Gastroesophageal Reflux Disease

Gastroesophageal reflux disease (GERD), Gastro-oesophageal reflux disease (GORD), Gastric reflux disease, or Acid reflux disease is defined as chronic symptoms or mucosal damage produced by the abnormal reflux in the esophagus.

This is commonly due to transient or permanent changes in the barrier between the esophagus and the stomach. This can be due to incompetence of the lower esophageal sphincter, transient lower esophageal sphincter relaxation, impaired expulsion of gastric reflux from the esophagus, or a hiatus hernia. If the reflux reaches the throat, it is called laryngopharyngeal reflux disease.

The most-common symptoms of GERD are heartburn, regurgitation, and trouble swallowing (dysphagia).

The less-common symptoms include pain with swallowing (odynophagia), excessive salivation (this is common during heartburn, as saliva is generally slightly basic and is the body's natural response to heartburn, acting similarly to an antacid), nausea, and chest pain.

GERD sometimes causes injury of the esophagus. These injuries may include Reflux esophagitis—necrosis of esophageal epithelium causing ulcers near the junction of the stomach and esophagus, Esophageal strictures — the persistent narrowing of the esophagus caused by reflux-induced inflammation, Barrett's esophagus—metaplasia (changes of the epithelial cells from squamous to columnar epithelium) of the distal esophagus, and Esophageal adenocarcinoma — a rare form of cancer.

Several other atypical symptoms are associated with GERD, but there is good evidence for causation only when they are accompanied by esophageal injury. These symptoms are chronic cough, laryngitis (hoarseness, throat clearing), asthma, erosion of dental enamel, dentine hypersensitivity, and damaged teeth.

GERD may be difficult to detect in infants and children. Symptoms may vary from typical adult symptoms. GERD in children may cause repeated vomiting, effortless spitting up, coughing, and other respiratory problems. Inconsolable crying, failure to gain adequate weight, refusing food, bad breath, and belching or burping are also common. Children may have one symptom or many — no single symptom is universal in all children with GERD.

Common symptoms of Pediatric Reflux are irritability and pain, sometimes screaming suddenly when asleep. They may also have constant or sudden crying or "colic" like symptoms. Babies can be inconsolable especially when laid down flat. They may have poor sleep habits typically with arching their necks and back during or after feeding. They may have excessive possetting or vomiting, frequent burping or frequent hiccups, excessive dribbling or runny nose, swallowing problems, gagging and choking. Babies are often very gassy and extremely difficult to "burp" after feeds, they may refuse feeds or may frequent feeds for comfort. They may also manifest night time coughing. Extreme cases of acid reflux can cause apnea and respiratory problems such as asthma, bronchitis and pneumonia if stomach contents are inhaled. They may also have bad breath – smelling acidy, and rancid/acid smelling diapers with loose stool. Bowel movements can be very frequent or babies can be constipated.


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