GERDrelated

GERD-related describes diseases and symptoms linked to gastroesophageal reflux disease (GERD) or its complications. GERD is defined by reflux of stomach contents into the esophagus, causing symptoms or mucosal injury. Conditions commonly considered GERD-related include esophagitis, Barrett's esophagus, and esophageal strictures, as well as extraesophageal manifestations such as chronic cough, laryngitis, and dental erosion. Long-standing GERD may increase the risk of esophageal adenocarcinoma, particularly with Barrett's esophagus.

Pathophysiology and risk factors: transient relaxation of the lower esophageal sphincter, an underlying LES hypotonia, hiatal hernia, obesity, pregnancy, and delayed gastric emptying promote reflux and mucosal injury. The clinical expression depends on acid exposure, mucosal defenses, and individual susceptibility.

Clinical features: typical symptoms include heartburn and regurgitation; dysphagia or chest pain may indicate mucosal damage. Extraesophageal signs such as chronic cough, hoarseness, or throat clearing can occur. Alarm features like unintended weight loss, progressive dysphagia, or gastrointestinal bleeding require urgent evaluation.

Diagnosis: based on history; endoscopy is used to assess complications or for surveillance in selected patients. Ambulatory pH monitoring with impedance and esophageal manometry assist in uncertain cases or before planned surgery.

Management: lifestyle changes (weight reduction, smaller meals, head-of-bed elevation, avoiding late meals and triggers), and pharmacotherapy. Proton pump inhibitors are first-line; H2 blockers, antacids, and prokinetics have adjunct roles. Refractory GERD may be addressed with surgical fundoplication or endoscopic procedures in carefully selected individuals.

Prognosis and surveillance: with appropriate treatment, GERD-related symptoms and complications can be controlled, though the condition is often chronic. Patients with Barrett's esophagus require regular endoscopic surveillance according to guidelines due to cancer risk.