GERD Pocket Guide: Gastro esophageal reflux disorder (GERD) Illustrated

GERD- Introduction:
Gastro esophageal reflux disorder (GERD) is a commonly occurring disorder in the modern world. It is primarily defined as "a condition that develops when the reflux of stomach contents causes troublesome symptoms and/or complications." The Montreal definition of the disorder was developed by an international consensus group of experts and family physicians over a period of 2 years. A series of statements was drafted based on evidence from systematic reviews of the literature in 3 databases (EMBASE, Cochrane Central Register of Controlled Trials, and MEDLINE). The group went through multiple sessions of voting to modify and approve the statements in order to incorporate all possible complications and broaden the definition of GERD. Gastro esophageal reflux occurring frequently (more than once a week) is designated gastrointestinal reflux disease and affects the quality of life significantly.(1)
The main symptom of GERD in adults is frequent heartburn, also called acid indigestion—burning-type pain in the lower part of the mid-chest, behind the breast bone, and in the mid-abdomen. Most children under 12 years with GERD, and some adults, have GERD without heartburn. Instead, they may experience a dry cough, asthma symptoms, or trouble swallowing. Complications of GERD include erosive esophagitis, hemorrhage, ulcerative esophagitis, and esophageal strictures. GERD is a known risk factor for development of Barrett's esophagus (BE) and esophageal adenocarcinoma, the most rapidly rising incidence of cancer in the western world. GERD is described in subcategories for ease in diagnosis, non-erosive esophageal reflux disease NERD and additional pathologies that follow as result of GERD.(2)
Table of Contents
Useful Web Resources
GERD- Definition and Prevalence
Introduction
GERD- Clinical Features
Pathophysiology of GERD
Functional Abnormalities at the Esophagogastric Junction
Clearance of Refluxate
Nature of Refluxate
GERD- Diagnosis
Response to PPI Therapy (Proton Pump Inhibitors)
Esophageal pH-Monitoring
Esophageal Impedance Monitoring and High-Resolution Manometry (HRM)
Radiological Findings
Barium Swallow Radiograph
Endoscopy
Treatment of GERD
Lifestyle Modifications
Antisecretory Drugs
H2-Receptor Blockers
Proton Pump Inhibitors (PPIs)
Novel Pharmaceutical Approaches
Stereoisomers
Extended-Release PPIs
Newer PPIs
Potassium-Competitive Acid Blockers (PCABs)
Combinations of PPI with Other Agents
Agents in Pipeline
Alternative Treatments
Surgical Management
Surgical Technique
Restoration of Intra-Abdominal Esophagus
Reconstruction of Extrinsic Sphincter
Reinforcement of Intrinsic Sphincter
Special Precaution After the Surgery
Endoscopic Therapy
Complications of GERD
Benign Esophageal Stricture
Barrett's Esophagus
Diagnosis of BE
Medical Management of BE
Endoscopic Treatment of BE
Extra Esophageal Syndromes
References