ISBN-13: 9780128098554 / Angielski / Twarda / 2017 / 652 str.
ISBN-13: 9780128098554 / Angielski / Twarda / 2017 / 652 str.
GERD: A New Understanding of Pathology, Pathophysiology, and Treatment transforms the assessment of GERD from its present state which is largely dependent on clinical definition and management to a more objective scientific basis dependent on pathologic assessment of biopsies, transforming the way GERD is defined. It provides an examination of the way the esophagus develops, the genetic signals that determine its epithelial composition through fetal life to full development, and the way exposure of the esophagus to gastric juice causes damage at a cellular level. Identification of cellular changes provides new pathologic criteria for diagnosis of GERD and delivers an accurate method of assessment of severity of damage to the lower esophageal sphincter using a new biopsy protocol. By providing new techniques of diagnosis of sphincter damage, new methods of identifying patients who will remain controlled with medical therapy emerge, permitting early intervention.