GERD - 1st Edition - ISBN: 9780123694164, 9780080464749

GERD

1st Edition

Reflux to Esophageal Adenocarcinoma

Authors: Parakrama Chandrasoma Parakrama Chandrasoma Tom DeMeester
eBook ISBN: 9780080464749
Hardcover ISBN: 9780123694164
Paperback ISBN: 9781493300730
Imprint: Elsevier Science
Published Date: 18th September 2006
Page Count: 464
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Description

Gastroesophageal Reflux Disease (GERD) is one of the most common maladies of mankind. Approximately 40% of the adult population of the USA suffers from significant heartburn and the numerous antacids advertised incessantly on national television represents a $8 billion per year drug market. The ability to control acid secretion with the increasingly effective acid-suppressive agents such as the H2 blockers (pepcid, zantac) and proton pump inhibitors (nexium, prevacid) has given physicians an excellent method of treating the symptoms of acid reflux.

Unfortunately, this has not eradicated reflux disease. It has just changed its nature. While heartburn, ulceration and strictures have become rare, reflux-induced adenocarcinoma of the esophagus is becoming increasingly common. Adenocarcinoma of the esophagus and gastric cardia is now the most rapidly increasing cancer type in the Western world.

The increasing incidence of esophageal adenocarcinoma has created an enormous interest and stimulus for research in this area. GERD brings together a vast amount of disparate literature and presents the entire pathogenesis of reflux disease in one place. In addition to providing a new concept of how gastroesophageal reflux causes cellular changes in the esophagus, GERD also offers a complete solution to a problem that has confused physicians for over a century. Both clinical and pathological information about reflux disease and its treatment are presented. GERD is meant to be used as a comprehensive reference for gastroenterologists, esophageal surgeons, and pathologists alike.

Key Features

  • Outlines how gastroesophageal reflux causes cellular changes in the esophagus
  • Brings together the pathogenesis of the disease in one source and applies it toward clinical treatment
  • Tom DeMeester is THE leading international expert on reflux disease; Parakrama Chandrasoma is one of the leading pathologists in the area
  • Book contains approximately 350 illustrations
  • Ancillary web site features color illustrations: www.chandrasoma.com

Readership

Gastroenterologists, esophageal surgeons and pathologists.

