Gastroesophageal Reflux Disease: Symptoms, Causes and Treatment

Dear Colleagues,

Gastroesophageal reflux disease (GERD), which is characterized by the reflux of gastric contents into the distal and proximal esophagus, the pharynx, and the airway, causing troublesome symptoms and/or complications, is one of the most common chronic gastrointestinal disorders worldwide and has a high cost for treatment. The disease has a multifactorial pathogenesis, including a compromised anti-reflux barrier (such as incompetent lower esophageal sphincter (LES) and upper esophageal sphincter (UES) functions), a chemical component, impaired esophageal peristalsis, transient LES relaxation (TLESR), decreased mucosal integrity and delayed stomach emptying. GERD has various phenotypes ranging from Barrett’s esophagus, high- or low-grade esophagitis, non-erosive esophagitis, and esophageal hypersensitivity to supra-esophageal reflux disease. The principle of the treatment is to relieve the symptoms and minimize the risk of developing complications such as esophageal adenocarcinoma and aspiration pneumonia from chronic GERD. Traditionally, lifestyle modifications and proton pump inhibitor (PPI) therapy are first-line treatments of GERD. Based on the response to the treatment, many patients with refractory symptoms may require further evaluation with upper gastrointestinal endoscopy, ambulatory pH monitoring with or without impedance, and motility testing. Surgical intervention will be considered for patients suffering from GERD unless they exhibit intolerance to medical treatment. Despite prolonged acid suppression and surgical management, a good proportion of patients still experience ongoing GERD-related symptoms, which results in multiple clinic visits and expensive workup. As GERD is a complex disease involving the esophageal defensive mechanism against gastric reflux at different levels, management should target those contributing factors beyond acid control.

This Special Issue aims to give an update on the current status, challenges and future directions in the diagnosis and treatment of GERD. Original research articles and reviews are welcome. In this Special Issue, we would like to focus on the pathophysiology, novel diagnostic methods to help identify underlying pathogenesis and new treatments for GERD. Furthermore, we would like to focus on the unmet needs of patients treated with current GERD treatments. We will focus on a subgroup of patients suffering from supra-esophageal reflux disease, including this disease’s mechanism, complications, diagnosis and treatment. Finally, we would like to focus on potential treatment targets which can affect esophageal motility and hypersensitivity in managing GERD.

Prof. Dr. Reza Shaker
Dr. Ling Mei
Guest Editors

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• gastroesophageal reflux disease
• pathogenesis of gastroesophageal reflux disease
• diagnosis and treatment
• supra-esophageal reflux disease
• lower esophageal sphincter
• upper esophageal sphincter