Gastroesophageal reflux disease - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Gastroesophageal reflux disease (GERD) is a clinical diagnosis. The classic symptoms are heartburn and regurgitation. A therapeutic trial of a proton-pump inhibitor (PPI) can serve for both diagnosis and initial treatment.
Upper endoscopy is indicated to evaluate for complications; for atypical, persistent, or relapsing symptoms; or for alarm features (e.g., weight loss, anemia).
High rate of relapse upon stopping treatment.
Serious complications of GERD include stricture, Barrett esophagus, or esophageal carcinoma.

Moderate to severe esophagitis with multiple linear, clean-based esophageal ulcers

From the collection of Dr Douglas G. Adler; used with permission

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History & Exam
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Diagnostics Tests
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Definition

Epidemiology

Etiology

Pathophysiology

Images

Moderate to severe esophagitis with multiple linear, clean-based esophageal ulcers
Barrett segment lined by gastric-type epithelium without intestinal metaplasia in the form of goblet cells (magnification ×100). (A) Mucin staining using Alcian Blue-Periodic Acid Schiff showing neutral magenta color (mucin of gastric epithelial type); (B) H&E staining reveals a Barrett esophagus segment lined by gastric-type epithelium without intestinal metaplasia but with features of high-grade dysplasia
Upper gastrointestinal endoscopy revealing a fistula related to esophageal carcinoma (arrow)

Citations

Key Articles

Katz PO, Dunbar KB, Schnoll-Sussman FH, et al. ACG clinical guideline for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2022 Jan 1;117(1):27-56.[Abstract][Full Text]
Muthusamy VR, Lightdale JR, Acosta RD, et al; ASGE Standards of Practice Committee. The role of endoscopy in the management of GERD. Gastrointest Endosc. 2015;81(6):1305-10.[Abstract][Full Text]
Freedberg DE, Kim LS, Yang YX. The risks and benefits of long-term use of proton pump inhibitors: expert review and best practice advice from the American Gastroenterological Association. Gastroenterology. 2017 Mar;152(4):706-15.[Abstract]
Ness-Jensen E, Hveem K, El-Serag H, et al. Lifestyle intervention in gastroesophageal reflux disease. Clin Gastroenterol Hepatol. 2016 Feb;14(2):175-82.[Abstract][Full Text]

Referenced Articles

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