GERD (Gastro-esophageal Reflux Disease): important notes

Let’s check some important notes of GERD including clinical features, diagnosis and treatment

Factors preventing gastro-oesophageal reflux

• 1.Esophago-gastric angle
• 2.Pinchcock action of the right crus of diaphragm
• 3.Rosette like folds of mucous membrane at the cardia.

Etiology: Incompetence of the lower oesophageal sphincter(LES) causes gastro-esophageal reflux.

Important notes of Clinical features in GERD

• Retrosternal burning pain (heartburn) and epigastricpain which is aggravated by fatty foods (fattydyspepsia)–common symptom
• Dysphagia  due to peptic strictureand opainful swalloing-odynophagia
• Recurrent pulmonary aspiration may cause aspirationpneumonia.

Diagnosis

1.Endoscopy – may show reflux esophagitis, pepticstricture or Barrett’s esophagus.

2.Manometry – to exclude achlasia.

3.24 hours pH recording – gold standard.

4. X-ray with Barium swallow

5.Bernstein test – acid infusion test.

Treatment

Medical- includes antiemetics (metoclopramide), PPIs(omeprazole).

b.Surgery- total (described by Nissen) or partialfundoplication (laparoscopic).

Also read:Acid reflux: causes, symptoms & management

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