Risk factors include obesity, pregnancy, smoking, hiatus hernia, and taking certain medicines. Treatment is typically via lifestyle changes, medications, and sometimes surgery. Lifestyle changes include not lying down for three hours after eating, losing weight, avoiding certain foods, and stopping gates timing belt pdf. The most common symptoms of GERD in adults are an acidic taste in the mouth, regurgitation, and heartburn.
GERD sometimes causes injury of the esophagus. GERD may be difficult to detect in infants and children, since they cannot describe what they are feeling and indicators must be observed. Symptoms may vary from typical adult symptoms. Most children will outgrow their reflux by their first birthday. However, a small but significant number of them will not outgrow the condition.
This is particularly true when a family history of GERD is present. GERD may lead to Barrett’s esophagus, a type of intestinal metaplasia, which is in turn a precursor condition for esophageal cancer. GERD is caused by a failure of the lower esophageal sphincter. In healthy patients, the “Angle of His”—the angle at which the esophagus enters the stomach—creates a valve that prevents duodenal bile, enzymes, and stomach acid from traveling back into the esophagus where they can cause burning and inflammation of sensitive esophageal tissue. Hiatal hernia, which increases the likelihood of GERD due to mechanical and motility factors. Obesity: increasing body mass index is associated with more severe GERD.
Zollinger-Ellison syndrome, which can be present with increased gastric acidity due to gastrin production. A high blood calcium level, which can increase gastrin production, leading to increased acidity. Scleroderma and systemic sclerosis, which can feature esophageal dysmotility. The use of medicines such as prednisolone. Visceroptosis or Glénard syndrome, in which the stomach has sunk in the abdomen upsetting the motility and acid secretion of the stomach. GERD has been linked to a variety of respiratory and laryngeal complaints such as laryngitis, chronic cough, pulmonary fibrosis, earache, and asthma, even when not clinically apparent. Endoscopic image of peptic stricture, or narrowing of the esophagus near the junction with the stomach: This is a complication of chronic gastroesophageal reflux disease and can be a cause of dysphagia or difficulty swallowing.
The diagnosis of GERD is usually made when typical symptoms are present. Reflux can be present in people without symptoms and the diagnosis requires both symptoms or complications and reflux of stomach content. Barium swallow X-rays should not be used for diagnosis. The current gold standard for diagnosis of GERD is esophageal pH monitoring. It is the most objective test to diagnose the reflux disease and allows monitoring GERD patients in their response to medical or surgical treatment.
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One practice for diagnosis of GERD is a short-term treatment with proton-pump inhibitors, with improvement in symptoms suggesting a positive diagnosis. Endoscopy, the looking down into the stomach with a fibre-optic scope, is not routinely needed if the case is typical and responds to treatment. Reflux changes may not be erosive in nature, leading to “nonerosive reflux disease”. Other causes of chest pain such as heart disease should be ruled out before making the diagnosis. The treatments for GERD include lifestyle modifications, medications, and possibly surgery.
Initial treatment is frequently with a proton-pump inhibitor such as omeprazole. Certain foods and lifestyle are considered to promote gastroesophageal reflux, but most dietary interventions have little supporting evidence. Avoidance of specific foods and of eating before lying down should be recommended only to those in which they are associated with the symptoms. The primary medications used for GERD are proton-pump inhibitors, H2 receptor blockers and antacids with or without alginic acid.