Gastroesophageal Reflux Disease (GERD)
FOODS
(spicy, alcohol,
fatty, junk foods)
Heart burn, Barret's Esophagus, Chest Pain, Regurgitation, Disrupted sleep, Chronic
cough, Laryngitis, Unable to swallow, Drooling, Hoarseness of Voice, Stress and Older
Repeated damage to esophagus
Normal squamous epithelium
replaced with columnar cells
(Metaplasia)
Barrret"s Esophagus:
precancerous lesion
Over time, may progress
adeenocarcinoma
DELAYED GASTRIC
SMOKING CIGARETTES DYSPHAGIA HYPERTENSION
EMPTYING
Blood Pressure
(145/85 mm Hg)
1 pack of cigarette per
day for the past 10
years. Amlodipine, a calcium Gas build up in
channel blocker that
relaxes the LES
stomach, ↑
pressure on the
cardia
Pressure receptors
indirectly
stimulate the
age,
vargus nerve
Abnormal LES Relaxation
Vagus nerve (CN-X)
Excessive or Prolonged Transient Lower stimulates
Esophageal Sphincter Relaxation LES relaxation
↑
HCI stomach can be pushed up by intra-abdominal pressure
Conditions with acid ↑
production
(exercise, obesity) or positional changes (lying down) (see "Peptic Ulcer Disease")
"Heart Burn' Water Regurgitation
(Epigastric/ Retrosternal Burning Sensattion (water brash)
Aspiration of acid into
Scarring can form May persist despite treatment = larynx, lungs
esophageal 'NERD" (non-erosive reflux disease Irritation of upper
respiratory track
structure can Mechanical Dysphagia
bleed Chronic cough
(Solid Foods)
structure can (especially at night),
bleed asthma, hoarse voice