Dr. Siva Maran, MD
Morristown Gastroenterology

705 North High Street Suite A
Morristown, TN 37814
Phone: 423-587-0860
Fax: 423-289-1267

Gastroesophageal reflux disease

Gastroesophageal reflux 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 ("transient").

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:

Heartburn
Regurgitation
Trouble swallowing (dysphagia)

Less-common symptoms include:

Pain with swallowing (odynophagia)
Increased salivation (also known as water brash)
Nausea
Chest pain

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 esophagus.
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:

Chronic cough
Laryngitis (hoarseness, throat clearing)
Asthma
Erosion of dental enamel
Dentine hypersensitivity
Sinusitis and damaged teeth
Pharyngitis

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.



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