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Related Concept Videos

Gastroesophageal Reflux Disease II: Clinical Features and Management01:29

Gastroesophageal Reflux Disease II: Clinical Features and Management

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Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
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Gastroesophageal Reflux Disease I: Meaning and Pathophysiology01:29

Gastroesophageal Reflux Disease I: Meaning and Pathophysiology

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Gastroesophageal Reflux Disease (GERD) involves the recurrent backflow of the stomach or duodenal contents into the esophagus, leading to troublesome symptoms and potential esophageal mucosal damage. Although GERD is often referred to as a disease, it is more accurately described as a syndrome, as it encompasses a range of symptoms and complications rather than a singular pathological entity, impacting a large number of individuals as the most prevalent upper gastrointestinal problem. Roughly...
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Esophageal Strictures-I: Introduction01:30

Esophageal Strictures-I: Introduction

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Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
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Esophageal Strictures-II: Clinical Features and Management01:26

Esophageal Strictures-II: Clinical Features and Management

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Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
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Barrett Esophagus-II: Clinical Manifestations and Management01:21

Barrett Esophagus-II: Clinical Manifestations and Management

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Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
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Barrett Esophagus-I: Introduction01:21

Barrett Esophagus-I: Introduction

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Barrett's esophagus is a medical condition where the esophageal mucosa is significantly damaged by stomach acid or other digestive fluids, often due to long-term exposure associated with gastroesophageal reflux disease (GERD). In GERD, a weakened or abnormally relaxed lower esophageal sphincter allows stomach acid to flow persistently into the esophagus.
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more...
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Esophageal Reflux Hypersensitivity: A Comprehensive Review.

Akinari Sawada1, Daniel Sifrim2, Yasuhiro Fujiwara1

  • 1Department of Gastroenterology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.

Gut and Liver
|January 2, 2023
PubMed
Summary

Reflux hypersensitivity (RH) involves reflux symptoms and symptom association despite normal acid exposure. Current knowledge on RH, a phenotype of gastroesophageal reflux disease, is summarized, highlighting unmet treatment needs.

Keywords:
Behavioral disordersFunctional esophageal disordersGastroesophageal reflux diseaseImpedance-pH monitoringReflux hypersensitivity

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Area of Science:

  • Gastroenterology
  • Esophageal Physiology
  • Functional Gastrointestinal Disorders

Background:

  • Reflux hypersensitivity (RH) is a phenotype of gastroesophageal reflux disease (GERD).
  • Rome IV criteria define RH by typical reflux symptoms and positive reflux-symptom association with normal acid exposure.
  • Esophageal hypersensitivity is a key factor in RH pathophysiology, often overlapping with other functional gastrointestinal disorders.

Purpose of the Study:

  • To summarize current knowledge on reflux hypersensitivity (RH).
  • To review the pathophysiology and diagnostic criteria of RH.
  • To highlight the unmet medical needs in RH treatment.

Main Methods:

  • Literature review of Rome IV criteria and Lyon consensus.
  • Summary of current understanding of esophageal hypersensitivity mechanisms.
  • Analysis of the overlap between RH and other functional gastrointestinal disorders.

Main Results:

  • Rome IV provides clear diagnostic criteria for RH.
  • The Lyon consensus established expert-defined cutoff values for RH diagnosis.
  • Esophageal hypersensitivity is central to RH, with identified pathophysiological mechanisms.

Conclusions:

  • Reflux hypersensitivity is a distinct GERD phenotype characterized by symptom perception despite normal acid reflux.
  • Understanding RH pathophysiology is crucial, but effective treatments remain a significant unmet need.
  • Further research is needed to address the therapeutic gap in managing reflux hypersensitivity.