1. GERD
Brandon Hoff

2. What is GERD?
Gastroesophageal Reflux Disease
Acid Reflux Disease

3. What is GERD? Failure of the gastroesophageal sphincter
Irritation and inflammation of the esophagus from stomach acid
Effects 1/3 of the population at least once a month
Effects 10% of the population on a daily basis

4. Basic Anatomy of the Upper GI Tract
Mouth
Pharynx
Esophagus
Stomach

5. Gastroesophageal Sphincter
AKA: Lower Esophageal Sphincter; Cardiac Sphincter
Ring of muscle on the inferior portion of the esophagus between the esophagus and stomach
Prevents food and stomach content from reentering the esophagus

6. Gastroesophageal Sphincter
Normal Function
Relaxes during swallowing to allow food to pass
Constricts after ingestion to prevent the back flow of food
Function with GERD
The sphincter relaxes between swallowing which allows stomach content and corrosive acid to enter the esophagus
Causes damage to the lining of the esophagus

7. Stomach vs. Esophagus Stomach Esophagus pH Goblet Cells
Goblet Cells
Provides an alkaline layer of mucus to protect the stomach lining.
Esophagus
Around 7.0
No Goblet Cells

8. Causes unclear Things that make the sphincter weaker Lifestyle
Medications
Diet
Eating Habits
Other Medical Problems

9. Lifestyle
Alcohol
Cigarettes
Poor posture (slouching)

10. Medications
Calcium Channel Blockers
Theophylline

11. Diet Fatty & Fried Foods Chocolate Onions Garlic Caffeine Acidic Foods
Spicy Foods
Mint

12. Eating Habits
Large Meals
Eating 2-3 Hours Before Bedtime

13. Other Medical Causes Hiatal Hernia Pregnancy
Diabetes with Rapid Weight Gain

14. Symptoms Heartburn is the most common
Starts in the upper abdomen and spreads up the neck
Can last up to two hours
Worse after eating
Not everyone with GERD has
Regurgitation of bitter acid while sleeping or bending over
Bitter taste
Persistent dry cough
Hoarseness
Tightness in throat
Wheezing

15. Complications of GERD
Esophagitis & Ulcers

16. Complications of GERD (cont)
Bleeding

17. Complications of GERD (cont)
Stricture

18. Complications of GERD (cont)
Laryngopharyngeal Reflex

19. Complications of GERD (cont)
Respiratory Problems
Asthma
75% have GERD

20. Complications of GERD (cont)
Cancer of the Esophagus

21. Treatment
Relieve Symptoms
Prevent Damage to the Esophagus

22. Medical Treatment Lifestyle changes Medications Antacids PPI’s
Block the production of stomach acid
Coating agents
Protects mucus membranes and sores by providing another layer
Promotility Agents
Tightens the sphincter and promotes faster emptying of the stomach
Surgery
Last option
Fundoplication
Suturing of the fundus around the inferior part of the esophagus
Forms a one-way valve
Increases the pressure in the lower portion on the esophagus

23. Emergency Situations in Pt. with GERD
Severe chest pain or pressure
Especially if it radiates
Vomiting blood
Vomiting with chest pain
Dark tarry stool
Difficulty swallowing solids and liquids

24. Summary What GERD is Causes Complications Treatment
Emergency Management

25. References
Donley, Kelli M. "GERD, Asthma Connection Vague: Research Continues." Endonurse.Com. 1 Sept May 2008 <
"Gastroesophageal Reflux Disease (GERD)." Emedicinehealth. 10 Aug May 2008 <
Gillson, Sharon. "Causes of Gastroesophageal Reflux Disease." About.Com. 2 Jan May 2008 <
"Heartburn/GERD Health Center." Webmd. 18 May 2008 <
Lehrer, Jenifer K. "The Heartburn (Acid Reflex) Health Topic." Mdhelp.Com. 3 May May 2008 <
"What Causes GERD?" GERD.Com. Nov May 2008 <