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Gastroesophageal reflux disease (GERD)

Definition :

Gastroesophageal reflux disease (GERD) is a condition in which food or liquid travels backwards from the stomach to the esophagus (the tube from the mouth to the stomach). This action can irritate the esophagus, causing heartburn and other symptoms.

Cause :

Gastroesophageal reflux is a common condition that often occurs without symptoms after meals. In some people, the reflux is related to a problem with the lower esophageal sphincter, a band of muscle fibers that usually closes off the esophagus from the stomach. If this sphincter doesn`t close properly, food and liquid can move backward into the esophagus and may cause the symptoms.


Sign & Symptoms :

  • Heartburn
    • Involves a burning pain in the chest (under the breastbone)
    • Increased by bending, stooping, lying down, or eating
    • Relieved by antacids
    • More frequent or worse at night
  • Belching
  • Regurgitation of food
  • Nausea and vomiting
  • Vomiting blood
  • Hoarseness or change in voice
  • Sore throat
  • Difficulty swallowing
  • Cough or wheezing

Diagnose :

  • A positive stool guaiac
  • Continuous esophageal pH monitoring showing reflux
  • Endoscopy showing ulceration or inflammation of the esophagus
  • Esophageal manometry showing abnormal sphincter pressure
  • A barium swallow showing reflux
  • A positive Bernstein test for gastric acid reflux

Treatment :

  • Antacids after meals and at bedtime
  • Histamine H2 receptor blockers
  • Promotility agents
  • Proton pump inhibitors

Anti-reflux operations (Nissen fundoplication) may help a small number of patients who have persistent symptoms despite medical treatment. There are also new therapies that can be performed through an endoscope (a flexible tube passed through the mouth into the stomach) for reflux.


Prevention :

Avoid foods and activities that worsen symptoms. Maintain a healthy weight.


Risk Factor :

The risk factors for reflux include hiatal hernia, pregnancy, and scleroderma.

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