Gastroesophageal Reflux Disease

Gastroesophageal reflux disease, or GERD, is a condition in which stomach contents, including acid, pepsin, and sometimes bile, flow backward into the esophagus due to dysfunction of the lower esophageal sphincter, or the LES.

Normally, the LES prevents reflux, but in GERD, it relaxes inappropriately, especially after meals, often triggered by gastric distention.

Risk factors include obesity, aging, pregnancy, and a sliding hiatal hernia. Substances like nicotine, alcohol, and anticholinergic drugs further weaken the LES tone.

Reflux episodes may reduce esophageal clearance, allowing stomach acid to remain in contact with the esophageal lining, leading to inflammation or esophagitis.

Chronic exposure can cause esophageal fibrosis, impaired motility, and Barrett esophagus, a condition in which the normal squamous epithelium is replaced by specialized columnar cells.

Common symptoms include heartburn, regurgitation, chest discomfort, dysphagia, hoarseness, and chronic cough, often worse after eating or when lying down.