Sunday, December 14th, 2008 at
3:40 am
What Is Gerd?
Gastroesophageal reflux disease (GERD) is a more serious form of gastroesophageal reflux (GER), which is common. GER occurs when the lower esophageal sphincter (LES) opens spontaneously, for varying periods of time, or does not close properly and stomach contents rise up into the esophagus. GER is also called acid reflux or acid regurgitation, because digestive juicescalled acidsrise up with the food.
The esophagus is the tube that carries food from the mouth to the stomach. The LES is a ring of muscle at the bottom of the esophagus that acts like a valve between the esophagus and stomach.
Gastroesophageal reflux disease, or GERD, affects at least an estimated 5% to 7% of the global population – men, women, and children. (Prevalence based on once per day heartburn.) heartburn and/or acid regurgitation experienced weekly has been found to occur in 19.8% of individuals.[1]
Anyone, including infants and children, can have GERD. If not treated, it can lead to more serious health problems. In some cases, you might need medicines or surgery. However, many people can improve their symptoms by
Avoiding alcohol and spicy, fatty or acidic foods that trigger heartburn
Eating smaller meals
Not eating close to bedtime
losing weight if needed
Wearing loose-fitting clothes
What are the symptoms of uncomplicated GERD?
The symptoms of uncomplicated GERD are primarily heartburn, regurgitation, and nausea. Other symptoms occur when there are complications of GERD and will be discussed with the complications.
What causes heartburn and GERD?
To understand gastroesophageal reflux disease or GERD, it is first necessary to understand what causes heartburn. Most people will experience heartburn if the lining of the esophagus comes in contact with too much stomach juice for too long a period of time. This stomach juice consists of acid, digestive enzymes, and other injurious materials. The prolonged contact of acidic stomach juice with the esophageal lining injures the esophagus and produces a burning discomfort.
Pathophysiology
The physiological and anatomical factors that prevent the reflux of gastric juice from the stomach into the esophagus include the following:
The lower esophageal sphincter (LES) must have a normal length and pressure and a normal number of episodes of transient relaxation (relaxation in the absence of swallowing).
The gastroesophageal junction must be located in the abdomen so that the diaphragmatic crura can assist the action of the LES, thus functioning as an extrinsic sphincter. The presence of a hiatal hernia disrupts this synergistic action and can promote reflux.
Complications of Long-Term GERD
If gastroesophageal reflux disease (GERD – also referred to as acid reflux disease) is not treated effectively, the constant acid reflux can irritate the lining of the esophagus, and serious complication can occur.
The more serious complications of GERD that may occur are Barrett’s esophagus, esophageal cancer, laryngeal cancer, erosive esophagitis, and esophageal strictures.
Management of GERD with chest pain
Coronary artery disease should be given ample consideration early in the diagnostic protocol in patients presenting with chest pain because the implications of this diagnosis are more profound than are those of GERD. Patients with unexplained chest pain should be considered to have a cardiac cause for their pain until proven otherwise, and should be evaluated by an ECG and Exercise stress test before a GI evaluation.
By: James Sameul
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