Review article: from gastrin to gastro-oesophageal reflux disease--a century of acid suppression.

Abstract:

:To commemorate Edkins' discovery of gastrin in 1905, we review a century of progress in the physiology and pathobiology of gastrin and acid secretion especially as it pertains to clinical aspects of gastro-oesophageal reflux disease. Although initially ignored, Edkins' observations eventually led to the enthusiastic investigation of gastrin and acid regulation in peptic ulcer disease, culminating in important therapeutic advances in the management of acid peptic disease. Following the improved understanding of gastric secretory physiology, and the development of acid suppressants with increasing efficacy, the use of surgical intervention for peptic ulcer disease was almost eliminated. Surgery became obsolete with the discovery of Helicobacter pylori. Three other advances are also influencing modern practice: the gastrotoxicity of aspirin and non-steroidal anti-inflammatory drugs is now increasingly appreciated, the role of endoscopy in the diagnosis and therapy of upper gastrointestinal bleeding, and the use of intravenous acid-suppressive agents. The major issue for the future resides within the epidemic of gastro-oesophageal reflux disease. How to diagnose, categorize and treat this condition and how to identify and prevent neoplasia, are the challenges of the new century.

journal_name

Aliment Pharmacol Ther

authors

Malfertheiner P,Fass R,Quigley EM,Modlin IM,Malagelada JR,Moss SF,Holtmann G,Goh KL,Katelaris P,Stanghellini V,Talley NJ,Tytgat GN,Wright NA

doi

10.1111/j.1365-2036.2006.02817.x

subject

Has Abstract

pub_date

2006-03-15 00:00:00

pages

683-90

issue

6

eissn

0269-2813

issn

1365-2036

pii

APT2817

journal_volume

23

pub_type

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