Articles
GERD
Tsung-Hsien Chiang M.D.
Division of Gastroenterology and Hepatology, Department of Internal Medicine,
Far Eastern MemorialHospital
Gastroesophageal reflux disease, commonly referred to as GERD, or acid reflux, is a condition in which the liquid content of the stomach regurgitates (backs up, or refluxes) into the esophagus. The liquid can inflame and damage the lining of the esophagus although this occurs in a minority of patients. The regurgitated liquid usually contains acid and pepsin that are produced by the stomach. Acid is believed to be the most injurious component of the refluxed liquid. GERD is a chronic condition. Once it begins, it usually is life-long. If there is injury to the lining of the esophagus, this also is a chronic condition. Moreover, after the esophagus has healed with treatment and treatment is stopped, the injury will return in most patients within a few months. Once treatment for GERD is begun, therefore, it usually will need to be continued indefinitely.
The cause of GERD is complex. There probably are multiple causes, and different causes may be operative in different individuals or even in the same individual at various times. The factors that contribute to causing GERD are the lower esophageal sphincter, hiatal hernias, esophageal contractions, and emptying of the stomach.
What are the symptoms of uncomplicated GERD?
The symptoms of uncomplicated GERD are primarily heartburn, regurgitation, and nausea.
What are the complications of GERD?
The symptoms of complicated GERD are ulcers, strictures, Barrett's esophagus, cough, asthma, inflammation of the throat and larynx, inflammation and infection of the lungs, and fluid in the sinuses and middle ears.
How is GERD diagnosed and evaluated?
The ways of diagnosis for GERD are included as follows: therapeutic trial, endoscopy, X-rays, examination of the throat and larynx, esophageal acid testing, esophageal motility testing, gastric emptying studies, and acid perfusion test.
The ways of treatment for GERD are included as follows: life-style changes, antacids usage, histamine antagonist usage, proton pump inhibitor usage, pro-motility drugs, and surgery.
