Background

Gastroesophageal reflux disease (GERD) affects 20-30% of the population in Europe and the USA. In addition to symptom induced impairment of life quality GERD is associated with morphologic changes in the esophagus. Reflux causes esophagitis, columnar metaplasia without and with intestinal metaplasia (=Barrett's esophagus). Those with Barrett's esophagus are at risk to develop adenocarcinoma of the esophagus (0.5% annual incidence; this is 1 out of 10 persons with Barrett's esophagus may develop cancer in 20 years). Progression towards cancer occurs along a sequence involving specific histologic changes: Barrett's, low-, high grade dysplasia (=intraepithelial neoplasia) and cancer. Conceptually cancer development can be prevented if the precursor lesions (columnar lined esophagus without and with intestinal mataplasia) are detected and treated. As a consequence screening endoscopy seems to be useful for prevention of esophageal adenocarcinoma.

GERD presents with a spectrum of different symptoms (heartburn, regurgitation, cough, wheezing, burning sensation in the throat, globus sensation etc.). As a consequence patients with GERD symptoms approach physicians of different specialities.

Therefore Gastroesophageal reflux disease (GERD) represents a perfect example, where the interdisciplinary approach is required for disease management. In keeping with this notion, physicians at the Medical University Vienna (MUW), recently launched an interdisciplinary platform for GERD management in Austria, the "GERD Center of Excellence".

The "GERD Center of Excellence" is supported by the Austrian Ministry of Health and the Austrian Medical Chamber. According to a recent Austrian Press Agency (APA) report, Walter Dorner M.D., the President of the Austrian Medical Chamber, pointed out the importance of an interdisciplinary approach towards complex diseases and stated that he largely supports the activities of the "GERD Center of Excellence".