Gastroesophageal Reflux Disease (GERD)

GERD: Definition, Factors causing, Symptoms, Complications, Treatment

Acid Peptic Diseases are:

   1. Gastroesophageal Reflux Disease (GERD)

   2. Peptic Ulcer Disease (PUD)

        - Gastric Ulcer

        - Duodenal Ulcer (common)

Gastroesophageal Reflux Disease (GERD):

 Definition:

GERD is a digestive disorder characterized by the return of stomach's contents back up into the esophagus due to the weakening or inappropriate relaxation of lower sphincter of esophagus. 

Factors causing GERD:

Dietary and lifestyle choices like:

   1. Certain foods like chocolates, fatty foods, alcohol beverages

   2. Obesity

   3. Pregnancy

Symptoms:    

   1. Heartburn: A burning feeling of chest just after eating

   2. Regurgitation of food or liquids with a taste of acid

   3. Dyspepsia: discomfort in upper abdomen

   4. Stomach pain sometimes

   5. Extra esophageal:

       - Chronic cough

       - Persistent hoarseness and laryngitis

       - Persistent sore throat

       - Dental erosions 

Complications: 

   1. Chronic esophagitis: Bleeding and stricture (hematemesis or          melena) 

   2. Barrett's metaplasia

   3. Adenocarcinoma

Treatment: 

Lifestyle modification is most important.

   1. Avoidance of food that reduce lower esophageal sphincter pressure making them reflex genic e.g. fatty food, coffee, tea etc.

   2. Avoidance of acidic food that are inherently irritating 

   3. Elevation of head and neck

   4. Avoidance of eating just before sleeping

   5. Weight reduction

Certain drugs can be given to such patients

   1. Proton pump inhibitors e.g. Omeprazole, Pantoprazole etc.

   2. Histamine-2 receptor antagonists e.g. Ranitidine

Or Surgery if needed: Laparoscopic Nissen fundoplication

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