Question

What is GERD?

Answer 1

GERD - Gastro Esophageal Reflux Disease

Explanation:

Gastro Esophageal Reflux Disease is a condition,where gastric content flushes out through the gastroesophageal junction and the refluxed content causes severe irritation of the lower part of esophageal mucosa leading to heartburn.

Causes

1. Esophageal Hernia:(Erosive)

In case of hiatal esophageal hernia and rolling esophageal hernia,part of stomach herniates into the lower end of esophagus with or without a piece of omentum,which leads to random entry of gastric content(mostly responsible is HCL) into the esophagus and resulting in erosive conditions.

1. Non erosive GERD :

This is seen in patients suffering from Hypertensive lower esophageal sphincter,a condition where there is no alteration in esophageal contraction pattern as a result just after e meal,gastric content specially HCL when comes up into the lower end of esophagus leads to massive Heart burn.

Pathology

As a result of this,severe inflammatory reactions occurs in the esophagus and can lead to ulceration.

Clinical Features

Nausea,vomiting,upper abdominal discomfort,pain,heart burn(mimics pain in the heart)

Long term Complications

1.Ulceration and perforation

2.Adenocarcinoma of affected region(as metaplasia occurs from esophageal type of epithelium to columnar type of epithelium)

Treatment

1. Proton pump inhibitors like Omeprazole,lansoprazole,pantoprazol (20 mg OD for 6 weeks) combined with Domperidone(helps in gastric emptying so chances of reflux is reduced passively)

2. Histamine receptor blockers:(H2 blocker) Famotidine,Ranitidine etc.