0 Gastroesophageal reflux disease (GERD)

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Gastroesophageal reflux disease (GERD)

Normal pH range in Stomach is 1-4
Normal pH range in Oesophagus is 5-7
Thus regurgitation of acidic content is harmful to oesophagus.

Normal protective mechanisms :

  • LES (lower esophageal sphincter - pressure 20-25 mmHg)
  • Oesophageal motility

Minor protective mechanisms :
  • Mucosal folds
  • Angle of  "His"
  • RIGHT Crus of diaphragm


Presentation :

  • Heart burn
  • Water brash (if into mouth)


Investigations for GERD :
  1. 24 hr pH monnitoring (IOC)
  2. Manometry (Screening method of choice)
  3. Endoscopy and barium studies have also been used.
  4. Bernstein test (Obsolete)
Treatment : 
  • Medical - PPI (Proton pump inhibitors)
  • Surgery - Same as for hiatus hernia (i.e Fundoplication , Hill's repair)




MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

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