Gastroesophageal reflux disease

Gastroesophageal reflux disease (GERD) is a common chronic disorder affecting millions of people worldwide. This is a review of a number of published studies in the past year that increase current understanding or raise important issues about this disorder. Among the areas covered are the epidemiology and role of genetics in GERD; its pathogenesis with respect to duodenogastric reflux and impaired epithelial barrier function; the effects of atropine on transient lower esophageal sphincter relaxations; the role of acid suppression, heat shock proteins, and the enzyme cyclooxygenase-2 in Barrett esophagus and esophageal adenocarcinoma; the complication rates in laparoscopic fundoplication; and the results of ablation therapy for the treatment of Barrett esophagus and esophageal adenocarcinoma. These investigations reinforce a sense of the complexity of GERD and provide optimism that modern technology will continue to be used to develop more effective treatments.