Dear Colleagues,

Gastroesophageal reflux disease (GERD) is the most prevalent gastrointestinal tract disease in the world and has recently been increasing in incidence not only in Europe and the United States but also in Asia. These are organic diseases that show reflux of gastric contents to the esophagus, but there is erosive reflux esophagitis that shows erosion in the lower esophageal mucosa and non-erosive gastroesophageal reflux disease (NERD) that does not show erosion. Furthermore, recently, although there is no reflux of gastric contents to the esophagus, it has become important to differentiate it from functional esophageal diseases such as functional heartburn and reflux hypersensitivity that show heartburn and acid reflux symptoms as in GERD. In recent years, with the progress of high-resolution manometry and 24 h pH-monitoring devices, it has become possible to distinguish organic esophageal motility disorders such as esophageal achalasia, Jackhammer’s disease, and diffuse esophageal spasm. In addition, it is important to distinguish eosinophilic esophagitis, whose number of patients is increasing in recent years. The mainstream of treatment is acid secretion inhibitors, but recently, P-CAB with a different action point from PPI has appeared, and it has been shown to have epoch-making effects. Unlike conventional PPI, it has an early and stable effect of increasing gastric pH and has become a drug that can almost reach the cure even in refractory erosive esophagitis. Furthermore, recent advances in prokinetics have enabled long-term control of lesions and symptoms when used in combination with PPI or P-CAB. This may include herbal medicine. On the other hand, the development of a method for inhibiting the gastroesophageal reflux mechanism endoscopically or surgically, which is not drug therapy, is also rapidly progressing. In this Special Issue, I would like to present the latest progress on GERD as a cutting-edge feature.

Prof. Dr. Hidekazu Suzuki
Guest Editor

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• high resolution manometry
• 24 h pH monitoring
• ARMS or ARMA
• surgery
• PCAB
• PPI
• prokinetics