Tuesday, August 2, 2011

Gastroesophageal Reflux Disease(GERD)

GERD or gastroesophageal reflux disease occurs when stomach acid from the stomach back into the esophagus, often causes inflammation of the esophagus - esophagitis. Reflux refers to the movement upward or reverse upward from the stomach to the esophagus.

If untreated gastroesophageal reflux disease the patient may experience great discomfort and inflammation of the esophagus. This is sometimes linked to serious complications such as narrowing (criticism) of the esophagus, Barrett's esophagus (severe damage to the esophagus, which is linked to the development of cancer), ulceration, and bleeding.

Complications are more likely to occur as a result of reflux at night, days of reflux. However, reflux of day can also lead to complications.

What is erosive esophagitis?

This is when the lining of the esophagus has been damaged or eroded by long-term exposure to stomach acid - a common problem with acid reflux is not treated.
How common are GERD and erosive esophagitis?
In industrialized countries, between 20% and 40% of adults experience heartburn regularly. Heartburn is the main symptom of gastroesophageal reflux disease.

hospitalized patients commonly have concurrent conditions such as GERD. A contemporary condition is one that accompanies another.

It is estimated that more than half of those suffering from GERD may have erosive esophagitis.

What are the symptoms of GERD?

Heartburn is usually the main symptom, a burning sensation that rises from the stomach or lower chest towards the neck and throat.

A bitter or acid in the bottom of the gorge is sometimes experienced.

Most of us experience occasional heartburn. When this happens two or more times a week, and 'therefore more likely to be a symptom of GERD.

The correlation between the severity of symptoms and the presence / degree of esophagitis is poor, and can not be used as diagnostic guidelines.

What causes GERD?

GERD occurs when the anti-reflux mechanism at the junction between the esophagus and stomach do not work properly. This may be due to a weak lower esophageal sphincter should close the esophagus from the stomach and stop acid reflux from happening.
How is GERD diagnosed?

If a patient experiences heartburn at least twice a week, GERD is usually suspect.

The doctor will do a careful review of symptoms.

History Endoscopy can be used to confirm the diagnosis is suspected. However, less than 50% of patients with GERD have diagnostic endoscopic abnormalities.

GERD and erosive esophagitis as they are treated?

For management to be effective GERD gastric acidity of the patient should be reduced, while its intragastric pH should be above 4 - keeping it above 4 reduces damage to the esophagus of refluxed gastric contents.

PPI (proton pump inhibitor) therapy is very effective in maintaining intragastric pH above 4, as it suppresses the secretion of stomach acid, and is the recommended first-line treatment for all patients with GERD (Guidelines Geneva). Proton pump inhibitors inhibit the proton (acid) pumps the cells lining the stomach wall - preventing the secretion of gastric acid.

Since starting treatment with the most successful therapy, the greater initial cost of the drug will likely be offset by a rapid control of symptoms for the patient and the reduced need for repeated consultations.

No comments:

Post a Comment