Gastroesophageal Reflux Disease (GERD)

Abstract

Gastroesophageal reflux disease (GERD) is a common clinical problem, affecting millions of people worldwide. Patients are recognized by both classic and atypical symptoms. Acid suppressive therapy provides symptomatic relief and prevents complications in many individuals with GERD. Advances in diagnostic and therapeutic modalities have improved our ability to identify and manage disease complications. Here, we discuss the pathophysiology and effects of GERD, and provide information on the clinical approach to this common disorder.

Figure 1

Endoscopic view of Los Angeles grade D esophagitis (circumferential esophageal erosions, ulceration, and inflammation).

Figure 2

High resolution esophageal impedance and pH tracings. Impedance (measure of electrical conductance) within the lumen of the esophagus is measured simultaneously using multiple probes and the measurements are displayed with the proximal measures at the top progressing distally towards the stomach. The bottom tracing is the pH at the most distal measurement point. Highlighted in yellow are measurements that document liquid reflux from the stomach correlating with a drop in pH indicating reflux of gastric acid. this tracing is a small snapshot of 24 hours of data.