Biomaterial Database

Gastroesophageal reflux disease: beyond mucosal injury. 2007

Reza Shaker

Division of Gastroenterology and Hepatology, Department of Medicine, MCW Digestive Disease Center, Medical College of Wisconsin, Milwaukee, WI 53223, USA. rshaker@mcw.edu

Emerging information on physiology and pathophysiology of gastroesophageal reflux disease raises the question of whether our thought process should go beyond mucosal injury and consider 2 parallel tracks that may cross each other at some time, but at other times they may indeed remain parallel, that is, neurally mediated effects of reflux events beyond the esophageal wall and inflammation mediated effect of reflux within the esophageal wall. In this process, intraesophageal events with and without causing mucosal injury may induce changes in the neural function on a temporary or long-term basis resulting in symptoms at different organs and various levels not completely in lock-step with esophageal mucosal injury. Emerging data also suggest the influence of liminal and subliminal esophageal acid exposure on cerebral cortical networks involved in motor function such as swallowing in addition to its effect on sensory centers. These observations suggest the existence of a more extensive influence of esophageal sensory input to the cerebral cortical processing mechanisms than previously thought and may provide new avenues for research in pathophysiology of reflux disease.

UI	MeSH Term	Description	Entries
D008279	Magnetic Resonance Imaging	Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques.	Chemical Shift Imaging,MR Tomography,MRI Scans,MRI, Functional,Magnetic Resonance Image,Magnetic Resonance Imaging, Functional,Magnetization Transfer Contrast Imaging,NMR Imaging,NMR Tomography,Tomography, NMR,Tomography, Proton Spin,fMRI,Functional Magnetic Resonance Imaging,Imaging, Chemical Shift,Proton Spin Tomography,Spin Echo Imaging,Steady-State Free Precession MRI,Tomography, MR,Zeugmatography,Chemical Shift Imagings,Echo Imaging, Spin,Echo Imagings, Spin,Functional MRI,Functional MRIs,Image, Magnetic Resonance,Imaging, Magnetic Resonance,Imaging, NMR,Imaging, Spin Echo,Imagings, Chemical Shift,Imagings, Spin Echo,MRI Scan,MRIs, Functional,Magnetic Resonance Images,Resonance Image, Magnetic,Scan, MRI,Scans, MRI,Shift Imaging, Chemical,Shift Imagings, Chemical,Spin Echo Imagings,Steady State Free Precession MRI
D009092	Mucous Membrane	An EPITHELIUM with MUCUS-secreting cells, such as GOBLET CELLS. It forms the lining of many body cavities, such as the DIGESTIVE TRACT, the RESPIRATORY TRACT, and the reproductive tract. Mucosa, rich in blood and lymph vessels, comprises an inner epithelium, a middle layer (lamina propria) of loose CONNECTIVE TISSUE, and an outer layer (muscularis mucosae) of SMOOTH MUSCLE CELLS that separates the mucosa from submucosa.	Lamina Propria,Mucosa,Mucosal Tissue,Muscularis Mucosae,Mucous Membranes,Membrane, Mucous,Membranes, Mucous,Mucosae, Muscularis,Mucosal Tissues,Propria, Lamina,Tissue, Mucosal,Tissues, Mucosal
D009475	Neurons, Afferent	Neurons which conduct NERVE IMPULSES to the CENTRAL NERVOUS SYSTEM.	Afferent Neurons,Afferent Neuron,Neuron, Afferent
D002540	Cerebral Cortex	The thin layer of GRAY MATTER on the surface of the CEREBRAL HEMISPHERES that develops from the TELENCEPHALON and folds into gyri and sulci. It reaches its highest development in humans and is responsible for intellectual faculties and higher mental functions.	Allocortex,Archipallium,Cortex Cerebri,Cortical Plate,Paleocortex,Periallocortex,Allocortices,Archipalliums,Cerebral Cortices,Cortex Cerebrus,Cortex, Cerebral,Cortical Plates,Paleocortices,Periallocortices,Plate, Cortical
D003679	Deglutition	The act of taking solids and liquids into the GASTROINTESTINAL TRACT through the mouth and throat.	Swallowing,Deglutitions,Swallowings
D004947	Esophagus	The muscular membranous segment between the PHARYNX and the STOMACH in the UPPER GASTROINTESTINAL TRACT.
D005744	Gastric Acid	Hydrochloric acid present in GASTRIC JUICE.	Hydrochloric Acid, Gastric,Acids, Gastric,Acids, Gastric Hydrochloric,Gastric Acids,Gastric Hydrochloric Acid,Gastric Hydrochloric Acids,Hydrochloric Acids, Gastric
D005764	Gastroesophageal Reflux	Retrograde flow of gastric juice (GASTRIC ACID) and/or duodenal contents (BILE ACIDS; PANCREATIC JUICE) into the distal ESOPHAGUS, commonly due to incompetence of the LOWER ESOPHAGEAL SPHINCTER.	Esophageal Reflux,Gastro-Esophageal Reflux Disease,GERD,Gastric Acid Reflux,Gastric Acid Reflux Disease,Gastro-Esophageal Reflux,Gastro-oesophageal Reflux,Gastroesophageal Reflux Disease,Reflux, Gastroesophageal,Acid Reflux, Gastric,Gastro Esophageal Reflux,Gastro Esophageal Reflux Disease,Gastro oesophageal Reflux,Gastro-Esophageal Reflux Diseases,Reflux Disease, Gastro-Esophageal,Reflux, Gastric Acid,Reflux, Gastro-Esophageal,Reflux, Gastro-oesophageal
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000344	Afferent Pathways	Nerve structures through which impulses are conducted from a peripheral part toward a nerve center.	Afferent Pathway,Pathway, Afferent,Pathways, Afferent