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Gastroesophageal reflux disease

Contents of this page:


Digestive system
Digestive system
Gastroesophageal reflux disease
Gastroesophageal reflux disease
Upper gastrointestinal system
Upper gastrointestinal system
Gastroesophageal reflux - series
Gastroesophageal reflux - series

Alternative Names    Return to top

Peptic esophagitis; Reflux esophagitis; GERD; Heartburn - chronic

Definition    Return to top

Gastroesophageal reflux disease (GERD) is a condition in which food or liquid travels backwards from the stomach to the esophagus (the tube from the mouth to the stomach). This action can irritate the esophagus, causing heartburn and other symptoms.

Causes    Return to top

Gastroesophageal reflux is a common condition that often occurs without symptoms after meals. In some people, the reflux is related to a problem with the lower esophageal sphincter, a band of muscle fibers that usually closes off the esophagus from the stomach. If this sphincter doesn't close properly, food and liquid can move backward into the esophagus and may cause the symptoms.

The risk factors for reflux include hiatal hernia (a condition in which part of the stomach moves above the diaphragm, which is the muscle that separates the chest and abdominal cavities), pregnancy, and scleroderma.

A number of studies suggest that obesity contributes to gastroesophageal reflux. For instance, the Nurses Health Study found that being overweight or obese significantly increased reflux symptoms in women. (Women who lost weight in the study, meanwhile, had fewer symptoms.)

Heartburn and gastroesophageal reflux can be brought on or worsened by pregnancy and by many different medications. Such drugs include:

If you suspect that one of your medications may be causing heartburn, talk to your doctor. Never change or stop medication you take regularly without talking to your doctor.

Symptoms    Return to top

Exams and Tests    Return to top

A number of tests may help diagnose reflux or identify complications:

Treatment    Return to top

General measures include:

Medications that alleviate symptoms include:

Anti-reflux operations (Nissen fundoplication and others) may help a small number of patients whose symptoms do not go away with lifestyle changes and drugs, Even after surgery, many patients still need to take drugs to relieve their symptoms. There are also new therapies that can be performed through an endoscope (a flexible tube passed through the mouth into the stomach) for reflux.

Outlook (Prognosis)    Return to top

The majority of people respond to nonsurgical measures, with lifestyle changes and medications. However, many patients need to continue to take drugs to control their symptoms.

Possible Complications    Return to top

When to Contact a Medical Professional    Return to top

Call your health care provider if symptoms worsen or do not improve with lifestyle changes or medication.

Also call for any of the following symptoms:

Prevention    Return to top

References    Return to top

Wang, KK, Sampliner, R E. Updated guidelines 2008 for the diagnosis, surveillance and therapy of Barrett's esophagus. Am J Gastroenterol. 2008;103(3):788-97.

Khan, M, Santana, J, Donnellan, C, Preston, C, Moayyedi, P. Medical treatments in the short term management of reflux oesophagitis. Cochrane Database Syst Rev(2). 2007;CD003244.

Wilson, J F. In the clinic. Gastroesophageal reflux disease. Ann Intern Med. 2008;149(3): ITC2-1-15; quiz ITC2-16

Update Date: 9/7/2008

Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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