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Panminerva Medica 1998 June;40(2):132-8

lingua: Inglese

Gastroesophageal ­reflux dis­ease. Pathogenesis, symp­toms and com­pli­ca­tions

Cioffi U., Rosso L.*, De Simone M.*

From the Department of General and Oncologic Surgery * Department of General and Thoracic Surgery Ospedale Maggiore Policlinico, IRCCS University of Milan, Italy


The onset of GERD ­depends on sev­er­al fac­tors lead­ing to a pro­longed expo­si­tion of the esoph­a­geal muco­sa to inflam­ma­to­ry ­agents. Various mech­a­nisms play a role in dif­fer­ent ­patients, but gen­er­al­ly, ­decreased LES tone and ­delayed esoph­a­geal clear­ance are the major caus­es. Although pyro­sis and regur­gi­ta­tion are the most fre­quent com­plaints, the ­patient may have dif­fer­ent symp­toms or can be asymp­to­mat­ic. The symp­toms are not nec­es­sar­i­ly cor­re­lat­ed with dam­aged muco­sa. Recognized com­pli­ca­tions ­caused by ­reflux ­include esoph­a­gitis, stric­ture, hem­or­rhage, Barrett’s epi­the­li­um and ulcer­a­tion, aspi­ra­tion and res­pir­a­to­ry impli­ca­tions. The sever­ity of com­pli­ca­tions may be an impor­tant ele­ment in pre­dict­ing wheth­er the ­patient can be suc­cess­ful­ly treat­ed med­i­cal­ly or sur­gi­cal­ly. The exact knowl­edge of the path­o­gen­e­sis is man­da­to­ry for car­ry­ing out the most effec­tive treat­ment.

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