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
- Heart burn
- Water brash (if into mouth)
Investigations for GERD :
- 24 hr pH monnitoring (IOC)
- Manometry (Screening method of choice)
- Endoscopy and barium studies have also been used.
- Bernstein test (Obsolete)
- Medical - PPI (Proton pump inhibitors)
- Surgery - Same as for hiatus hernia (i.e Fundoplication , Hill's repair)
MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel