Peptic Esophagitis

Winkelstein, A

doi:10.1001/jama.1935.02760110034008

Cited by 173 publications

(8 citation statements)

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“…The association between gastroesophageal reflux and inflammation of the distal esophageal mucosa was first expounded by Winkelstein in 1935 [1] . Barrett himself acknowledged that gastroesophageal reflux may be a cause of the eponymously titled metaplastic lesion that precedes adenocarcinoma [2] , and future human observations [3] and animal experiments [4] were to provide evidence for such.…”

Section: Introductionmentioning

confidence: 99%

Gastroesophageal Reflux in Relation to Adenocarcinomas of the Esophagus: A Pooled Analysis from the Barrett’s and Esophageal Adenocarcinoma Consortium (BEACON)

Cook

Corley

Murray³

et al. 2014

PLoS ONE

138

112

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BackgroundPrevious studies have evidenced an association between gastroesophageal reflux and esophageal adenocarcinoma (EA). It is unknown to what extent these associations vary by population, age, sex, body mass index, and cigarette smoking, or whether duration and frequency of symptoms interact in predicting risk. The Barrett’s and Esophageal Adenocarcinoma Consortium (BEACON) allowed an in-depth assessment of these issues.MethodsDetailed information on heartburn and regurgitation symptoms and covariates were available from five BEACON case-control studies of EA and esophagogastric junction adenocarcinoma (EGJA). We conducted single-study multivariable logistic regressions followed by random-effects meta-analysis. Stratified analyses, meta-regressions, and sensitivity analyses were also conducted.ResultsFive studies provided 1,128 EA cases, 1,229 EGJA cases, and 4,057 controls for analysis. All summary estimates indicated positive, significant associations between heartburn/regurgitation symptoms and EA. Increasing heartburn duration was associated with increasing EA risk; odds ratios were 2.80, 3.85, and 6.24 for symptom durations of <10 years, 10 to <20 years, and ≥20 years. Associations with EGJA were slighter weaker, but still statistically significant for those with the highest exposure. Both frequency and duration of heartburn/regurgitation symptoms were independently associated with higher risk. We observed similar strengths of associations when stratified by age, sex, cigarette smoking, and body mass index.ConclusionsThis analysis indicates that the association between heartburn/regurgitation symptoms and EA is strong, increases with increased duration and/or frequency, and is consistent across major risk factors. Weaker associations for EGJA suggest that this cancer site has a dissimilar pathogenesis or represents a mixed population of patients.

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Section: Introductionmentioning

confidence: 99%

Gastroesophageal Reflux in Relation to Adenocarcinomas of the Esophagus: A Pooled Analysis from the Barrett’s and Esophageal Adenocarcinoma Consortium (BEACON)

Cook

Corley

Murray³

et al. 2014

PLoS ONE

138

112

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“…Winklestein first described gastro‐oesophageal reflux disease (GERD) in 1935, 1 and Allison 2 highlighted the association between oesophagitis and hiatus hernia. For many years it was thought that a hiatus hernia had to be present for reflux to occur 3 .…”

Section: Introductionmentioning

confidence: 99%

The role of the hiatus hernia in gastro‐oesophageal reflux disease

Gordon¹,

Kang²,

Neild³

et al. 2004

Aliment Pharmacol Ther

165

130

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A sliding hiatus hernia disrupts both the anatomy and physiology of the normal antireflux mechanism. It reduces lower oesophageal sphincter length and pressure, and impairs the augmenting effects of the diaphragmatic crus. It is associated with decreased oesophageal peristalsis, increases the cross-sectional area of the oesophago-gastric junction, and acts as a reservoir allowing reflux from the hernia sac into the oesophagus during swallowing. The overall effect is that of increased oesophageal acid exposure. The presence of a hiatus hernia is associated with symptoms of gastrooesophageal reflux, increased prevalence and severity of reflux oesophagitis, as well as Barrett's oesophagus and oesophageal adenocarcinoma. The efficacy of treatment with proton pump inhibitors is reduced. Our view on the significance of the sliding hiatus hernia in gastrooesophageal reflux disease has changed enormously in recent decades. It was initially thought that a hiatus hernia had to be present for reflux oesophagitis to occur. Subsequently, the hiatus hernia was considered an incidental finding of little consequence. We now appreciate that the hiatus hernia has major patho-physiological effects favouring gastro-oesophageal reflux and hence contributing to oesophageal mucosal injury, particularly in patients with severe gastro-oesophageal reflux disease.

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“…This technique for measuring gastroesophageal régurgitation has been described. 6 Three hun¬ dred milliliters of 0.1 N hydrochloric acid were introduced into the stomach of 9 subjects to serve as an indicator of gastroesophageal reflux, should it occur; no acid was given to the remaining 3 …”

Section: Methodsmentioning

confidence: 99%

Gastroesophageal Regurgitation

Tuttle¹

1961

JAMA

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Peptic Esophagitis

Cited by 173 publications

References 0 publications

Gastroesophageal Reflux in Relation to Adenocarcinomas of the Esophagus: A Pooled Analysis from the Barrett’s and Esophageal Adenocarcinoma Consortium (BEACON)

Gastroesophageal Reflux in Relation to Adenocarcinomas of the Esophagus: A Pooled Analysis from the Barrett’s and Esophageal Adenocarcinoma Consortium (BEACON)

The role of the hiatus hernia in gastro‐oesophageal reflux disease

Gastroesophageal Regurgitation

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