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Gastroesophageal Reflux Disease

 
 
 
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Overview

Gastroesophageal reflux disease is a condition in which there is incompetence of the lower oesophageal sphincter, resulting in reflux of gastric acid.

Pathogenesis

  • Risk Factors for Gastroesophageal Reflux

  • Family history of reflux
  • Advanced age
  • Obesity
  • Hiatus hernia
  • Pregnancy
  • Scleroderma
  • Smoking

Manifestations

  • Complications of Gastroesophageal Reflux

  • Oesophagitis
  • Oesophageal strictures
  • Barrett’s oeseophagus
  • Oesophageal adenocarcinoma
  • Aspiration pneumonitis

Management

  • Management of Gastroesophageal Reflux

  • Non-Pharmacologic

  • Weight loss
  • Smoking cessation
  • Avoidance of certain foods - fatty, spicy, acidic
  • Elevation of the head of the bed
  • Pharmacologic

  • Antacids
  • Proton pump inhibitors - omeprazole, esomeprazole, pantoprazole
  • H2 receptor antagonists - ranitidine, nizatidine
  • Surgical

  • Fundoplication
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