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GERD

GERD. Brandon Hoff. What is GERD?. Gastroesophageal Reflux Disease Acid Reflux Disease. What is GERD?. Failure of the gastroesophageal sphincter Irritation and inflammation of the esophagus from stomach acid Effects 1/3 of the population at least once a month

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GERD

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  1. GERD Brandon Hoff

  2. What is GERD? • Gastroesophageal Reflux Disease • Acid Reflux Disease

  3. What is GERD? • Failure of the gastroesophageal sphincter • Irritation and inflammation of the esophagus from stomach acid • Effects 1/3 of the population at least once a month • Effects 10% of the population on a daily basis

  4. Basic Anatomy of the Upper GI Tract • Mouth • Pharynx • Esophagus • Stomach

  5. Gastroesophageal Sphincter • AKA: Lower Esophageal Sphincter; Cardiac Sphincter • Ring of muscle on the inferior portion of the esophagus between the esophagus and stomach • Prevents food and stomach content from reentering the esophagus

  6. Gastroesophageal Sphincter • Normal Function • Relaxes during swallowing to allow food to pass • Constricts after ingestion to prevent the back flow of food • Function with GERD • The sphincter relaxes between swallowing which allows stomach content and corrosive acid to enter the esophagus • Causes damage to the lining of the esophagus

  7. Stomach vs. Esophagus • Stomach • pH • 1.5-3.5 • Goblet Cells • Provides an alkaline layer of mucus to protect the stomach lining. • Esophagus • pH • Around 7.0 • No Goblet Cells

  8. Causes • unclear • Things that make the sphincter weaker • Lifestyle • Medications • Diet • Eating Habits • Other Medical Problems

  9. Lifestyle • Alcohol • Cigarettes • Poor posture (slouching)

  10. Medications • Calcium Channel Blockers • Theophylline

  11. Diet • Fatty & Fried Foods • Chocolate • Onions • Garlic • Caffeine • Acidic Foods • Spicy Foods • Mint

  12. Eating Habits • Large Meals • Eating 2-3 Hours Before Bedtime

  13. Other Medical Causes • Hiatal Hernia • Pregnancy • Diabetes with Rapid Weight Gain

  14. Symptoms • Heartburn is the most common • Starts in the upper abdomen and spreads up the neck • Can last up to two hours • Worse after eating • Not everyone with GERD has • Regurgitation of bitter acid while sleeping or bending over • Bitter taste • Persistent dry cough • Hoarseness • Tightness in throat • Wheezing

  15. Complications of GERD • Esophagitis & Ulcers

  16. Complications of GERD (cont) • Bleeding

  17. Complications of GERD (cont) • Stricture

  18. Complications of GERD (cont) • Laryngopharyngeal Reflex

  19. Complications of GERD (cont) • Respiratory Problems • Asthma • 75% have GERD

  20. Complications of GERD (cont) • Cancer of the Esophagus

  21. Treatment • Relieve Symptoms • Prevent Damage to the Esophagus

  22. Medical Treatment • Lifestyle changes • Medications • Antacids • PPI’s • Block the production of stomach acid • Coating agents • Protects mucus membranes and sores by providing another layer • Promotility Agents • Tightens the sphincter and promotes faster emptying of the stomach • Surgery • Last option • Fundoplication • Suturing of the fundus around the inferior part of the esophagus • Forms a one-way valve • Increases the pressure in the lower portion on the esophagus

  23. Emergency Situations in Pt. with GERD • Severe chest pain or pressure • Especially if it radiates • Vomiting blood • Vomiting with chest pain • Dark tarry stool • Difficulty swallowing solids and liquids

  24. Summary • What GERD is • Causes • Complications • Treatment • Emergency Management

  25. References • Donley, Kelli M. "GERD, Asthma Connection Vague: Research Continues." Endonurse.Com. 1 Sept. 2001. 20 May 2008 <http://www.endonurse.com/articles/diseases_disorders/589_191feat4.html>. • "Gastroesophageal Reflux Disease (GERD)." Emedicinehealth. 10 Aug. 2005. 27 May 2008 <http://www.emedicinehealth.com/reflux_disease_gerd/article_em.htm>. • Gillson, Sharon. "Causes of Gastroesophageal Reflux Disease." About.Com. 2 Jan. 2007. 27 May 2008 <http://heartburn.about.com/od/gerdacidrefluxdisease/a/causes_of_gerd.htm>. • "Heartburn/GERD Health Center." Webmd. 18 May 2008 <http://www.webmd.com/heartburn-gerd/>. • Lehrer, Jenifer K. "The Heartburn (Acid Reflex) Health Topic." Mdhelp.Com. 3 May 2007. 27 May 2008 <http://www.medhelp.org/HealthTopics/Acid_Reflux.html>. • "What Causes GERD?" GERD.Com. Nov. 2007. 25 May 2008 <http://www.gerd.com/consumer/gerd-causes.aspx>.

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