Table of Contents

  • Preface
  • Chapter 1: Overview of Gastroesophageal Reflux Disease
    • Publisher Summary
    • PHYSIOLOGICAL VERSUS PATHOLOGICAL REFLUX
    • PREVALENCE OF GASTROESOPHAGEAL REFLUX DISEASE
    • HISTOLOGIC DEFINITION OF GASTROESOPHAGEAL REFLUX DISEASE
    • PREVALENCE OF BARRETT ESOPHAGUS
    • MANAGEMENT OF BARRETT ESOPHAGUS
    • PREVALENCE OF REFLUX-INDUCED ADENOCARCINOMA
  • Chapter 2: The Past, Present, and Future of Columnar-Lined (Barrett) Esophagus
    • Publisher Summary
    • THE HISTORY OF COLUMNAR-LINED ESOPHAGUS
    • Literature Review
    • Literature Review
    • Literature Review
    • Literature Review
    • THE REASONS FOR CONFUSION
    • HISTORICAL EVOLUTION OF COLUMNAR-LINED (BARRETT) ESOPHAGUS (Table 2.2)
    • Literature Review
    • THE STATE OF THE ART AND TODAY’S PROBLEMS
    • SOLUTIONS TO THE PROBLEM AND WHAT WE HOPE TO SHOW
  • Chapter 3: Fetal Development of the Esophagus and Stomach
    • Publisher Summary
    • THE STUDY OF EMBRYOLOGY OF THE FOREGUT
    • EARLY DEVELOPMENT OF THE GASTROINTESTINAL TRACT
    • EARLY DEVELOPMENT OF THE FOREGUT
    • EPITHELIAL DEVELOPMENT IN THE FETAL ESOPHAGUS
    • Literature Review
    • EPITHELIAL DEVELOPMENT IN THE FETAL STOMACH
    • Literature Review
    • EPITHELIAL DEVELOPMENT IN THE FETAL GASTROESOPHAGEAL JUNCTION
    • Literature Review
    • SUMMARY OF EPITHELIAL DEVELOPMENT OF THE ESOPHAGUS
    • CONTROL OF FOREGUT EPITHELIAL DEVELOPMENT
  • Chapter 4: Normal Anatomy; Present Definition of the Gastroesophageal Junction
    • Publisher Summary
    • ANATOMY AND PHYSIOLOGY
    • ENDOSCOPIC/GROSS LANDMARKS
    • THE MEANING OF ENDOSCOPIC/GROSS LANDMARKS
    • PRESENT DEFINITION OF THE GASTROESOPHAGEAL JUNCTION
    • WHAT IS THE CARDIA? LET’S REMOVE THIS TERM FROM OUR VOCABULARY
    • THE LOGICAL CONCLUSION THAT SHOULD BE TESTED
  • Chapter 5: Histologic Definitions and Diagnosis of Epithelial Types
    • Publisher Summary
    • DEFINITIONS
    • PROBLEMS WITH THE DEFINITIONS
    • DIAGNOSIS OF DIFFERENT EPITHELIAL TYPES
    • Literature Review
  • Chapter 6: Cardiac Mucosa
    • Publisher Summary
    • WHAT IS CARDIAC MUCOSA?
    • WHERE IS CARDIAC MUCOSA LOCATED (Figure 6.1)?
    • IS CARDIAC MUCOSA PRESENT IN EVERYONE?
    • Literature Review
    • WHAT IS OXYNTOCARDIAC MUCOSA, AND WHERE IS IT?
    • HOW MUCH CARDIAC AND OXYNTOCARDIAC MUCOSA ARE PRESENT?
    • WHAT DOES THE PRESENCE/ABSENCE AND AMOUNT OF CARDIAC MUCOSA MEAN?
    • WHAT DOES INCREASING LENGTH OF CARDIAC MUCOSA MEAN?
    • A HUMAN EXPERIMENT
    • Literature Review
    • SUMMARY STATEMENT REGARDING CARDIAC MUCOSA
  • Chapter 7: New Histologic Definitions of Esophagus, Stomach, and Gastroesophageal Junction
    • Publisher Summary
    • LET US ESTABLISH COMMON GROUND IN HISTOLOGY
    • Literature Review
    • LET US UNDERSTAND THE PROBLEM
    • NORMAL HISTOLOGY OF THE ESOPHAGUS AND STOMACH: A STATEMENT OF FACT AND NEW HISTOLOGIC DEFINITIONS
    • APPLICATION OF THESE DEFINITIONS TO PRACTICE
  • Chapter 8: Pathology of Reflux Disease at a Cellular Level: Part 1—Damage to Squamous Epithelium and Transformation into Cardiac Mucosa
    • Publisher Summary
    • REFLUX-INDUCED DAMAGE OF THE SQUAMOUS EPITHELIUM
    • COLUMNAR METAPLASIA OF THE SQUAMOUS EPITHELIUM
    • SUMMARY
  • Chapter 9: The Pathology of Reflux Disease at a Cellular Level: Part 2—Evolution of Cardiac Mucosa to Oxyntocardiac Mucosa and Intestinal Metaplasia
    • Publisher Summary
    • HISTOLOGIC COMPOSITION OF COLUMNAR-LINED ESOPHAGUS
    • CARDIAC TO OXYNTOCARDIAC MUCOSA: THE BENIGN GENETIC SWITCH
    • CARDIAC MUCOSA TO INTESTINAL METAPLASIA: THE SECOND GENETIC SWITCH
    • Literature Review
    • Literature Review
    • Literature Review
    • Literature Review
    • Literature Review
    • Literature Review
    • Literature Review
  • Chapter 10: Pathology of Reflux Disease at a Cellular Level: Part 3—Intestinal (Barrett) Metaplasia to Carcinoma
    • Publisher Summary
    • CARCINOGENESIS IN INTESTINAL METAPLASIA
    • DOES ADENOCARCINOMA ARISE IN ESOPHAGUS WITHOUT INTESTINAL (BARRETT) METAPLASIA?
    • Literature Review
    • NATURAL HISTORY OF DYSPLASIA: SURVEILLANCE FOR BARRETT ESOPHAGUS
    • Literature Review
    • Literature Review
    • Literature Review
    • DOES DYSPLASIA REVERSE?
    • THEORETICAL CONSIDERATIONS RELATING TO ADENOCARCINOMA DISTRIBUTION IN THE COLUMNAR-LINED ESOPHAGUS
    • ASSESSMENT OF CANCER RISK IN BARRETT ESOPHAGUS
    • Literature Review
    • CLINICALLY USEFUL MOLECULAR TESTS
    • Literature Review
    • CAUSE OF CARCINOGENESIS IN BARRETT ESOPHAGUS
