Gastroesophageal Reflux Disease (Patient Counselling Guide)

Gastroesophageal Reflux Disease (GERD), also known as acid reflux, is a condition in which the stomach contents regurgitate (back up or reflux) into the esophagus causing inflammation (esophagitis) and damage to the esophageal wall. The regurgitated liquid usually contains acid and pepsin (an enzyme that begins the digestion of proteins in the stomach) that are produced by the stomach. Acid is believed to be the most injurious component of the refluxed liquid. Over time, the inflammation can wear away the esophageal lining, causing complications eg, esophageal ulcer, esophageal stricture (narrowing of the esophagus), or Barrett's esophagus (precancerous changes to the esophagus). GERD can be categorized depending on the presence of esophageal mucosal breaks as seen in esophagoscopy (a procedure wherein a flexible viewing tube called an endoscope is passed through the mouth and used to examine the esophagus): erosive esophagitis (characterized by mucosal breaks eg, erosions or ulcerations) and non-erosive reflux disease (NERD) (presence of symptoms of GERD but without esophageal mucosal injury). The following conditions can increase the risk of GERD: obesity, hiatal hernia(bulging of top of stomach up to the diaphragm), pregnancy, smoking, delayed stomach emptying, and connective tissue disorders eg, scleroderma. On the other hand, the following are factors that can aggravate acid reflux: smoking, consumption of large meals or eating fatty foods, eating late at night, alcohol and caffeine, and certain medications eg, aspirin.

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