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Review
The relevance of transient lower oesophageal sphincter relaxations in the pathophysiology and treatment of GORD
  1. Neel Sharma1,
  2. Simon H C Anderson2
  1. 1Li Ka Shing Faculty of Medicine, Institute of Medical and Health Sciences Education, The University of Hong Kong, Hong Kong, China
  2. 2Department of Gastroenterology, Guy's and St Thomas’ Hospital, London, UK
  1. Correspondence to Dr Neel Sharma, Li Ka Shing Faculty of Medicine, Institute of Medical and Health Sciences Education, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong, China; n.sharma{at}qmul.ac.uk

Abstract

Gastro-oesophageal reflux disease (GORD) is associated with the passage of gastric contents into the oesophagus resulting in potential oesophageal damage and impaired quality of life. GORD is a frequently encountered problem in today's population, with 25% of people in western populations reporting such symptoms at least once a month. Proton pump inhibitors (PPI) are the drug of choice, with surgery being employed in refractory cases. Although acid suppression is often effective, some patients remain symptomatic despite maximal PPI therapy. By delving into the mechanisms of the disease, it is clear that transient lower oesophageal sphincter relaxations are a key component of its pathophysiology. Research has demonstrated various therapeutic targets for reducing the frequency of such relaxations through GABA and glutamate modulation, for instance. This review highlights such modulations and hopes to explore these mechanisms and therapeutic targets in an area that will no doubt see a change in its pharmacological management in the near future.

  • Gastroesophageal Reflux Disease

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