GERD: Reflux to Esophageal Adenocarcinoma

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Academic Press, Jul 26, 2010 - Science - 464 pages
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Gastroesophageal Reflux Disease (GERD) is one of the most common maladies of mankind. Approximately 40% of the adult population of the USA suffers from significant heartburn and the numerous antacids advertised incessantly on national television represents a $8 billion per year drug market. The ability to control acid secretion with the increasingly effective acid-suppressive agents such as the H2 blockers (pepcid, zantac) and proton pump inhibitors (nexium, prevacid) has given physicians an excellent method of treating the symptoms of acid reflux.

Unfortunately, this has not eradicated reflux disease. It has just changed its nature. While heartburn, ulceration and strictures have become rare, reflux-induced adenocarcinoma of the esophagus is becoming increasingly common. Adenocarcinoma of the esophagus and gastric cardia is now the most rapidly increasing cancer type in the Western world.

The increasing incidence of esophageal adenocarcinoma has created an enormous interest and stimulus for research in this area. GERD brings together a vast amount of disparate literature and presents the entire pathogenesis of reflux disease in one place. In addition to providing a new concept of how gastroesophageal reflux causes cellular changes in the esophagus, GERD also offers a complete solution to a problem that has confused physicians for over a century. Both clinical and pathological information about reflux disease and its treatment are presented. GERD is meant to be used as a comprehensive reference for gastroenterologists, esophageal surgeons, and pathologists alike.
  • Outlines how gastroesophageal reflux causes cellular changes in the esophagus
  • Brings together the pathogenesis of the disease in one source and applies it toward clinical treatment
  • Tom DeMeester is THE leading international expert on reflux disease; Parakrama Chandrasoma is one of the leading pathologists in the area
  • Book contains approximately 350 illustrations
  • Ancillary web site features color illustrations:

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Overview of Gastroesophageal Reflux Disease
The Past Present and Future of ColumnarLined Barrett Esophagus
Fetal Development of the Esophagus and Stomach
Normal Anatomy Present Definition of the Gastroesophageal Junction
Histologic Definitions and Diagnosis of Epithelial Types
Cardiac Mucosa
New Histologic Definitions of Esophagus Stomach and Gastroesophageal Junction
Pathology of Reflux Disease at a Cellular Level Part 1Damage to Squamous Epithelium and Transformation into Cardiac Mucosa
Pathology of Reflux Disease at an Anatomic Level
Reflux Disease Limited to the Dilated EndStage Esophagus The Pathologic Basis of NERD
Definition of Gastroesophageal Reflux Disease and Barrett Esophagus
Diagnosis of Gastroesophageal Reflux Disease Barrett Esophagus and Dysplasia
Research Strategies for Preventing RefluxInduced Adenocarcinoma
Rationale for Treatment of Reflux Disease and Barrett Esophagus
Treatment Strategies for Preventing RefluxInduced Adenocarcinoma

The Pathology of Reflux Disease at a Cellular Level Part 2Evolution of Cardiac Mucosa to Oxyntocardiac Mucosa and Intestinal Metaplasia
Pathology of Reflux Disease at a Cellular Level Part 3Intestinal Barrett Metaplasia to Carcinoma
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Page 8 - Devesa SS, Blot WJ, Fraumeni JF Jr. Changing patterns in the incidence of esophageal and gastric carcinoma in the United States.
Page 9 - Blot WJ, Devesa SS, Kneller RW, Fraumeni JF Jr. Rising incidence of adenocarcinoma of the esophagus and gastric cardia.

About the author (2010)

Dr. Parakrama Chandrasoma was born in Sri Lanka and received his medical education and initial pathology training in the Medical School of the University of Sri Lanka. He has postgraduate degrees in internal medicine, including the M.D. (Sri Lanka) and Membership of the Royal College of Physicians (UK). He immigrated to the United States in 1978. Upon completing his pathology residency, he assumed duties as Chief of Surgical Pathology at the Los Angeles County + University of Southern California Medical Center He has held this position since. After an initial interest in neuropathology, Dr. Chandrasoma joined Dr. Tom DeMeester’s Foregut Surgery team as pathologist in 1991. This led to a productive study of gastroesophageal reflux disease spanning 16 years and resulting in the development of numerous original concepts relating to the pathogenesis of gastroesophageal reflux disease. Dr. Chandrasoma has written over 140 peer reviewed papers and 6 previous pathology textbooks, including a general text on Gastrointestinal Pathology and a text on Gastroesophageal Reflux Disease, and is a Professor of Pathology at the Keck School of Medicine at the University of Southern California. He is married with three children and lives in Pasadena, California.

Professor of Clinical Surgery and Chair of the Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.

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