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>.