Summary
Background: Gastro-oesophageal reflux disease has a complex pathophysiology. Therefore, therapeutic considerations should not only include the peptic component of the disease.
Methods: A variety of studies in rats and in humans demonstrate the consequences of gastro-oesophageal reflux and medical and surgical interventions in terms of inflammation, epithelial growth stimulation, apoptosis and oxidative stress in the epithelium of the oesophagus.
Results: Gastro-oesophageal reflux disease consists of a variety of pathophysiologically important factors. These include changes in the anatomy, gastro-oesophageal motility, epithelial growth, inflammation, apoptosis and molecular structure and may lead to carcinogenesis. Surgery restores the antireflux barrier and improves oesophageal and gastric motility, thus preventing the consequences of the disease.
Conclusions: Antireflux surgery provides a causative therapy of gastrointestinal reflux disease.