Professional Documents
Culture Documents
GORD
While typical GERD symptoms are balanced between comparator groups, the distribution of
complications becomes progressively skewed in gender, geographic and racial distribution.
*GORD symptoms are similar between Western and Middle Eastern countries, but are lower in
Eastern countries.
PATHOPHYSIOLOGY
The earlier belief that increased gastro
esophageal reflux mainly results from
one dominant mechanism has been
replaced by acceptance that GORD is
multifactorial
| Possible gastroesophageal reflux disease pathophysiologies
AT Cellular level :
Exposure of the oesophageal
wall to the refluxate results in :
a | An inflammatory response occurs in the squamous
epithelium, induced by the release of inflammatory
mediators, which
b | Leads to the subsequent chemoattraction and infiltration
of immune cells and is
c | Followed by the proliferative
response of the epithelium..
Kandulski, A. & Malfertheiner, P. Nat. Rev. Gastroenterol. Hepatol. 9,
15–22 (2012);
So , it is not that simple
THREE ROLES
Body
weight
Gut
microbiot
a
Firing
foods
OBESITY
Gastroesophageal Pressure Gradients & GERD:
The Importance of Obesity
It plays several important biological roles including: aiding in digestion and absorption of
nutrients from partially digested food, production of SCFA – a primary energy source for
intestinal epithelial cells (IECs), stimulating immune responses by releasing ligands, and
protection against enteropathogens by production of antimicrobial peptides (AMPs)
Factors affecting gut microbiota
Is dysbiosis of the upper-GI tract to blame for
esophageal gastroesophageal reflux disease
(GERD) and it’s related conditions, Barrett’s
esophagus and adenocarcinoma?
Undoubtedly, we need to eradicate virulent H. pylori in
people with adverse clinical manifestations, but this
conclusion cannot be generalized to all H. pylori positive
subjects.
For the past four years we’ve known
that individuals with GERD have imbalances in
the microbial ecology of the distal esophagus.
Weight
control
Healthy
microbiota
Thank You