Clinician's Guide to Oesophageal Diseases

Gastro-oesophageal reflux is one of the commonest chronic medical disorders affecting the western world with nearly 10 per cent of the population seeking medical advice at some point in their lifetime. Certainly it is by far the commonest organic dyspeptic disorder, being at least four times as common as peptic ulcer. Interest in the disorder has mushroomed in the since 1990 both because of easy availability of specific investigations and the development of dramatically effective medical treatment, the proton pump inhibitors, whilst the advent of laparoscopic fundoplication has resulted in a resurgence of interest in surgery. Adenocarcinoma of the oesophagus, a consequence of gastro-oesophageal reflux, has been reported to be increasing in incidence more rapidly than any other malignancy in the Western world. Usually it is secondary to Barrett's oesophagus, itself a result of long-standing gastro-oesophageal reflux. Thus gastro-oesophageal reflux is not always a benign disease. This book focuses particularly on clinical aspects of gastro-oesophageal reflux, but will also include sections on other common clinical oesophageal problems including motility disorders, non-cardiac chest pain, neoplasms and the place of the oesophageal laboratory in the district general hospital.