  • Chapter 11: Pathology of Reflux Disease at an Anatomic Level
    • Publisher Summary
    • Literature Review
    • IDENTIFICATION AND VALIDATION OF THE TRUE GASTROESOPHAGEAL JUNCTION
    • Literature Review
    • THE ANATOMIC CHANGES ASSOCIATED WITH SLIDING HIATAL HERNIA
    • STAGES BETWEEN NORMAL AND SLIDING HIATAL HERNIA: THE REFLUX-DAMAGED DISTAL ESOPHAGUS—DEFINING THE END-STAGE ESOPHAGUS
    • Literature Review
    • RELATIONSHIP OF THE DILATED END-STAGE ESOPHAGUS TO COLUMNAR-LINED ESOPHAGUS
    • THE DISCREPANCY HAS NOW DISAPPEARED
    • ANATOMY AND HISTOLOGY OF A SLIDING HIATAL HERNIA
    • THE GREAT HISTORICAL MISUNDERSTANDING CONTINUES TO THE PRESENT
  • Chapter 12: Reflux Disease Limited to the Dilated End-Stage Esophagus: The Pathologic Basis of NERD
    • Publisher Summary
    • GASTROESOPHAGEAL REFLUX VERSUS REFLUX DISEASE
    • REFLUX DISEASE LIMITED TO THE DILATED END-STAGE ESOPHAGUS
    • A NEW LOOK AT INTESTINAL METAPLASIA OF THE GASTRIC CARDIA
    • Literature Review
    • Literature Review
    • Literature Review
    • A NEW LOOK AT ADENOCARCINOMA OF THE GASTRIC CARDIA
    • Literature Review
  • Chapter 13: Definition of Gastroesophageal Reflux Disease and Barrett Esophagus
    • Publisher Summary
    • PRESENTLY USED CRITERIA FOR DEFINING GASTROESOPHAGEAL REFLUX DISEASE
    • DEFINITIONS BASED ON QUANTITATING GASTROESOPHAGEAL REFLUX
    • PROPOSED NEW CRITERION FOR DEFINING GASTROESOPHAGEAL REFLUX DISEASE
    • REFLUX CARDITIS: A NEW ENTITY THAT DEFINES GASTROESOPHAGEAL REFLUX DISEASE WITH PERFECTION
    • Literature Review
    • Literature Review
    • Literature Review
    • Literature Review
    • Literature Review
    • Literature Review
    • Literature Review
    • A NEW DEFINITION OF BARRETT ESOPHAGUS
    • Literature Review
  • Chapter 14: Diagnosis of Gastroesophageal Reflux Disease, Barrett Esophagus, and Dysplasia
    • Publisher Summary
    • A NEW DIAGNOSTIC METHOD FOR REFLUX DISEASE
    • THE DIAGNOSIS OF REFLUX CARDITIS AND BARRETT ESOPHAGUS
    • THE DIAGNOSIS OF DYSPLASIA IN BARRETT ESOPHAGUS
    • Literature Review
    • Literature Review
    • Literature Review
    • Literature Review
    • Literature Review
  • Chapter 15: Research Strategies for Preventing Reflux-Induced Adenocarcinoma
    • Publisher Summary
    • MECHANISMS OF CELLULAR CHANGES IN REFLUX DISEASE
    • THE MECHANISM OF METAPLASIA: EPITHELIA DO NOT “MOVE”
    • THE REFLUX-ADENOCARCINOMA SEQUENCE
    • RECOGNITION OF DIFFERENT RISK LEVELS IN THE EPITHELIA OF COLUMNAR-LINED ESOPHAGUS
    • THE STATE OF PRESENT PHARMACEUTICAL INTERVENTION IN REFLUX DISEASE
    • ACID SUPPRESSIVE DRUGS PROMOTE ESOPHAGEAL ADENOCARCINOMA
    • PROPOSED NEW PHARMACEUTICAL RESEARCH TARGETS AIMED AT PREVENTING ADENOCARCINOMA
    • RESEARCH INTO SURGICAL METHODS OF PREVENTING ADENOCARCINOMA
    • IDENTIFYING FACTORS IN GASTRIC JUICE RESPONSIBLE FOR MOLECULAR EVENTS
    • MOLECULAR RESEARCH INTO CARCINOGENESIS
  • Chapter 16: Rationale for Treatment of Reflux Disease and Barrett Esophagus
    • Publisher Summary
    • THE PRESENT RATIONALE FOR TREATMENT OF REFLUX DISEASE
    • ACID SUPPRESSION WITH DRUGS AS TREATMENT FOR REFLUX DISEASE
    • Literature Review
    • Literature Review
    • Literature Review
    • DOES ACID SUPPRESSIVE DRUG THERAPY INCREASE THE RISK OF ADENOCARCINOMA?
    • Literature Review
    • ANTIREFLUX SURGERY AS TREATMENT FOR REFLUX DISEASE
    • Literature Review
    • Literature Review
    • Literature Review
    • Literature Review
    • Literature Review
    • Literature Review
    • Literature Review
    • Literature Review
    • Literature Review
    • ABLATION AS TREATMENT FOR BARRETT ESOPHAGUS
  • Chapter 17: Treatment Strategies for Preventing Reflux-Induced Adenocarcinoma
    • Publisher Summary
    • ASYMPTOMATIC VERSUS SYMPTOMATIC PATIENTS
    • Literature Review
    • PRESENT TREATMENT OF REFLUX DISEASE
    • OUTCOME OF PRESENT TREATMENT REGIMENS
    • REFLUX DISEASE IS THE PREMALIGNANT PHASE OF CANCER
    • ANTIREFLUX SURGERY CAN PREVENT PROGRESSION IN THE REFLUX TO ADENOCARCINOMA SEQUENCE; CANCER CAN BE PREVENTED
    • DEFINITION OF THE BIOPSY PROTOCOL FOR INDEX DIAGNOSIS
    • CLASSIFICATION OF RISK BASED ON BIOPSY RESULTS
    • RECOMMENDATIONS FOR TREATMENT OF BIOPSY-DEFINED GROUPS
    • RECOMMENDED CHANGES IN THE TREATMENT OF DEFINED PATIENT GROUPS
    • Literature Review
    • Literature Review
    • COST OF ANTIREFLUX SURGERY
    • Literature Review
    • Literature Review
    • RESOURCES NEEDED TO IMPLEMENT RECOMMENDED CHANGES
    • SUMMARY OF RECOMMENDED CHANGES
  • Index

