Gastroesophageal Reflux Disease (GERD) is a chronic condition where stomach contents (acid, bile, pepsin) reflux into the esophagus, causing troublesome symptoms or complications.
Mechanism
Lower esophageal sphincter (LES) incompetence: transient relaxations, low pressure, or hiatal hernia allow reflux.
Typical Symptoms
- Heartburn (retrosternal burning)
- Regurgitation (sour/bitter taste)
Atypical/Extraesophageal Symptoms
- Chronic cough, laryngitis, asthma exacerbation
- Dental erosion, globus sensation
- Non-cardiac chest pain
Complications
- Erosive esophagitis, strictures, Barrett's esophagus (premalignant), adenocarcinoma.
Management
- Lifestyle: Weight loss, head-of-bed elevation, avoid triggers (fat, caffeine, alcohol, late meals), smoking cessation.
- Medications: PPIs (first-line), H2RAs, antacids, alginates.
- Surgery: Fundoplication (refractory cases).
Diagnosis: clinical, PPI trial, endoscopy, pH-impedance monitoring.
