Recent Advances in Management of Gastroesophageal Reflux

Abstract

Results of Dr. Cohen's investigations of the human lower esophageal sphincter have revolutionized our understanding of the pathogenesis of heartburn. In this article, he applies his findings to a consideration of the medical and surgical therapy appropriate for patients with gastroesophageal reflux (with or without esophagitis) and the attendant complications of ulcer and stricture. Differentiating esophageal from cardiac pain is a major clinical problem. Both respond to nitroglycerin. Reproduction of pain with typical ECG changes during treadmill exercise stress is a helpful finding.—AR