GERD is a collection of unpleasant clinic symptoms and histology’s changes,
resulting from chronic excessive repetition of the stomach contents down the esophagus (refluxate).
GERD can cause frequent to daily heartburn and damage to the esophagus.
The main symptoms are : Heartburn and Regurgitation.
These common elements affect our health and quality of life.
There are those who believe that GERD affects quality of life more than untreated high blood pressure,
duodenum ulcer, and mild heart failure.
GERD leads to serious physical and psychosocial consequences,
as a result of certain foods can worsen and urged discomfort.
Some patients avoid social situations involving meals or high levels of stress.
As a result of GERD causes increase in discomfort when lying supine,
there are disorders of rest and sleep patterns.
GERD which not treated can lead to serious consequences such as
Barrett’s esophagus which occurs when there is chronic exposure to acid,
causes Squamous epithelium type become Metaphysics epithelium type,
preliminary status of esophageal adenocarcinoma.
When developing this disorder, it is possible that typical treatment for GERD
will not prevent disease progression toward cancer.

Epidemiology

American College of Gastroenterology reports that more than – 60 million Americans
experience acid indigestion at least once a month.
Some researchers claim that 20% of patients reported Acid Reflux,
experience weekly symptoms, while many others experience daily symptoms.
International Association of gastrointestinal functional disorders reports
that GERD affects  5% -7% of the population.
Advanced age adults have a higher risk of complications of GERD
due to a long exposure of the esophagus to acid for many years.
In addition there is a higher incidence for Hiatal Hernia, decreased salivary volume and medications
which decreased pressure from esophagus lower sphincter.

Acid Reflux – Causes

Increaseing Acid provision, ghange the protection mechanism of acid esophageal,
esophagus motility disorder, hiatal hernia, overweight, spinal column damage,
partial paralysis of the stomach (gastroparesis).
All this can expose the patient to Acid Reflux.
Patients suffering from diseases such as Zollinger-ellison syndrome,
Thyroid disease, Diabetes or mixed disorders such Connective
can develop dysfunction of the esophagus associated with motion

Acid Reflux – Diagnosis

Early accurate diagnosis helps prevent complications and damage to quality of life.
Eeffective diagnostic tools are clinical presentation and medical history,
including characteristics, the way the disease developed,
frequency of symptoms duration and their progress.

Acid Reflux – Symptoms

Returns heartburn and/or regurgitation which become worse after a big meal, lying down or bending.
non origin cardiac chest pain and frequent hiccups.
Ulcers such aphthous, Middle ear infection, Erosion of the palate, Pharyngitis, and Sinusitis.
Reflux can occur in circumstances of pregnancy, and Overweight.
Patients who smoke or are taking certain medications may experience worsening of Reflux.

Treatment

Due to the chronic nature of the disease, management requires an ongoing process throughout life
even after control of symptoms achieved.
The patient will need monitoring, support and education to aid in the adjustment of daily life
and dedication to medical care.
Initial treatment for mild GERD begins with lifestyle adjustment that persist throughout the therapy.
In general nutritional recommendations include avoiding certain foods cause a rise of Acid Reflux like:

• chocolate,
• alcohol
• cola
• mint
• spicy foods or oils
• citrus fruit
• coffee
• onions and garlic.

There is a recommendation on interventions to prevent pressure on the lower esophagus cage:

• Raising the head of the bed on 6-10  inches.
• Weight loss according to the recommendations.
• Avoiding large meals.
• Avoiding lying about three hours after a meal.
• Avoiding smoking.

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