Gastroesophageal refulx disease (GERD) is one of the most common chronic disorders of modern humans. In this report, we describe some recent advances in our understanding of various aspects of this disorder. The issues addressed include 1) the role ofhelicobacter pyloriinfection and acid-pepsin secretion in the pathogenesis of GERD and its complications, 2) the presence on electron microscopy of novel morphologic feature, 3) the contribution of free radicals to esophageal ijury, 4) the addition of intractable nausea to its atypical presentations, 5) the results of a cost-utility analysis for medical versus surgical treatment, and 6) advances in our approach to treatment of GERD. Collectively, these studies expand our base of knowledge about GERD on all major fronts: pathogenesis, diagnosis, and treatment.
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