Gastroesophageal reflux disease overview: Difference between revisions
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==Pathophysiology== | ==Pathophysiology== | ||
Pathophysiology of GERD depends on several mechanisms that lead to the retrograde movement of the acidic content of the stomach to the esophagus. These mechanisms include transient lower esophageal sphincter relaxation, hypotensive lower esophageal sphincter, hiatal hernia, and prolonged esophageal acid clearance. | |||
==Causes== | ==Causes== | ||
Common causes of GERD include obesity, autonomic neuropathy, systemic sclerosis, esophageal achalasia, and hiatus hernia. Other causes of GERD include hypochlorhydria, hypercalcemia, and [[Zollinger-Ellison syndrome]]. | |||
==Differentiating {{PAGENAME}} from Other Diseases== | ==Differentiating {{PAGENAME}} from Other Diseases== |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:
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Overview
Gastroesophageal reflux disease is defined as chronic symptoms due to damage to the esophageal mucosa as a result of abnormal reflux of acidic stomach contents into the esophagus[1]. This is commonly due to transient or permanent changes in the barrier between the esophagus and the stomach. This can be due to incompetence of the lower esophageal sphincter (LES), transient LES relaxation, impaired expulsion of gastric reflux from the esophagus, or a hiatal hernia. Chronic GERD is associated with an increased risk of Barrett's esophagus which is a premalignant condition of the esophageal mucosa which is in turn associated with an increased risk of adenocarcinoma of the esophagus.
Historical Perspective
GERD is believed to be first described and treated by the ancient Egyptians according to the papyrus which was discovered by Edwin Smith at Thebes. The esophagus itself was named by the ancient Greeks. Friedenwald and Feldman described the symptoms of GERD in 1925. Robbins and Jankelson used the radiological procedures to observe GERD in 1926.
Classification
GERD can be classified based on the endoscopic appearance of the esophageal mucosa and the clinical presentation of the disease.
Pathophysiology
Pathophysiology of GERD depends on several mechanisms that lead to the retrograde movement of the acidic content of the stomach to the esophagus. These mechanisms include transient lower esophageal sphincter relaxation, hypotensive lower esophageal sphincter, hiatal hernia, and prolonged esophageal acid clearance.
Causes
Common causes of GERD include obesity, autonomic neuropathy, systemic sclerosis, esophageal achalasia, and hiatus hernia. Other causes of GERD include hypochlorhydria, hypercalcemia, and Zollinger-Ellison syndrome.
Differentiating Gastroesophageal reflux disease overview from Other Diseases
GERD must be differentiated from other diseases like gastritis, peptic ulcer, crohn's disease, gastric adenocarinoma, and gastrinoma.
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications, and Prognosis
Natural History
Complications
Prognosis
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Laboratory Findings
Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Prevention
References
- ↑ DeVault KR, Castell DO. Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease. The Practice Parameters Committee of the American College of Gastroenterology. Am J Gastroenterol 1999;94:1434-42. PMID 10364004.