GERD Awareness Week

Medical Author: Jay W. Marks, M.D.
Medical Editor: Leslie J. Schoenfield, M.D., Ph.D.

Gastro-esophageal reflux disease, commonly referred to as GERD, or acid reflux, is a condition in which the liquid content of the stomach regurgitates (backs up, or refluxes) into the esophagus. The liquid can damage the lining of the esophagus, causing inflammation (esophagitis), although this occurs in a minority of patients. The regurgitated liquid contains acid and pepsin that are produced by the stomach. (Pepsin is an enzyme that begins the digestion of proteins in the stomach.) The refluxed liquid also may contain bile that has backed-up into the stomach from the duodenum. (The duodenum is the first part of the small intestine that attaches to the stomach.) Acid is believed to be the most injurious component of the refluxed liquid. Pepsin and bile also may injure the esophagus, but their role in the production of symptoms and esophageal damage (esophagitis) is not as clear as the role of acid.

Symptoms of uncomplicated GERD include

• heartburn,
• regurgitation, and
• nausea.

Complications of GERD include:

• Ulcers
• Strictures
• Barrett's Esophagus
• Cough and Asthma
• Inflammation of the throat and larynx
• Inflammation and infection of the lungs
• Fluid in the sinuses and ears

GERD At A Glance

• GERD is a condition in which the acidified liquid contents of the stomach backs up into the esophagus.



• The causes of GERD include an abnormal lower esophageal sphincter, hiatal hernia, abnormal esophageal contractions, and slow emptying of the stomach.



• GERD may damage the lining of the esophagus, thereby causing inflammation (esophagitis), although usually it does not.



• The symptoms of uncomplicated GERD are heartburn, regurgitation, and nausea.



• Complications of GERD include ulcers and strictures of the esophagus, Barrett's esophagus, cough and asthma, throat and laryngeal inflammation, inflammation and infection of the lungs, and collection of fluid in the sinuses and middle ear.



• Barrett's esophagus is a pre-cancerous condition that requires periodic endoscopic surveillance for the development of cancer.



• GERD may be diagnosed or evaluated by a trial of treatment, endoscopy, biopsy, x-ray, examination of the throat and larynx, 24 hour esophageal acid testing, esophageal motility testing, emptying studies of the stomach, and esophageal acid perfusion.



• GERD is treated with life-style changes, antacids, histamine antagonists (H2 blockers), proton pump inhibitors (PPIs), pro-motility drugs, foam barriers, surgery, and endoscopy.

For more information about GERD, please visit the MedicineNet.com GERD Center.

Last Editorial Review: 10/31/2002