Gastroesophageal Reflux Disease: A Gastroenterologist's Perspective

Gastroesophageal reflux disease (GERD) is a commonly diagnosed condition often associated with the typical symptoms of heartburn and regurgitation, although it may present with atypical symptoms such as chest pain, hoarseness, chronic cough, and asthma. In most cases, the patient's reduced quality of life drives clinical care and diagnostic testing. Because of its widespread impact on voice and swallowing function as well as its social implications, it is important that speech-language pathologists (SLPs) understand the nature of GERD and its consequences. The purpose of this article is to summarize the nature of GERD and GERD-related complications such as GERD-related peptic stricture, Barrett's esophagus and adenocarcinoma, and laryngeal manifestations of GERD from a gastroenterologist's perspective. It is critical that SLPs who work with a multidisciplinary team understand terminology, diagnostic tools, and treatment to ensure best practice.

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Diagnosis and management of gastroesophageal reflux disease

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/s0102-67202014000300013 ◽

2014 ◽

Vol 27 (3) ◽

pp. 210-215 ◽

Cited By ~ 9

Author(s):

Maria Aparecida Coelho de Arruda Henry

Keyword(s):

Quality Of Life ◽

Surgical Treatment ◽

Gastroesophageal Reflux Disease ◽

Drug Use ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Disease Diagnosis ◽

Clinical Treatment ◽

Atypical Symptoms

INTRODUCTION: Gastroesophageal reflux disease (GERD) is probably one of the most prevalent diseases in the world that also compromises the quality of life of the affected significantly. Its incidence in Brazil is 12%, corresponding to 20 million individuals. OBJECTIVE: To update the GERD management and the new trends on diagnosis and treatment, reviewing the international and Brazilian experience on it. METHOD: The literature review was based on papers published on Medline/Pubmed, SciELO, Lilacs, Embase and Cochrane crossing the following headings: gastroesophageal reflux disease, diagnosis, clinical treatment, surgery, fundoplication. RESULTS: Various factors are involved on GERD physiopathology, the most important being the transient lower esophageal sphincter relaxation. Clinical manifestations are heartburn, regurgitation (typical symptoms), cough, chest pain, asthma, hoarseness and throat clearing (atypical symptoms), which may be followed or not by typical symptoms. GERD patients may present complications such as peptic stenosis, hemorrhage, and Barrett's esophagus, which is the most important predisposing factor to adenocarcinoma. The GERD diagnosis must be based on the anamnesis and the symptoms must be evaluated in terms of duration, intensity, frequency, triggering and relief factors, pattern of evolution and impact on the patient's quality of life. The diagnosis requires confirmation with different exams. The goal of the clinical treatment is to relieve the symptoms and surgical treatment is indicated for patients who require continued drug use, with intolerance to prolonged clinical treatment and with GERD complications. CONCLUSION: GERD is a major digestive health problem and affect 12% of Brazilian people. The anamnesis is fundamental for the diagnosis of GERD, with special analysis of the typical and atypical symptoms (duration, intensity, frequency, triggering and relief factors, evolution and impact on the life quality). High digestive endoscopy and esophageal pHmetry are the most sensitive diagnosctic methods. The clinical treatment is useful in controlling the symptoms; however, the great problem is keeping the patients asymptomatic over time. Surgical treatment is indicated for patients who required continued drug use, intolerant to the drugs and with complicated forms of GERD.

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CLINICAL PRESENTATION FEATURES IN THE ORAL CAVITY PATIENTS WITH GASTROESOPHAGEAL REFLUX DISEASE

Ukrainian Dental Almanac ◽

10.31718/2409-0255.3.2020.01 ◽

2020 ◽

pp. 5-8

Author(s):

O.P. Kerzyuk ◽

N.M. Rozhko ◽

A.V. Kindrat

Keyword(s):

