1. Definition
GERD (gastroesophageal reflux disease) is a chronic condition in which stomach acid frequently flows back into the esophagus, causing inflammation and irritation.
2. Epidemiology
The global prevalence of GERD varies, but it is estimated to affect around 10-20% of the adult population in Western countries.
3. Pathophysiology
- Lower Esophageal Sphincter (LES)
The most important safeguard is a properly functioning LES, which acts like a valve to prevent stomach contents from flowing back into the esophagus. - Support from the Diaphragm
The diaphragmatic crura exert additional pressure on the esophagus and reinforce the closure function of the LES. - Angle of His
This anatomical angle between the esophagus and the stomach creates a natural “bend,” reducing the likelihood of spontaneous acid reflux.
GERD (gastroesophageal reflux disease) is primarily driven by dysfunction of the lower esophageal sphincter (LES). As a result, acidic gastric contents frequently flow back up, irritating and inflaming the esophageal lining. Over time, this repeated exposure can lead to erosive damage, ulceration, and complications such as Barrett’s esophagus, which increases the risk of esophageal cancer.
4. Forms
- Non-Erosive Reflux Disease (NERD)
- Patients experience typical GERD symptoms (e.g., heartburn, acid regurgitation) but show no visible esophageal mucosal damage during endoscopy.
- Erosive Reflux Disease (ERD)
- Characterized by visible breaks or lesions on the esophageal lining (esophagitis) when examined endoscopically.
- Barrett’s Esophagus
- A condition where the normal esophageal lining is replaced by tissue similar to the intestinal lining. Barrett’s esophagus is often considered a complication of chronic acid reflux and can increase the risk of esophageal cancer.
- Laryngopharyngeal Reflux (LPR)
- Also referred to as “silent reflux,” LPR occurs when reflux reaches the upper esophagus and larynx (voice box), often causing throat irritation, chronic cough, or hoarseness, with fewer classic GERD symptoms.
5. Symptoms
- Heartburn
- Acid Regurgitation
- Dysphagia
- Chronic Cough, respectively asthma bronchiale and chronic bronchitis
- Epigastric pain