1.

Summary
Gastro-esophageal Reflux
Gastro-esophageal reflux disease (GERD) is described as back
flow or return of stomach acid and its content to the esophageal
tract. The lower esophageal sphincter has lost its responsibility
from backflow prevention, resulting in damage of its epithelial
mucosa. Burning sensation, dysphagia and heartburn are
commonly experienced by the patient. Obesity, hiatal hernia, and
drugs may be the trigger for GOR.
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Gastro-esophageal reflux disease (GERD) as the name implies, is

described as back flow or return of stomach acid and its content
back to the esophageal tract. Physiologically, distally in the
esophagus, lower esophageal spinchter (LES) is designed to ensure
a one-way flow of acid secretion thus preventing backflow. In GERD,
LES becomes relax and loose its contractility of its sphincter
resulting in ingested food and gastric juice reflux. As consequences,
the pressure gradient increases leading to acid flow towards the
esophagus resulting in damage of its epithelial mucosa and
esophagitis.
Probable causes such as cigarette smoking, obesity, hiatal hernia,
excessive alcohol intake, obesity, and pregnancy may be the
contributing factors for GERD development. GERD can cause
inflammatory response in the esophageal wall resulting in lesion and
ulceration. With the long consequences, precancerous lesion can
progressed to fibrosis, basal cell hyperplasia and adenocarcinoma.
Individual may experience chronic cough, asthma attacks, heartburn
(may be confused with chest pain), vomiting, and upper abdominal

pain. Alcohol or food consists of acids can also result in dysphagia.

Symptoms in GERD can be worsen when an individual lying supine
due to the increased of abdominal pressure.
Proton pump inhibitors (PPIs), a monotherapy drugs may be
prescribed for individuals with GERD. Other therapies such as
antacids group (Mylanta), histamine-2 (H2) blockers which can be
given to lessen the release of stomach acid, by inhibition of
Hydrogen Potassium ATPase in the parietal cells. Cessation of
smoking and weight reduction can also help to reduce the
symptoms. When medical treatment fails, laparoscopic
fundoplication may be performed as the most common surgical
intervention.
References:
1. Gastroesophageal Reflux Disease (GERD)/Heartburn in Children
[Internet]. Stanfordchildrens.org. 2016 [cited 21 November 2016].
Available from: http://www.stanfordchildrens.org/en/topic/default?
id=gastroesophageal-reflux-disease-gerdheartburn-in-children-90P01994
2. McCance, K.L., & Huether, S.E. The biologic basis for disease in
adults and children. St. Louis, Missouri: Elsevier Mosby.

Courtesy: Marielle Ancilla Domini