Gastroesophageal reflux disease (GERD)

  • GERD is a digestive disorder that affects the ring of muscle between your Esophagus and stomach. This ring is called the lower esophageal sphincter.
  • Causes : in normal digestion, your LES opens to allow food into our stomach. Then it closes to stop food and acidic stomach juices from flowing back into your esophagus. GERD happens when the LES is weak or relaxes when it shouldn’t. This let’s the stomach’s contents flow up into the Esophagus.
  • Some doctors believe a hiatal hernia may weaken the LES and raise your chances of gastrophageal reflux. Hiatal hernia happens when the upper part of your stomach moves up into the chest through a small opening in the diaphragm.
  • Several other things can make it more likely that you’ll have GERD : being obese, pregnancy, delayed emptying of stomach (gastroparesis), diseases of connective tissue such as rheumatoid arthritis or lupus.
  • Symptoms : most common is heartburn, the burning or pain of heartburn can last as long as 2 hours. Besides pain, you may also have nausea, bad breath, trouble breathing, wearing away of tooth enamel, a lump in your throat.
  • Treatment – antacids : they neutralize acid in the Esophagus and stomach and stop heartburn.
  • H2 blockers – cimetidine, famotidine
  • Proton pump inhibitors – dexlansoprazole, esomoprazole, Omeprazole, pantoprazole
  • Prokinetics – they elp to empty the stomach faster – include domperidone, metoclopramide
  • GERD complications – esophageal ulcer, esophageal stricture, Barrett’s Esophagus, lung problems such as chest congestion or aspiration, asthma, bronchitis or even pneumonia.

Source : Robbins and Cotran’s book of pathology

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