By ULY CLINIC

Gastroesophageal Reflux Disease (GERD)

Introduction

Gastroesophageal Reflux Disease (GERD) is a disorder resulting from gastric acid-pepsin activity and other gastric contents into the esophagus due to incompetent barriers at the gastroesophageal junction leading to active inflammation of the distal third of the esophagus.

Diagnostic Features

Heartburn and regurgitation are cardinal symptoms.
Odynophagia, dysphagia, weight loss and bleeding
Chronic cough, laryngitis, pharyngitis
Chronic bronchitis, asthma, COPD, pneumonia, chronic sinusitis and dental decay PLUS
Endoscopic evidence mucosal ulceration OR
Histological evidence of chronic active inflammation OR
PositSive finding with a gold standard 24-hours esophageal pH testing.

Pharmacological Treatment:

Omeprazole (PO) 20mg once daily for 8 weeks

Esomeprazole (PO) 20mg once daily for 8 weeks.

Note:

For refractory cases acid suppression therapy may require continuation up to 6 months.
Life style modification and avoidance of triggers diet is important including avoidance of smoking, alcohol and NSAID use.
Refer to next level centre with adequate expertise and facility for refractory cases or cases with alarming symptoms (red flags) such as bleeding, dysphagia or weight loss

Updated on, 2.11.2020

References

1. STG

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Gastroesophageal Reflux Disease (GERD)

Introduction

Diagnostic Features

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