Details

No. of pages:
464
Language:
English
Copyright:
© Elsevier Science 2006
Published:
Imprint:
Elsevier Science
eBook ISBN:
9780080464749
Hardcover ISBN:
9780123694164
Paperback ISBN:
9781493300730

About the Author

Parakrama Chandrasoma

Dr. Parakrama Chandrasoma was born in Sri Lanka and received his medical education and initial pathology training in the Medical School of the University of Sri Lanka. He has postgraduate degrees in internal medicine, including the M.D. (Sri Lanka) and Membership of the Royal College of Physicians (UK). He immigrated to the United States in 1978. Upon completing his pathology residency, he assumed duties as Chief of Surgical Pathology at the Los Angeles County + University of Southern California Medical Center He has held this position since. After an initial interest in neuropathology, Dr. Chandrasoma joined Dr. Tom DeMeester’s Foregut Surgery team as pathologist in 1991. This led to a productive study of gastroesophageal reflux disease spanning 16 years and resulting in the development of numerous original concepts relating to the pathogenesis of gastroesophageal reflux disease. Dr. Chandrasoma has written over 140 peer reviewed papers and 6 previous pathology textbooks, including a general text on Gastrointestinal Pathology and a text on Gastroesophageal Reflux Disease, and is a Professor of Pathology at the Keck School of Medicine at the University of Southern California. He is married with three children and lives in Pasadena, California.

Affiliations and Expertise

Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

Parakrama Chandrasoma

Dr. Parakrama Chandrasoma was born in Sri Lanka and received his medical education and initial pathology training in the Medical School of the University of Sri Lanka. He has postgraduate degrees in internal medicine, including the M.D. (Sri Lanka) and Membership of the Royal College of Physicians (UK). He immigrated to the United States in 1978. Upon completing his pathology residency, he assumed duties as Chief of Surgical Pathology at the Los Angeles County + University of Southern California Medical Center He has held this position since. After an initial interest in neuropathology, Dr. Chandrasoma joined Dr. Tom DeMeester’s Foregut Surgery team as pathologist in 1991. This led to a productive study of gastroesophageal reflux disease spanning 16 years and resulting in the development of numerous original concepts relating to the pathogenesis of gastroesophageal reflux disease. Dr. Chandrasoma has written over 140 peer reviewed papers and 6 previous pathology textbooks, including a general text on Gastrointestinal Pathology and a text on Gastroesophageal Reflux Disease, and is a Professor of Pathology at the Keck School of Medicine at the University of Southern California. He is married with three children and lives in Pasadena, California.

