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$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.