Current Research and Scholarly Interests
My primary research interest concerns factors involved in the pathogenesis of gastro-esophageal reflux disease (GERD) and its complications, such as Barrett's esophagus. Over the past decade I have explored the potential role of COX-2 expression and activity, prostaglandin and leukotriene production and cell proliferation in inducing and amplifying symptoms and disease evolution. Ongoing studies in the area of Barrett's metaplasia involve characterizing unique cell surface or intracellular molecular changes that occur in the early stages of metaplastic transformation and identification of environmental factors that predispose to esophageal metaplasia. In particular, I am interested in the role of acid and bile reflux in modifying cellular alterations and contributing to dysplasia and neoplasia. Furthermore, in clinical studies, I am investigating the role of 24-hour dual pH monitoring in the management of patients with reflux-like dyspepsia, esophagitis, and Barretts esophagus, and particularly the role of intensive proton pump inhibitor therapy in chemoprevention against esophageal adenocarcinoma. I have a very active clinical base of patients with Barretts esophagus in which advanced diagnostic (narrow band imaging, in vivo confocal microscopy, chromo-endoscopy) as well as therapeutic (endoscopic mucosal resection, radiofrequency ablation) modalities are prospectively explored and validated.