Affiliations and Expertise

Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

Tom DeMeester

Professor of Clinical Surgery and Chair of the Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.

Affiliations and Expertise

University of Southern California, Keck School of Medicine, Los Angeles, California, USA

Reviews

“This is the most comprehensive book ever written about gastroesophageal reflux disease. Dr. Tom R. DeMeester has been the leading authority on this disease of the 20th century, and has headed for the last 15 years one of the most productive units of foregut surgery in the world. Dr. Chandrasoma has recently emerged as a leading pathologist in this area. The authors have extensively covered all aspects of gastroesophageal reflux disease, from the anatomy to the pathophysiology, from the diagnosis to the rationale for treatment. They have carefully reviewed the literature in view of their own experience, explaining how this disease can progress from symptoms to cancer. An essential reading for whoever treats patients with gastroesophageal reflux disease, from gastroenterologists to surgeons.” --Marco G. Patti, MD, Professor of Surgery, University of California, San Francisco "One would be hard pressed to find a better collaboration to characterize the total clinical spectrum of esophageal adenocarcinoma than Tom DeMeester and Para Chandrasoma. This textbook is rich with the fruits of the knowledge and experience of these two outstanding investigators, including not only the full range of commonly accepted knowledge and beliefs in this field but also developing concepts on the histopathologic relationship between chronic reflux and injury to the distal esophageal mucosa that have resulted from detailed observation and clinical research from this illustrious team. Failure to appreciate the histologic changes that occur with, and therefore predict, the process of development of adenocarcinoma leave the clinician with a false sense of understanding. As the authors state, “most influential physicians on the subject today simply do not look through the microscope and have no true understanding of histology.” The approach that this team follows at the University of Southern California is based on their belief that “to be successful, the super specialized clinical esophagologist must understand the significance of the microscopic pathology of the biopsies that are taken, and the super specialized esophageal pathologist must understand the clinical basis of columnar-lined esophagus." All of us who are involved in the care of patients with esophageal adenocarcinoma owe a debt of gratitude to Drs. DeMeester and Chandrasoma for producing the exceptional material contained within this text." --Donald O. Castell, MD, Professor of Medicine, Director, Esophageal Disorders Program, Medical University of South Carolina “Everyone interested in esophageal disease should read this book. It is unlike any other I have ever read on the subject and is likely the most controversial and thought provoking of any on this disease. The book represents the collected experience and opinions of the book’s 2 authors – an accomplished pathologist (Dr. Chandrasoma) and arguably the most accomplished esophageal surgeon of his time (Dr. DeMeester) – who have worked together at the same institution for approximately 15 years in a surgical esophageal and foregut group that sees complex and difficult gastroesophageal reflux disease (GERD) cases. This book is extremely well written, carefully and thoughtfully prepared, and offers the open-minded reader a view of GERD that they would not read in any standard textbook or review article on the subject. The rich descriptions of the histopathology, views on carditis, cardiac intestinal metaplasia; and the microscopic definition of the gastroesophageal junction are valuable to all that study this disease.” – Philp O. Katz, Thomas Jefferson University and Albert Einstein Medical Center, Philadelphia, PA, Gastroenterology, 2007 “This book describes a novel, fascinating, straight-forward approach towards understanding and management of gastroesophageal reflux disease(GERD), a disease that is ‘all about us’. The contribution, written by two outstanding authorities with world-wide reputation and acceptance in the field of esophagology, esophageal surgery and gastrointestinal histopathology, mediates a novel and easy to follow concept for every day clinical praxis in the management of persons with gastroesophageal reflux disease. The book is well written, clearly structured and easy to read. Numerous excellent cartoons, black/white and color images profoundly add to improve understanding of physiology and histopathology. In addition, the authors present a critical appraisal towards recent literature on the topic including their own work. The conclusions drawn by the authors are well founded by the literature. The book is highly recommended to those who want to become better in the management of their patients with gastroesophageal reflux disease.” – Johannes Lenglinger and Martin Riegler, European Surgery, 2007. "This timely and authoritative book was written by two masters in the field whose experiance spans two decades and includes supervision of studies involving more than 10,000 patients. The book is well written and demonstrates the advantages of having a limited number of authors and a narrow focus - namely; consistency of style and a cohesive philosophy." - Subhas Banerjee and Jacques Van Dam, Stanford University School of Medicine, 2007