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Oral Cavity ◽

Oral Mucosa ◽

Reflux Disease ◽

Social Issues ◽

Atypical Symptoms ◽

Periodontal Tissues ◽

Number Of Patients

Nowadays, gastroesophageal reflux disease (GERD) is particularly relevant because it concerns many health and social issues. According to international and national statistics, the number of GERD patients is constantly increasing, especially among the socially active segments of the population. GERD is one of the most important problems of modern gastroenterology due to the increase in the number of patients with this pathology, the presence of both typical and atypical symptoms significantly impair the quality of patients’ life. Atypical symptoms of GERD may lead to overdiagnosis of some diseases and worsen their course; sometimes patients run the risk of developing serious complications with the need of long-term medical treatment in case of insufficient awareness of physicians about GERD. Increased attention should be given to issues of concomitant pathology of the oral cavity and diseases of the esophagus taking into account the anatomical proximity, the commonness of the blood supply, innervation and humoral regulation, because the mouth is the first division of the alimentary canal. Therefore, all GERD-associated changes in the oral cavity can be divided into change in soft tissues (the vermilion border, mucosa, tongue, periodontal tissues) and hard tissues of teeth and a deterioration of the content and quality of oral fluid. Our study aimed at examining the prevalence and variation of pathological changes in the oral mucosa of GERD patients. We examined 90 patients aged 25–35 years and 45–55 years. Patients were divided into 3 groups of 30 patients in each group: 1 group – patients with diagnosed GERD with high acidity; 2 group – patients with low acidity, 3 group – control. The patients have been examined by a gastroenterologist based on generally accepted criteria, esophageal pH monitoring data as well as fibrogastroduodenoscopy of esophagus and stomach. Dental assessment included evaluating the state of oral hygiene (index Green-Vermilion), and oral mucosa condition; the periodontal status was assessed by the index Rassel. In conclusion, the findings indicate a variety of changes in oral cavity in patients with GERD, both with high and with low acidity. The prospect of our further research will be to develop an algorithm for diagnosis and treatment of oral GERD manifestations and secondary dental disease prevention.

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Comparison of presentation and impact on quality of life of gastroesophageal reflux disease between young and old adults in a Chinese population

World Journal of Gastroenterology ◽

10.3748/wjg.v17.i41.4674 ◽

2011 ◽

Vol 17 (41) ◽

pp. 4674

Author(s):

Shou-Wu Lee

Keyword(s):

Quality Of Life ◽

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Chinese Population ◽

Old Adults

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Effects of coexisting upper gastrointestinal symptoms on daily life and quality of life in patients with gastroesophageal reflux disease symptoms

Esophagus ◽

10.1007/s10388-020-00801-1 ◽

2021 ◽

Author(s):

Kimio Isshi ◽

Hiroto Furuhashi ◽

Akio Koizumi ◽

Koji Nakada

Keyword(s):

Quality Of Life ◽

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Daily Life ◽

Gastrointestinal Symptoms ◽

Disease Symptoms ◽

Upper Gastrointestinal Symptoms ◽

Upper Gastrointestinal

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POSTOPERATIVE DYSPHAGIA AFTER LAPAROSCOPIC FUNDOPLICATION AS A TREATMENT FOR GASTROESOPHAGEAL REFLUX DISEASE

British Journal of Surgery ◽

10.1093/bjs/znab160.061 ◽

2021 ◽

Vol 108 (Supplement_3) ◽

Author(s):

B Carrasco Aguilera ◽

S Amoza Pais ◽

T Diaz Vico ◽

E O Turienzo Santos ◽

M Moreno Gijon ◽

...

Keyword(s):

Gastroesophageal Reflux Disease ◽

Surgical Technique ◽

Gastroesophageal Reflux ◽

Hiatal Hernia ◽

Reflux Disease ◽

Laparoscopic Fundoplication ◽

Descriptive Study ◽

Postoperative Dysphagia

Abstract INTRODUCTION Laparoscopic Fundoplication (LF) as a treatment for gastroesophageal reflux disease (GERD) has positive clinical outcomes. However, postoperative dysphagia (PD) may appear as a side effect. Our objective is to analyze PD in patients operated on for LF in our center. MATERIAL AND METHODS Retrospective and descriptive study of patients operated on for GERD from September 1997 to February 2019. RESULTS 248 patients (60.5% men), with a mean age of 49.7 (21-82), were operated. 66.1% of the patients presented associated comorbidities, highlighting obesity (19.8%). 75% manifested typical symptoms, 19% presenting with Barrett’s esophagus. Sliding hiatal, paraesophageal, mixed and complex hernia were diagnosed in 151 (60.9%), 23 (9.3%), 12 (4.8%), and 4 (1.6%) patients, respectively. The LF Nissen was the most frequent technique (91.5%), using a caliper in 46% of the cases. PD was the most frequent symptom, present in 57 (23%) patients. It was resolved with dilation in 9 patients, requiring 6 patients surgical reintervention. In those PD cases, a caliper was used in 28 (49.1%) patients, without finding significant differences between them (P = .586). Nor were there significant differences between PD and obesity (P = .510), type of hiatal hernia (P = .326), or surgical technique (P = .428). After a median follow-up of 50.5 months, quality of life was classified as Visick I-II, III, and IV in 76.6%, 6.9% and 1.2% of the cases, respectively. CONCLUSION No association between PD and the use of calipers, surgical technique or type of hiatal hernia was found in our series.

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