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By ULY CLINIC

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Gastroesophageal Reflux Disease (GERD)

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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. 

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Diagnostic Features

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  • 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 

OR

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

 

Note:

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  • 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

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Updated on, 2.11.2020

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References

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1. STG

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