$Unique_ID{BRK03766} $Pretitle{} $Title{Gastroesophageal Reflux} $Subject{Gastroesophageal Reflux GER GERD Reflux Esophagitis Barrett Esophagus (Barrett Syndrome) Hiatus Hernia} $Volume{} $Log{} Copyright (C) 1989 National Organization for Rare Disorders, Inc. 668: Gastroesophageal Reflux ** IMPORTANT ** It is possible that the main title of the article (Gastroesophageal Reflux) is not the name you expected. Please check the SYNONYM listing to find the alternate names and disorder subdivisions covered by this article. Synonyms GER GERD Reflux Esophagitis Information on the following diseases can be found in the Related Disorders section of this report: Barrett Esophagus (Barrett Syndrome) Hiatus Hernia General Discussion ** REMINDER ** The information contained in the Rare Disease Database is provided for educational purposes only. It should not be used for diagnostic or treatment purposes. If you wish to obtain more information about this disorder, please contact your personal physician and/or the agencies listed in the "Resources" section of this report. Gastroesophageal Reflux is characterized by a flowing back (reflux) of stomach or small intestines (duodenum) acids or contents into the mouth, from the tube in the back of the mouth going to the stomach (esophagus) and sometimes the mouth. This condition is a common problem and may be a symptom of other gastrointestinal disorders. Symptoms The most common symptom of Gastroesophageal Reflux is a sensation of warmth or burning, rising up to the neck area (heartburn or pyrosis). It usually occurs at night. Vomiting (regurgitation) of stomach contents either into the mouth or choking on regurgitated material may occur. Patients may complain of wheezing at night, voice hoarseness, a need to clear the throat repeatedly, and a sensation of deep pressure at the base of the neck. Complications may include inflammation of the esophagus (esophagitis), contractions of the esophagus, and possibly ulceration of the esophagus. Inflammation of the esophagus may cause pain or difficulty upon swallowing. When the condition occurs frequently it can cause erosion of the wall of the esophagus (ulcer). Slowly bleeding esophageal ulcers may cause iron deficiency anemia. Esophageal ulcers often cause the same type of pain as a stomach (gastric) ulcers, but are usually localized and higher up in the digestive system. They heal slowly, tend to recur and usually leave a tightening (stricture) on healing. Patients who repeatedly abuse alcohol tend to develop the more erosive esophagitis with bleeding. If the patient stops drinking alcohol the ulcers usually heal. Some evidence suggests that Gastroesophageal Reflux can result in aspiration of regurgitated material into the lungs which may cause chronic bronchial disease. Causes Gastroesophageal Reflux is caused by an inappropriate relaxation of the sphincter in the esophagus or lack of pressure of the sphincter. This condition is often a symptom of other gastrointestinal disorders. Affected Population Gastroesophageal Reflux affects males and females in equal numbers. It is a very common condition. Related Disorders Symptoms of the following disorders can be similar to those of Gastroesophageal Reflux. Comparisons may be useful for a differential diagnosis: In Barrett Esophagus (also known as Barrett Syndrome), the lining of the esophagus appears to have undergone some changes that may be caused by frequent Gastroesophageal Reflux. The disorder can occur during childhood or later in life. About 10% of cases may involve malignant cells. (For more information on this disorder, choose "Barrett" as your search term in the Rare Disease Database.) Hiatal Hernia is a very common digestive disorder. Symptoms may include a flow back (reflux) of stomach contents into the esophagus (gastroesophageal reflux), pain and a burning sensation in the throat. The opening in the diaphragm becomes weakened and stretched, allowing a portion of the stomach to bulge through into the chest cavity. This disorder can easily be diagnosed by special GI testing by a radiologist. Therapies: Standard Gastroesophageal Reflux may be tolerated for many years if it is uncomplicated and responds well to medical treatment. Management consist of elevating the head of the bed at least six inches during sleep, avoiding strong stimulants, such as coffee, avoiding certain nerve blocking drugs (anticholinergics), and no smoking. Specific foods such as chocolate, fats and spicy foods also tend to aggravate the symptoms. Drug therapy for GER may include: Antacids to reduce stomach acid; bethanechol can diminish gastroesophageal reflux; Cimetidine reduces acid secretion and improves heartburn; metoclopramide can increase the tone of the esophagus and prevent reflux; Cisapride restores the decreased sphincter tone and affects the movement of the intestines (peristalsis). Surgical treatment may be indicated in severe cases. Patients who have repeated episodes of GER should not rely solely on antacids and should consult a physician in order to avoid possible complications. Therapies: Investigational This disease entry is based upon medical information available through April 1989. Since NORD's resources are limited, it is not possible to keep every entry in the Rare Disease Database completely current and accurate. Please check with the agencies listed in the Resources section for the most current information about this disorder. Resources For more information on Gastroesophageal Reflux, please contact: National Organization for Rare Disorders (NORD) P.O. Box 8923 New Fairfield, CT 06812-1783 (203) 746-6518 NIH/National Digestive Diseases Information Clearinghouse Box NDDIC Bethesda, MD 20892 (301) 468-6344 References INTERNAL MEDICINE, 2nd Ed.: Jay H. Stein, ed.-in-chief; Little, Brown and Co., 1987. Pp. 5. CISAPRIDE RESTORES THE DECREASED LOWER OESOPHAGEAL SPINCTER PRESSURE IN REFLUX PATIENTS. P. Ceccatelli. GUT, (May, 1988, issue 29(5)). Pp. 631-5. ASPIRATION OF SOLID FOOD PARTICLES INTO LUNGS OF PATIENTS WITH GASTROESOPHAGEAL REFLUX AND CHRONIC BRONCHIAL DISEASE. F.M. Crausaz, et al; Chest, (Feb., 1988, issue 93(2)). Pp. 376-8. THE PATHOGENESIS OF GASTROESOPHAGEAL REFLUX DISEASE. W.J. Dodds; AJR, (1988, (issue 151 (1)). Pp. 49-56. CHARACTERISTICS AND FREQUENCY OF TRANSIENT RELAXATIONS OF THE LOWER ESOPHAGEAL SPHINCTER IN PATIENTS WITH REFLUX ESOPHAGITIS. R.K. Mittal, et al.; Gastroenterology (Sep., 1988, issue 95(3)). Pp. 593-9. MECHANISMS OF LOWER ESOPHAGEAL SPINCTER INCOMPETENCE IN PATIENTS WITH SYMPTOMATIC GASTROESOPHAGEAL REFLUX. J. Dent, et al.; GUT (Aug., 1988, issue (29(8)). Pp. 1020-8.