Clinicians' Guide to Oesophageal Diseases

Gastro-oesophageal reflux is one of the commonest chronic medical disorders affecting the western world with nearly 10% 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 last decade both because of easy availability of specific investigations and the development of dramatically effective medical treatment - the proton pump inhibitors - while the advent of laparoscopic fundoplication has resulted in a resurgence of interest in surgery. There is now almost universal recognition that adenocarcinoma of the oesophagus is increasing in incidence in the western world more rapidly than any other tumor. 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 also includes 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.