Key Teaching

Points:
GERD is a chronic disease,
butsymptoms can be relieved

GERD
with treatment.
Lifestyle changes are important in
the course of treatment for GERD.
Create a food intake log to identify
triggers that worsen reflux.
Have small meals and avoid
GASTROESOPHAGEAL
REFLUX DISEASE
overeating.
Avoid lying down 2-3 hours after a
meal.
Raise the head of the bed 7-8
inches when sleeping; 'bed blocks'
work better than pillows.
Be aware of side effects of the
medications and when to report to
physician.
Consult physician if symptoms
persist to consider surgery or http://whatisgerd.weebly.com
endoscopy treatment.

What is GERD?
Gastroesophageal refers to the
stomach and esophagus (food pipe);
reflux is the backflow movement.
So, gastroesophageal reflux disease
(GERD) is a chronic digestive disease
where a substantial amount of
stomach acid backflows into the
esophagus. This is caused by a
weakening of the lower esophageal
sphincter. Since the lining of the
esophagus is not resistant to acidic
substances, the backflow of
stomach acid irritates the
esophageal lining.
Risk factors Diagnostic tests
Obesity Proton Pump Inhibitor (PPI) Acid
Hiatal hernia Suppression Symptom Test
Pregnancy PPI reduces stomach acid. A diagnosis of GERD can
Diabetes be made if signs and symptoms are improved with PPI.
Upper Endoscopy
Delayed stomach emptying
full examination of the esophagus, stomach,
Asthma duodenum first section of small intestine by a
Smoking tube with a camera called an endoscope. Biopsy of
Dry mouth tissue can also be done. Sedation is required.
Upper Gastrointestinal Chromoendoscopy
A bacteria called Helicobacter pylori
upper endoscopy with contrast dyes to detect
Connective tissue disorder abnormal tissues and small lesions in esophageal
lining
Signs and symptoms Esophageal manometry
test the strength and coordination of the esophageal
TYPICAL: muscles when lower esophageal sphincter contracts
Ambulatory 24-hour esophageal pH
Heartburn
monitoring (Gold Standard)
Acid regurgitation
catheter in place for 24 hours to test pH in distal
Water brush (hypersalivation) esophagus above the lower esophageal sphincter,
recording each reflux of stomach acid
ATYPICAL
(typical esophageal pH = 7; GERD pH < 4)
(ASSOCIATED SIGNS & SYMPTOMS):
Nausea and vomiting How to alleviate symptoms?
Difficulty and/or painful swallowing
Burping and hiccups LIFESTYLE CHANGES:
Sour taste Avoid food that worsens reflux
Gum inflammation citrus fruits and juices, spicy/ high fat food,
Teeth erosion and cavities onions, garlics, caffeine, chocolate
Avoid smoking and alcohol
Hoarseness, sore throat, change in voice
Avoid tight clothing
Upper stomach pain (epigastric pain)
Slow digestion, early satiety MEDICATIONS:
Proton Pump Inhibitors
H2 Receptor Antagonists
Antacids
SURGERY:
Fundoplication
Seek medical attention when you experience
chest pain or shortness of breath.