„There is no reflux, without failure of the anti-reflux mechanism in the lower end of the esophagus, i.e. the lower esophageal sphincter (LES)“. The failure of the LES may occur with or without impaired anchorage of the esophagus within the diaphragm, i.e. hiatal hernia.
Gastroesophageal reflux disease (GERD) is a life style disease and develops when the anti-reflux mechanism in the lower end of the esophagus, i.e. the lower esophageal sphincter (LES), fails. As a consequence gastric acid content returns into the esophagus causing reflux, inflammation, symptoms (heartburn, acid regurgitation, wheezing, coughing, asthma) and increased cancer risk in those individuals, having Barrett’s esophagus (BE).
GERD affects approximately 80% of the Western population and impairs life quality, productivity and well being due to the symptoms (heartburn, acid regurgitation, wheezing, coughing, asthma) and the anxiety to get esophageal cancer in those, who have Barrett’s esophagus (BE).
Reflux therapy aims to compensate/restore/outbalance the failure of the lower esophageal sphincter (LES) by:
short term (max. 3 months) proton pump inhibitor therapy (PPI)
life style, nutrition ±
laparoscopic anti reflux surgery (Fundoplication, LINX, Endostim)
Reflux related cancer prevention aims to:
assess cancer risk (endoscopy, biopsy, histopathology, Chandrasoma classification),
eliminate cancer risk (radiofrequency ablation of Barrett’s esophagus),
exclude recurrence of cancer risk (follow up).