Overview

During the last quarter century, there has been an explosion of knowledge in the areas of visceral and esophageal pain. The effectiveness of acid inhibition drugs (proton pump inhibitors), still the mainstay of treatment, is increasingly questioned as significant numbers of patients show little benefit from such therapy. Newer mechanisms of esophageal pain have been uncovered during last twenty years and it is quite clear that novel approaches are emerging in the treatment of pain.

Comprising contributions for leading expert authors, this is the first in-depth coverage of all aspects of esophageal pain. In great detail, chapters cover the scope of the problem; basic science – with regards to the nature of neural pathways, receptors involved in sensing pain and the role of central nervous system in sensing the pain; different stimuli responsible for the genesis of esophageal pain, including the role of acid, muscle spasm and reflux; hypersensitivity of pain receptors, spinal nerves and central nervous system; current state of the art in diagnosis and treatment strategies; and, lastly, newer pharmacological treatments currently in research and trial stages.

Audience

Primary Subject: Gastroenterology / Upper GI
Secondary Subject: Gastroenterology / Reflux and Swallowing
Audience Level: Professional

• Introduction
• 1. Heartburn and Esophageal Pain – Scope Of the Problem
  John Dent
• 2. Functional Heartburn: What Is It?
  Ronnie Fass

The Basics of Pain

• 3. Nature of Esophageal Pain Receptors
  Amanda J. Page and Ashley Blackshaw
• 4. Vagal and Spinal Distension Sensitive Primary Afferents of the Esophagus: Implications for Visceral Nociceptors
  Raj K. Goyal

Stimuli of Esophageal Pain

• 5. The Esophageal Mucosa and Heartburn
  Roy C. Orlando
• 6. Neutral Reflux (weakly acid) in Typical and Atypical GERD Symptoms
  Daniel Sifrim
• 7. Longitudinal Muscle Contraction, TLESR, Reflux & Pain
  Ravinder Mittal
• 8. Biomechanics of Sensation
  Hans Gregersen and Asbjørn Mohr Drewes

Peripheral and Central Mechanisms of Sensitivity and Hypersensitivity

• 9. Molecular Pathways and their Sensitization
  Pankaj Jay Pasricha
• 10. Cortical Processing of Esophageal Pain
  Adeyemi Lawal and Reza Shaker
• 11. Esophageal Hypersensitivity; is it peripheral or central?
  A. Sharma and Qasim Aziz

Diagnosis and Management of Esophageal Pain

• 12. Diagnostic Strategy for Esophageal Pain
  Peter J. Kahrilas
• 13. How to Treat Esophageal Chest Pain
  Satish S.C. Rao
• 14. New drugs on the Horizon for the Treatment of Esophageal Pain
  Anders Lehmann

About The Author

Ravinder Mittal, M.D.

Professor of medicine at the University of California San Diego in La Jolla, California.

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