Tuesday, 5 July 2011

GERD(Gasro-Esophageal Reflex Disorder)

It is a condition caused due to gastric contents into the esophagus and proximal structures.
Clinical Presentation:
  • symptoms- heart burn and regurgitation
  • Atypical chest pain
  • Extraesophageal manifestations-cough,laryngitis,asthma and  dental erosions. Also  there may be sinusitis,pulmonary fibrosis,pharyngitis and recurrent otitis media.
  • Response to therapeutic trial of PPI can be diagnostic but a negative response does not exclude the disease
Investigation:
  • Endoscopy to rule out other causes of such esophageal symptoms, like eosinophilic esophagitis,candidial esophagitis etc
  • 24hrs esophageal pH monitoring (investigation of choice)
  • Esophageal manometry to identify motos process contributing to refractory symptoms
Treatment:
  •  Antacids,histamine-2 receptor antagonists,PPI may relieve symptoms in mild and intermittent conditions
  • PPI(Proton Pump inhibitors) are more effective than other treatment modalities.
  • In conditions not responding to medical treatment,they are surgically managed by Nissen's Fundoplication

No comments:

Post a Comment