Gastro esophageal reflux disorder, Etiology, Pathogenesis, Clinical manifestation, Treatment. B.pharm and D pharm Students, Pharmacy. Pharmacology

1. A PRESENTATION BY:
AMAN GUPTA
LECTURER
GCRG COLLEGE OF PHARMACY

2. Gastro-oesophageal= Gastro + oesophageal.
Gastro= Stomach.
Oesophageal= esophagus[food pipe].
Reflux=flow back or return.
Gastroesophageal reflux is when the content of stomach backs up into
esophagus.
Definition:
Gastro-oesophageal reflux disease occurs when stomach acid leaks from
the stomach and moves up into the oesophagus (food pipe). This is also
known as 'reflux’.
OR
It is a digestive disease in which stomach acid or bile irritates the food pipe
lining. It occurs when stomach acid frequently flows back into the tube
connecting mouth and stomach (esophagus). This backwash (acid reflux)
can irritate the lining of the esophagus.

4.  When we eat, food passes from the throat to the stomach through the esophagus.
A ring of muscle fibers in the lower esophagus prevents swallowed food from
moving back up. These muscle fibers are called the lower esophageal sphincter
(LES).
 When this ring of muscle does not close all the way, stomach contents can leak
back into the esophagus. This is called reflux or gastroesophageal reflux .
Following factors may lead to GERD:
 Smoking
 Eating large meals or eating late at night
 Eating certain foods (triggers) such as fatty or fried foods
 Drinking certain beverages, such as alcohol or coffee
 Taking medications, such as aspirin
 Use of alcohol
 Obesity
 Pregnancy
 Reclining within 3 hours after eating

5. Lower Esophageal Sphincter [LES] does not close properly.
LES pressure decreases.
Intragastric pressure increases.
Back flow [reflux] of stomach content along with gastric acid.
Prolonged contact of gastric acid with esophageal mucosa.
Esophagitis=Inflammation in esophagus.
GERD

6. The most common symptoms of GERD include:
 Heartburn (acid indigestion).
 Burning chest pain that starts behind the breastbone and moves
upward to neck and throat.
 Feeling like food is coming back into the mouth, leaving an
acid or bitter taste.
 Pain in stomach.
 Nausea.
 Bad breath.
 Trouble breathing.
 Vomiting.
 Sleep problems.

7.  Endoscopy: A small lighted tube is put with a tiny video
camera on the end (endoscope) into the esophagus to look
for inflammation or irritation of the tissue (esophagitis).
 Upper GI Series: It's a special X-ray that shows your
esophagus, stomach, and the upper part of your small
intestine (duodenum).
 Esophageal Manometry: This test checks for low
pressure in the esophagus.

8. Non-Pharmacological Treatment:
 Keeping a healthy weight.
 Quit smoking and alcohol.
 Avoiding heavy meal at night.
 Eat smaller servings.
 Avoid oily food and beverages.
Pharmacological Treatment:
 Antacids: These drugs neutralize the acid in esophagus and stomach. For
example- Aluminum hydroxide gel, Magnesium hydroxide etc.
 H2 Blockers: These drugs bind on H2 receptor in stomach and block acid
secretion. For example- Ranitidine, Famotidine, Cimetidine etc.
 Proton Pump Inhibitors (PPIs): Omperazole, Pantoprazole, Rabiprazole etc.

9. THANK YOU