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GERD - A New Understanding of Pathology, Pathophysiology, and Treatment (Hardcover)
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GERD - A New Understanding of Pathology, Pathophysiology, and Treatment (Hardcover)
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GERD: A New Understanding of Pathology, Pathophysiology, and
Treatment transforms the assessment of gastroesophageal reflux
disease (GERD) from its present state, which is largely dependent
on clinical definition and management, to a more objective
scientific basis that depends on pathologic assessment. Sequential
chapters in this single-author book describe the fetal development
of the esophagus, the normal adult state, and the way exposure to
gastric juice causes epithelial and lower esophageal sphincter
damage at a cellular level. It allows recognition of the pathologic
manifestations of lower esophageal sphincter damage and develops
new histopathologic criteria for quantitating such damage. This
understanding provides new pathologic criteria for definition and
diagnosis of GERD from its earliest cellular stage. Algorithms
based on measurement of sphincter damage can identify, even before
the onset of clinical GERD, persons who will never develop GERD
during life, those who develop GERD but remain with mild and easily
controlled disease, and those who will progress to severe GERD with
failure to control symptoms, Barrett esophagus and adenocarcinoma.
Aggressive early intervention in the last group with the objective
of preventing disease progression to its end points of uncontrolled
symptoms and adenocarcinoma becomes feasible.
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