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In gastroenterology, esophageal pH monitoring is the current gold standard for diagnosis of gastroesophageal reflux disease (GERD). It provides direct physiologic measurement of acid in the esophagus and is the most objective method to document reflux disease, assess the severity of the disease and monitor the response of the disease to medical or surgical treatment.
The angle of His forms an anatomical sphincter. This prevents the reflux of stomach acid, digestive enzymes, and duodenal bile from entering the esophagus. [4] [5] This is important in preventing gastroesophageal reflux disease and inflammation of the esophagus. [5]
Patients that continue to have reflux symptoms or that have had uncontrolled reflux symptoms for more than 5 years are also candidates for surgical management. [6] Complications that arise from long term GERD such as severe esophagitis, stricture formation, and ulcer development, all of which can be seen on endoscopy, warrant surgical intervention.
This is then typically followed by surgery, although some treat the condition without surgery by using atropine. [1] Results are generally good in both the short term and the long term. [1] About one to two per 1,000 babies are affected, and males are affected about four times more often than females. [1] The condition is very rare in adults. [6]
Pyloromyotomy is a surgical procedure in which a portion of the muscle fibers of the pyloric muscle are cut. This is typically done in cases where the contents from the stomach are inappropriately stopped by the pyloric muscle, causing the stomach contents to build up in the stomach and unable to be appropriately digested.
Medications that may cause or worsen the disease include benzodiazepines, calcium channel blockers, tricyclic antidepressants, NSAIDs, and certain asthma medicines. Acid reflux is due to poor closure of the lower esophageal sphincter, which is at the junction between the stomach and the esophagus.
Stretta is a minimally invasive endoscopic procedure for the treatment of gastroesophageal reflux disease (GERD) that delivers radiofrequency energy in the form of electromagnetic waves through electrodes at the end of a catheter to the lower esophageal sphincter (LES) and the gastric cardia – the region of the stomach just below the LES.
Billroth II, more formally Billroth's operation II, is an operation in which a partial gastrectomy (removal of the stomach) is performed and the cut end of the stomach is closed.
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