Esophageal Motility and Gastroesophageal Reflux

Gastroesophageal reflux disease (GERD) represents a real social problem in the western world. About 20% of population has at least once a week, typical symptoms of this disease (heartburn and acid regurgitation); this incidence is probably underestimated because many patients have symptoms referable to extra-esofageal locations (asthma, cough, hoarseness, , non cardiogenic chest pain). The Montreal consensus conference defined GERD as “a condition which develops when the reflux of gastric contents causes troublesome symptoms and/or complications” (Vakil et al.,2006) But this definition does not take into account all possible pathogenetic causes and their therapeutic implications. Therefore seems more relevant to the definition of Brazilian consensus conference who considered GERD to be “a chronic disorder related to the retrograde flow of gastro-duodenal contents into the esophagus and/or adjacent organs, resulting in a spectrum of symptoms, with or without tissue damage”(Moraes-Filho et al.,2002). This definition recognizes the chronic character of the disease, and acknowledges that the refluxate can be gastric and duodenal in origin, with important implications for the treatment of this disease (Herbella & Patti, 2010).