Gastroesophageal Reflux Disease (GERD)

Gastroesophageal Reflux Disease (GERD)

Gastroesophageal reflux disease (GERD) is a notable condition in which stomach acid leaks backward from the stomach into the esophagus, causing a burning sensation, chest pain, and vomiting.

Rick factors.

  • Impairment in the tone, and the relaxation of the lower esophageal sphincter due to alcohol use, smoking, certain medications like bronchodilators.
  • Abnormal propulsion of food associated with delayed swallowing response or leakage of swallowed food backward from the stomach into the esophagus
  • Gastroparesis or delayed gastric emptying leads to delayed emptying of the stomach’s content after meal triggered by high-fat diets, and chocolate

GERD occurs in all ages. However, the prevalence of GERD increases in this population.

  • Obesity or overweight
  • Alcohol consumption
  • Smoking
  • Pregnancy
  • Scleroderma
  • Diabetes mellitus
  • Certain medications used such as theophylline

Primary symptoms of GERD

  • Epigastric burning later appeared in the chest and throat, and the more noticeable symptom is delivered after a big meal.
  • Wet burp or sour burp due to acid reflux into the esophagus.

Other possible complications of GERD (atypical reflux symptoms)

  • Symptoms related to the esophagus, such as chest pain or angina.
  • Respiratory difficulties such as chronic cough, asthma
  • Symptoms related to ear nose throat include hoarseness, sore throat, hypersalivation, laryngitis, earache, otitis media, and sinusitis.
  • Other symptoms, such as dental caries, halitosis.

Recommended indication for upper GI endoscopy:

  • Odynophagia
  • Difficulties swallowing
  • Frequent vomiting
  • Vomiting blood (haematemesis)
  • Iron deficiency anemia
  • Weight loss
  • Fever

Self instructions for GERD

  • Elevating the head of the bed by 15 centimeters is recommended for those who had nocturnal symptoms.
  • Consider sleeping on the left side.
  • Avoid a high-fat diet.
  • Avoid food-induced GERD like coffee, chocolate, alcohol or soda beverages, and foods that contain tomatoes and mint.
  • Avoid eating before bed for at least 3 hours.
  • Avoid consuming big meals.
  • Avoid late dinner.
  • Smoking cessation.
  • Normalize body weight.
  • Avoid certain medications such as anticholinergic, theophylline, a tricyclic antidepressant, calcium channel blocker, beta-adrenergic agonist, and alendronate.

Complications of GERD

  • Dysphagia caused by the chronic esophageal ulcer
  • Barrett’s esophagus, a condition in which esophageal epitheliums become damaged.
  • Esophageal cancer.


  • Consider taking H2RA, proton pump inhibitor, potassium competitive acid blocker for 4-8 weeks.
  • Surgery (highly recommend for those who)
    • Wish for effective treatment by avoiding taking medicines.
    • Unable to tolerate the side effects of medicines or poor adherence.
    • Have poor financial management.

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From Bangkok Hospital Phuket