GERD
Brandon Hoff
What is GERD?
Gastroesophageal Reflux Disease
Acid Reflux Disease
What is GERD?
Failure of the gastroesophageal sphincter
Irritation and inflammation of the esophagus from stomach acid
Effects 1/3 of the population at least once a month
Effects 10% of the population on a daily basis
Basic Anatomy of the Upper GI Tract
Mouth Pharynx Esophagus Stomach
Gastroesophageal Sphincter
AKA: Lower Esophageal Sphincter; Cardiac Sphincter
Ring of muscle on the inferior portion of the esophagus between the esophagus and stomach
Prevents food and stomach content from reentering the esophagus
Gastroesophageal Sphincter
Normal Function Relaxes during swallowing to allow food to
pass Constricts after ingestion to prevent the
back flow of food
Function with GERD The sphincter relaxes between swallowing
which allows stomach content and corrosive acid to enter the esophagus
Causes damage to the lining of the esophagus
Stomach vs. Esophagus
Stomach pH
1.5-3.5 Goblet Cells
Provides an alkaline layer of mucus to protect the stomach lining.
Esophagus pH
Around 7.0 No Goblet Cells
Causes
unclear Things that make the sphincter weaker
Lifestyle Medications Diet Eating Habits Other Medical Problems
Lifestyle
Alcohol Cigarettes Poor posture (slouching)
Medications
Calcium Channel Blockers
Theophylline
Diet
Fatty & Fried Foods Chocolate Onions Garlic Caffeine Acidic Foods Spicy Foods Mint
Eating Habits
Large Meals Eating 2-3 Hours Before Bedtime
Other Medical Causes
Hiatal Hernia Pregnancy Diabetes with Rapid Weight Gain
Symptoms
Heartburn is the most common Starts in the upper abdomen and spreads up the neck Can last up to two hours Worse after eating Not everyone with GERD has
Regurgitation of bitter acid while sleeping or bending over Bitter taste Persistent dry cough Hoarseness Tightness in throat Wheezing
Complications of GERD
Esophagitis & Ulcers
Complications of GERD (cont)
Bleeding
Complications of GERD (cont)
Stricture
Complications of GERD (cont)
Laryngopharyngeal Reflex
Complications of GERD (cont)
Respiratory Problems Asthma
75% have GERD
Complications of GERD (cont)
Cancer of the Esophagus
Treatment
Relieve Symptoms Prevent Damage to the Esophagus
Medical Treatment
Lifestyle changes Medications
Antacids PPI’s
Block the production of stomach acid Coating agents
Protects mucus membranes and sores by providing another layer Promotility Agents
Tightens the sphincter and promotes faster emptying of the stomach Surgery
Last option Fundoplication
Suturing of the fundus around the inferior part of the esophagus Forms a one-way valve Increases the pressure in the lower portion on the esophagus
Emergency Situations in Pt. with GERD Severe chest pain or pressure
Especially if it radiates Vomiting blood Vomiting with chest pain Dark tarry stool Difficulty swallowing solids and liquids
Summary
What GERD is
Causes
Complications
Treatment
Emergency Management
References Donley, Kelli M. "GERD, Asthma Connection Vague: Research Continues."
Endonurse.Com. 1 Sept. 2001. 20 May 2008 <http://www.endonurse.com/articles/diseases_disorders/589_191feat4.html>.
"Gastroesophageal Reflux Disease (GERD)." Emedicinehealth. 10 Aug. 2005. 27 May 2008 <http://www.emedicinehealth.com/reflux_disease_gerd/article_em.htm>.
Gillson, Sharon. "Causes of Gastroesophageal Reflux Disease." About.Com. 2 Jan. 2007. 27 May 2008 <http://heartburn.about.com/od/gerdacidrefluxdisease/a/causes_of_gerd.htm>.
"Heartburn/GERD Health Center." Webmd. 18 May 2008 <http://www.webmd.com/heartburn-gerd/>.
Lehrer, Jenifer K. "The Heartburn (Acid Reflex) Health Topic." Mdhelp.Com. 3 May 2007. 27 May 2008 <http://www.medhelp.org/HealthTopics/Acid_Reflux.html>.
"What Causes GERD?" GERD.Com. Nov. 2007. 25 May 2008 <http://www.gerd.com/consumer/gerd-causes.aspx>.
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