Definition:
Gastroesophageal reflux disease (GERD) is a condition in which the stomach contents (food or liquid) leak backwards from the stomach into the esophagus (the tube from the mouth to the stomach). This action can irritate the esophagus, causing heartburn and other symptoms.
Alternative Names:
Peptic esophagitis; Reflux esophagitis; GERD; Heartburn - chronic; Dyspepsia - GERD
Causes, incidence, and risk factors:
When you eat, food passes from the throat to the stomach through the esophagus (also called the food pipe or swallowing tube). Once food is in the stomach, a ring of muscle fibers prevents food from moving backward into the esophagus. These muscle fibers are called the lower esophageal sphincter, or LES. If this sphincter muscle doesn't close well, food, liquid, and stomach acid can leak back into the esophagus. This is called reflux or gastroesophageal reflux. This reflux may cause symptoms, or can even damage the esophagus. 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. Obesity, cigarettes, and possibly alcohol also increase the chance of GERD. Heartburn and gastroesophageal reflux can be brought on or worsened by pregnancy and many different medications. Such drugs include: Anticholinergics (e.g., for seasickness) Beta-blockers for high blood pressure or heart disease Bronchodilators for asthma Calcium channel blockers for high blood pressure Progestin for abnormal menstrual bleeding or birth control Sedatives for insomnia or anxiety Tricyclic antidepressants
If you suspect that one of your medications may be causing heartburn, talk to your doctor. Never change or stop a medication you take regularly without talking to your doctor.
References:
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
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