Gastroøsofagealt

Gastroøsofagealt is an adjective used in medical Danish to describe processes, structures or diseases that involve the stomach (gastro) and the esophagus (øsofagus). In practice, it is commonly applied to the gastroøsofageale junction, the distal esophagus and the proximal stomach, along with the diaphragmatic area where the esophagus passes through the diaphragm.

Anatomy and physiology: The gastroøsofageale junction marks the transition from esophagus to stomach. The lower esophageal sphincter (LES) provides the primary anti-reflux barrier, aided by the diaphragmatic crura and the phrenoesophageal membrane. Reflux occurs when LES tone is reduced or transient relaxations occur, allowing stomach contents to enter the esophagus.

Common gastroøsofagealte conditions include gastroesophageal reflux disease (GERD), typically presenting with heartburn and regurgitation; hiatal hernia; esophagitis; and Barrett's esophagus, a metaplastic change associated with an increased risk of esophageal adenocarcinoma in the setting of chronic reflux.

Diagnosis and treatment: GERD and related disorders are evaluated with endoscopy, pH monitoring, impedance testing and esophageal manometry. Management includes lifestyle modifications (weight management, head-of-bed elevation, meal timing), acid-suppressive therapy (proton pump inhibitors or H2 receptor antagonists), and sometimes prokinetics. Surgery, such as fundoplication, or endoscopic therapies may be considered for select cases.

Prognosis and epidemiology: GERD is common worldwide and affects individuals of various ages. Risk factors include obesity, smoking, hiatal hernia and pregnancy. Complications can include esophagitis, esophageal strictures, Barrett's esophagus and, with long-standing disease, esophageal cancer. Early recognition and appropriate management improve outcomes.