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ABSTRACT –

Gastroesophageal Reflux Disease (GERD) or Acid Reflux is a chronic digestive disorder where there is a defect in LES (Lower esophageal sphincter) which results in stomach acid flowing back into the esophageal tube causing an irritation in the esophageal tube lining.

CAUSES –

It is caused by recurring acid reflux due to which there is an inflammation in the esophagus.
Gradually, the inflammation can tear off the lining of esophagus and cause complications like:

• Esophageal strictures
• Bleeding
• Barrett’s esophagus
• Esophageal adenocarcinoma

The other factors causing GERD are:

• Obesity
• Hypercalcemia
• Hiatal hernia
• Zollinger-Ellison syndrome
• Visceroptosis
• Scleroderma and systemic sclerosis

SIGNS AND SYMPTOMS –

The symptoms may vary from adult to child.
In adults:

• Heart burn after eating which worsens in night
• Chest pain
• Regurgitation
• Acidic taste in mouth
• Difficulty in swallowing due to sore throat
• Ptyalism
• Nausea and coughing
• Laryngitis in case of night time acid reflux

In children:

• Repeated vomiting and burping
• Regurgitation and coughing
• Wheezing and bad breath
• Inconsolable crying
• Crying for food and then pulling off the bottle or breast only to cry for it again
• Failure to gain adequate weight

DIAGNOSIS –

• Esophagogastroduodenoscopy (EGD)
• Esophageal pH monitoring
• Endoscopy for checking presence of Dysplasia or Barrett’s syndrome

TREATMENT –

1. Medications:
   • Proton-pump inhibitors
   • Antacids
2. Lifestyle changes
3. Surgery
4. Esophagogastric dissociation:Surgery used to treat neurologically impaired children suffering from GERD.

RISK FACTORS –

• Obesity
• Pregnancy
• Hiatal hernia
• Delayed stomach emptying
• Scleroderma

Factors that aggravate this condition are:

• Smoking
• Medications like Aspirin
• Excessive eating or eating late at night
• Eating fatty food or drinking beverages like alcohol or coffee

EPIDEMIOLOGY –

• Gastroesophageal Reflux Disease is prevalent in 8% to 19% of Indian population.
• There is no gender predominance related to GERD.