disease (GERD), gastro-oesophageal reflux disease (GORD),
gastric reflux disease, or acid reflux disease is a
chronic symptom of mucosal damage caused by stomach acid
coming up from the stomach into the esophagus. A typical
symptom is heartburn.
GERD is usually caused by changes in the barrier between
the stomach and the esophagus, including abnormal
relaxation of the lower esophageal sphincter, which
normally holds the top of the stomach closed; impaired
expulsion of gastric reflux from the esophagus, or a
hiatal hernia. These changes may be permanent or temporary
Another kind of acid reflux, which causes respiratory and
laryngeal signs and symptoms, is called laryngopharyngeal
reflux (LPR) or "extraesophageal reflux disease"
(EERD). Unlike GERD, LPR is unlikely to produce heartburn,
and is sometimes called silent reflux.
Signs and symptoms
The most-common symptoms of GERD are:
Trouble swallowing (dysphagia)
Less-common symptoms include:
Pain with swallowing (odynophagia)
Increased salivation (also known as water brash)
GERD sometimes causes injury of the esophagus. These
injuries may include:
Reflux esophagitis – necrosis of esophageal epithelium
causing ulcers near the junction of the stomach and
Esophageal strictures – the persistent narrowing of the
esophagus caused by reflux-induced inflammation.
Barrett's esophagus – intestinal metaplasia (changes of
the epithelial cells from squamous to intestinal columnar
epithelium) of the distal esophagus.
Esophageal adenocarcinoma – a rare form of cancer.
Several other atypical symptoms are associated with GERD,
but there is good evidence for causation only when they
are accompanied by esophageal injury. These symptoms are:
Laryngitis (hoarseness, throat clearing)
Erosion of dental enamel
Sinusitis and damaged teeth
Some people have proposed that symptoms such as sinusitis,
recurrent ear infections, and idiopathic pulmonary
fibrosis are due to GERD; however, a causative role has
not been established.