Mechanisms of Barrett's oesophagus (clinical): LOS dysfunction, hiatal hernia, peristaltic defects

摘要: Barrett's oesophagus, with the potential to develop into oesophageal adenocarcinoma (OAC), is a major complication of gastrooesophageal reflux disease (GORD). However, about 50% patients developing OAC had no known GORD beforehand. Hence, while symptoms, oesophagitis, and have number common determinants (oesophagogastric junction (OGJ) incompetence, impaired clearance mechanisms, hiatus hernia) they also some independent determinants. Further, although excess acid exposure plays role in genesis long-segment oesophagus there minimal evidence supporting this for short-segment Barrett's. these may unique pathophysiological features as well. Long-segment seems share most, if not all, risk factors particularly high-grade oesophagitis. it uncertain OGJ function are more severely compared With respect Barrett's, pocket play an important pathogenic role. Conceptually, extension distal intra-sphincteric reflux, provides mechanism or osophageal mucosa without occurrence discrete events, which likely prompt symptoms lead development related acid/no interface at proximal margin be key short segment currently still somewhat speculative further studies required confirm this.