Gastroesophageal reflux disease

"GERD" redirects here. For other uses, see Gerd.
"Hyperacidity" redirects here. For the condition in which there is increased acid content in the stomach, see hyperchlorhydria.
"Acid reflex" redirects here. For the studio album by hip-hop artist Paris, see Acid Reflex.

Gastroesophageal reflux disease
Other namesBritish: Gastro-oesophageal reflux disease (GORD);[1] gastric reflux disease, acid reflux disease, reflux, gastroesophageal reflux
X-ray showing radiocontrast from the stomach (white material below diaphragm) entering the esophagus (three vertical collections of white material in the mid-line of the chest) due to severe reflux
Pronunciation
SpecialtyGastroenterology
SymptomsTaste of acid, heartburn, bad breath, chest pain, breathing problems[6]
ComplicationsEsophagitis, esophageal strictures, Barrett's esophagus[6]
DurationLong term[6][7]
CausesInadequate closure of the lower esophageal sphincter[6]
Risk factorsObesity, pregnancy, smoking, hiatal hernia, taking certain medicines[6]
Diagnostic methodGastroscopy, upper GI series, esophageal pH monitoring, esophageal manometry[6]
Differential diagnosisPeptic ulcer disease, esophageal cancer, esophageal spasm, angina[8]
TreatmentLifestyle changes, medications, surgery[6]
MedicationAntacids, H2 receptor blockers, proton pump inhibitors, prokinetics[6][9]
Frequency~15% (North American and European populations)[9]
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Gastroesophageal reflux disease (GERD) or gastro-oesophageal reflux disease (GORD) is a chronic upper gastrointestinal disease in which stomach content persistently and regularly flows up into the esophagus, resulting in symptoms and/or complications.[6][7][10] Symptoms include dental corrosion, dysphagia, heartburn, odynophagia, regurgitation, non-cardiac chest pain, extraesophageal symptoms such as chronic cough, hoarseness, reflux-induced laryngitis, or asthma.[10] In the long term, and when not treated, complications such as esophagitis, esophageal stricture, and Barrett's esophagus may arise.[6]

Risk factors include obesity, pregnancy, smoking, hiatal hernia, and taking certain medications. Medications that may cause or worsen the disease include benzodiazepines, calcium channel blockers, tricyclic antidepressants, NSAIDs, and certain asthma medicines. Acid reflux is due to poor closure of the lower esophageal sphincter, which is at the junction between the stomach and the esophagus. Diagnosis among those who do not improve with simpler measures may involve gastroscopy, upper GI series, esophageal pH monitoring, or esophageal manometry.[6]

Treatment options include lifestyle changes, medications, and sometimes surgery for those who do not improve with the first two measures. Lifestyle changes include not lying down for three hours after eating, lying down on the left side, raising the pillow or bedhead height, losing weight, and stopping smoking.[6][11] Foods that may precipitate GERD symptoms include coffee, alcohol, chocolate, fatty foods, acidic foods, and spicy foods.[12] Medications include antacids, H2 receptor blockers, proton pump inhibitors, and prokinetics.[6][9]

In the Western world, between 10 and 20% of the population is affected by GERD.[9] It is highly prevalent in North America with 18% to 28% of the population suffering from the condition.[13] Occasional gastroesophageal reflux without troublesome symptoms or complications is even more common.[6] The classic symptoms of GERD were first described in 1925, when Friedenwald and Feldman commented on heartburn and its possible relationship to a hiatal hernia.[14] In 1934 gastroenterologist Asher Winkelstein described reflux and attributed the symptoms to stomach acid.[15]

  1. ^ Carroll W (14 October 2016). Gastroenterology & Nutrition: Prepare for the MRCPCH. Key Articles from the Paediatrics & Child Health journal. Elsevier Health Sciences. p. 130. ISBN 978-0-7020-7092-1. Gastro-oesophageal reflux disease (GORD) is defined as 'gastrooesophageal reflux' associated with complications including oesophagitis...
  2. ^ "Definition of "gastro-" - Collins American English Dictionary". Archived from the original on 8 December 2015.
  3. ^ "Definition of "esophagus" - Collins American English Dictionary". Archived from the original on 8 December 2015.
  4. ^ "reflux noun - Definition, pictures, pronunciation and usage notes - Oxford Advanced American Dictionary at OxfordLearnersDictionaries.com". Archived from the original on 8 December 2015.
  5. ^ "GORD | Meaning & Definition for UK English". Lexico.com. Archived from the original on 11 February 2022. Retrieved 11 February 2022.
  6. ^ a b c d e f g h i j k l m n "Acid Reflux (GER & GERD) in Adults". National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). 5 November 2015. Archived from the original on 22 February 2020. Retrieved 21 February 2020.
  7. ^ a b Kahrilas PJ, Shaheen NJ, Vaezi MF (October 2008). "American Gastroenterological Association Institute technical review on the management of gastroesophageal reflux disease". Gastroenterology. 135 (4): 1392–1413, 1413.e1–5. doi:10.1053/j.gastro.2008.08.044. PMID 18801365.
  8. ^ Kahan S (2008). In a Page: Medicine. Lippincott Williams & Wilkins. p. 124. ISBN 978-0-7817-7035-4. Archived from the original on 8 September 2017.
  9. ^ a b c d Hershcovici T, Fass R (April 2011). "Pharmacological management of GERD: where does it stand now?". Trends in Pharmacological Sciences. 32 (4): 258–64. doi:10.1016/j.tips.2011.02.007. PMID 21429600.
  10. ^ a b Parker M (June 2010). "Book Review: Krause's Food and Nutrition TherapyMahanLKEscott-StumpS. Krause's Food and Nutrition Therapy. 12th ed. Philadelphia: Saunders; (2007). 1376 pp, $$149.95. ISBN: 978-1-4160-3401-8". Nutrition in Clinical Practice. 25 (3): 314. doi:10.1177/0884533610362901. ISSN 0884-5336.
  11. ^ "Best Sleeping Position For Acid Reflux: The Gerd Sleeping Position". SleepScore. 22 April 2019. Archived from the original on 26 April 2021. Retrieved 26 April 2021.
  12. ^ Kahrilas PJ, Shaheen NJ, Vaezi MF, et al. (October 2008). "American Gastroenterological Association Medical Position Statement on the management of gastroesophageal reflux disease". Gastroenterology. 135 (4): 1383–91, 1391.e1–5. doi:10.1053/j.gastro.2008.08.045. PMID 18789939.
  13. ^ El-Serag HB, Sweet S, Winchester CC, Dent J (June 2014). "Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review". Gut. 63 (6): 871–880. doi:10.1136/gutjnl-2012-304269. ISSN 0017-5749. PMC 4046948. PMID 23853213.
  14. ^ Granderath FA, Kamolz T, Pointner R (2006). Gastroesophageal Reflux Disease: Principles of Disease, Diagnosis, and Treatment. Springer Science & Business Media. p. 161. ISBN 978-3-211-32317-5. Archived from the original on 1 January 2020. Retrieved 28 August 2017.
  15. ^ Arcangelo VP, Peterson AM (2006). Pharmacotherapeutics for Advanced Practice: A Practical Approach. Lippincott Williams & Wilkins. p. 372. ISBN 978-0-7817-5784-3. Archived from the original on 5 January 2020. Retrieved 28 August 2017.