GERD (Gastroesophageal Reflux Disease / Acid
Reflux Disease) is
injury to the esophagus that develops from
chronic exposure of the esophagus to acid
coming up from the stomach (acid reflux). In
contrast, heartburn is the symptom of acid
in the esophagus, characterized by a burning
discomfort behind the breastbone (sternum).
Findings in Acid Reflux Disease include esophagitis (reflux
esophagitis) - inflammatory changes in the esophageal lining (mucosa), strictures,
difficulty swallowing (dysphagia) and
chronic chest pain. Patients may have only
one of those findings. Atypical symptoms of
Acid Reflux include cough, hoarseness, changes of
the voice, and sinusitis. Complicatons of
Acid Reflux include stricture
formation, Barrett's esophagus, esophageal
ulcers and possibly even to
esophageal
cancer.
Occasional heartburn is common but does
not necessarily mean one has Acid Reflux.
Patients
that have heartburn symptoms more than once
a week are at risk of developing Acid
Reflux. A hiatal hernia is usually asymptomatic, but
the presence of a hiatal hernia is a risk
factor for development of Acid Reflux.
Acid Reflux Symptoms
Adults The most prominent
symptom of
acid reflux is
heartburn, the sensation of burning pain in
the chest coming upward towards the mouth
caused by reflux of acidic contents from the
stomach to the esophagus.
Patients
with
acid reflux disease also tend to get the
feeling of a sour or salty taste at the back
of their throats due to regurgitation. This
can sometimes happen even if the pain of
heartburn is absent.
less common
Acid Reflux Disease/GERD
symptoms include:
- Chest pain without any of the above
- Dysphagia (difficulty swallowing)
- Halitosis (bad breath)
- Regurgitation (vomit-like taste in the
mouth)
- Repeated throat clearing
- Water brash (the sensation of a large
amount of non-acid liquid due to sudden
hypersecretion of saliva)
complication of
Acid Reflux Disease/GERD
symptoms:
- Strictures or scarring of esophagus
(especially young children).
- Barrett's esophagus (sometimes
referred to as Barrett's Disease)
-
Esophageal cancer
important warning symptoms
of Acid Reflux Disease/GERD:
-
Trouble swallowing Dysphagia
requires
immediate medical attention
-
Vomiting blood or partially digested
blood (looks like coffee grounds) requires
immediate medical attention as does
digested blood in the stools.
Children
Acid
Reflux Disease is commonly overlooked in infants
and children. Symptoms may vary from typical
adult symptoms. Acid Reflux Disease / GERD in children may cause
repeated vomiting, effortless spitting up,
coughing, and other respiratory problems.
Inconsolable crying, failure to gain
adequate weight, refusing food and bad
breath are also common. Children may have
one symptom or many -
no single symptom is
universally present in all children with
Acid Reflux Disease.
Babies' immature digestive systems are
usually the cause, and
most infants stop
having acid reflux by the time they reach
their first birthday. Some children don't
outgrow acid reflux, however, and continue
to have it into their teen years. Children
that have had heartburn that doesn't seem to
go away, or any other symptoms of Acid
Reflux Disease for a
while, should talk to their parents and
visit their doctor.
Diagnosing
Acid Reflux
Disease/GERD
A detailed history taking is vital to the
diagnosis of Acid Reflux Disease. Useful investigations may include
barium swallow X-rays, esophageal manometry,
esophageal pH monitoring and
Esophagogastroduodenoscopy (EGD). In
general, an EGD is done when the acid reflux patient
does not respond well to treatment, has had
symptoms or required medications for a
prolonged time (generally 5 years), has dysphagia,
anemia, blood in the stool
(detected chemically), has
weight loss, or
has changes in the voice.
Esophagogastroduodenoscopy (EGD) (a form
of endoscopy) involves the insertion of a
thin scope through the mouth and throat into
the esophagus and stomach (often while the
patient is sedated) in order to assess the
internal surface of the esophagus, stomach
and duodenum. |
