Definition of terms (GERD=gastroesophageal reflux disease)
Inflammation affecting the mucosal layer of the lower esophagus (visible or not visible) as a result of stomach acid flowing back up into the esophagus. The condition is characterized by heartburn, pain and acid reflux and has an adverse impact on the patient’s quality of life.
Reflux can be caused by the consumption of rich or fatty foods, certain alcoholic drinks or sweets, by an abnormal lower esophageal sphincter, a hiatal hernia or other factors such as excess weight, an unhealthy diet or stress.
Frequency of occurrence
In Western industrialized countries, the condition affects up to 20% of the population. 60% of cases show no visible changes (NERD=non-erosive reflux disease), while 40% show visible changes (ERD=erosive reflux disease).
Upper gastrointestinal endoscopy (gastroscopy, EGC=esophagogastroduodenoscopy) with visualization of, and tissue samples taken from, the area where the esophagus transitions into the stomach. Further investigations include measuring of pH levels and the gastroesophageal pH gradient after a liquid meal (pH monitoring using a capsule or rigid scope), measuring electrical resistance inside the esophagus (impedance testing), and measuring the composition of the refluxate (Bilitec).
Diet modifications, weight loss, modification of trigger factors (coping with stress, relaxation, psychotherapy focusing on specific stressful situations), medication (proton pump inhibitors=PPI), surgery (Nissen fundoplication).
In cases where symptoms persist for an extended period of time or where tissue analysis has revealed evidence of chronic changes (Barrett’s esophagus), it is advisable to perform further endoscopic investigations and tissue analysis.