GERD is a disease , that effects gastrointestinal tract. It is also considered as an acid reflux.

1. GERD
GASTR0 ESOPHAGAL REFLUX DISEASE
GERD is the condition of mucosal damage produced by the abnormal
reflux of gastric contents into oesophagus.
It can be chronic and relapsing.
It is associated with effects like heartburn,belching,nausea,vomiting.
ETIOLOGY:
Overeating.
Alcohol consumption,smoking.
Having foods with high garlic,ginger,onions.
Having Junk foods.
Usage of drugs like anti-cholinergics,CCB,morphine,atropine
Oral contraceptives,estrogen etc.
TYPES:
PHYSIOLOGIC VS PATHOLOGIC
Postprandial symptomatic
Short lived long lived
Asymptomatic
No nocturnal sx nocturnal sx

2. PATHOPHYSIOLOGY:
Decreased lower esophageal sphincter pressure altering
Disruption of anatomical barriers like hernia
Esopheal clearance
Mucosal resistance
Delayed gastric emptying
Alter in gastric pressure
Lower oesophageal sphincter becomes open
Reflux of gastric contents.
CLINICAL MANIFESTATIONS:
Heartburn after 2 hrs of food intake.
Nausea without vomiting.
Burning sensation, belching.
Dyspepsia.
Pain also radiate to neck, shoulder, throat.
Choking,regurgitation.
Hypersalaivation.
COMPLICATIONS:
Esophagitis- inflammation of esophagus.
Esophageal strictures-narrowing of esophagus.
Esophageal ulcers.

3. Hemorrhage.
Barrett’s esophagus.[replacement of squamous epithelial lining
With columnar epithelium-metaplasia.]
Precipitation of asthma attack.
DIAGNOSIS:
Symptoms evaluation.
Endoscopy.
Biopsy.
Oesophageal manometry.
Barium sulphate swallow.
Bernstein test.
EGD-Esophago-gastro-duodenoscopy.
TREATMENT:
NON-PHARMACOLOGICAL-
Avoid eating fast foods.
Avoid alcohol consumption and smoking.
Sleeping in a slopy posture helps.
Sleep after 3 hrs of food intake.
PHARMACOLOGICAL-
.ANTACIDS: they neutrilise excess acid in stomach
They provide sympotamatic relief.
EX-magnesium hydroxide;aluminium hydroxide.
.H2 receptor antagonists: they block H2 receptors, lowers acid
production. EX-ranitidine; cimetidine.

4. . PROTON PUMP INHIBITORS: they block proton pump;lowering
acid production. EX- pantoprazole, esmoprazole.
. PROMOTILITY AGENTS and MUCOSAL SURFACTANTS like
sucralfate etc are also used often.
..The common side effects of these medications include dizziness,
constipation, nausea,vomiting etc.
SURGICAL-
In severe cases surgery is preffered, the surgical procedures to cure
GERD include ‘anti-reflux surgery’ , “laproscopic nissen
funduplication” , ‘TTS ballon dilation of peptic sticture’.