GERD: Current Issues and Controversies : Special Topic Issue: Digestive Diseases 2000, Vol. 18, No. 1

This timely publication reviews cutting-edge knowledge and controversies associated with the diagnosis and treatment of GERD. It begins with a discussion of exciting new drug therapies which may impair transient lower esophageal sphincter relaxation and, if effective, may be particularly useful in patients with nonerosive or mild erosive reflux disease.

Intestinal metaplasia of the cardia and whether it is more likely caused by GERD or related to chronic Helicobacter pylori infection is dealt with next, also taking into consideration recent experience with cytokeratin immunohistochemical stains.

The following paper indicates that a short course of high-dose proton pump inhibitors is both accurate and cost-effective in identifying noncardiac chest pain secondary to GERD and may also be beneficial in patients with traditional reflux symptoms or GERD-related cough.

The controversies in Barrett's esophagus as related to GERD are dealt with in the next article, also addressing the question why only a small subset of Barrett's patients develop cancer.

The publication concludes with a paper on why antireflux surgery may fail, stressing the importance of selecting the right patient and elaborating on the skills required of the surgeon, as well as discussing the critical operative principles. Gastroenterologists confronted with the many facets of this protean disease will undoubtedly value the publication at hand as they are seeing more patients with both typical and atypical presentations of GERD and its complications.