Gastroesophageal Reflux Disease (also known as GERD) is a condition whereby the eating pipe or esophagus is irritated due to reflux or backflow of the stomach contents. GERD is clinically diagnosed and can be managed through lifestyle modifications and medications.
The esophagus comprises of an opening on its lower end (also known as the lower esophageal sphincter). This opens in response to food contents entering the stomach. However, if this sphincter weakens or undergoes abnormal relaxation, it gives way to the stomach acid to backflow up towards the esophageal lining and irritates it.
GERD’s contributing factors include obesity and pregnancy, while aggravating factors include large or late-night meals, fatty meals, alcoholic and caffeinated beverages, and smoking. GERD can also occur on a background of certain conditions like gastroparesis, hiatal hernia, and scleroderma (a connective tissue disease). In terms of prevalence, GERD is found in 10-20% of the people in the West, while the prevalence is less than 5% in Asia.
The signs and symptoms of GERD include:
GERD is diagnosed clinically through history and physical exam. Patients are usually started on a trial of medications, either by neutralizing the stomach acid, blocking the stomach acid production, or decreasing the stomach acid production. Diagnostic tests can be used in certain cases. These tests include:
The differential diagnosis for GERD includes pill esophagitis, infectious esophagitis, eosinophilic esophagitis, achalasia, gastritis, peptic ulcer disease, and esophageal cancer.
GERD can be managed through lifestyle modifications and medications. Lifestyle modifications include:
Medications for GERD are based on the severity of the condition. In mild GERD with intermittent symptoms, antacids can be used. For frequent episodes or chronic GERD, medications which block acid production, also known as PPIs or acid-reducing medications, also called H2-receptor blockers (cimetidine, ranitidine), can be used.
Procedures like Nissen fundoplication can be performed if symptoms persist. However, patients are usually started on a trial on PPIs first.
Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on May 19, 2023.
Acid Reflux (GER & GERD) in Adults - NIDDK (nih.gov)
Advances in the diagnosis and management of gastroesophageal reflux disease | The BMJ