influence the therapeutic strategy? Gastroesophageal reflux disease has become an endemic malady worldwide in the past decades. Understanding the longterm impacts of acid regurgitation on the esophagus would be imperative in order to better comprehend the behavior of this organ and to improve our knowledge about the possible complications of GERD.