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Gastroesophageal Reflux Disease
Gastroesophageal Reflux Disease (GERD) is a condition in which the acids from the stomach move backward from the stomach into the esophagus (an action called reflux). This can occur if the muscular actions in the esophagus or other protective mechanisms fail. [For a description of the actions in the esophagus, see Box, The Esophagus.] The hallmark symptoms of GERD are heartburn (a burning sensation in the chest and throat) and regurgitation (a sensation of acid backed up in the esophagus).
Conditions Associated with GERD Esophagitis. In most people, symptoms are short-lived and occur infrequently. In about 20% of cases, however, the condition becomes chronic. In such cases the acid can cause irritation, inflammation, and even erosion of the esophagus (a condition called esophagitis).
Non-Erosive Esophageal Reflux Disease. Symptoms of gastroesophageal reflux disease can occur without any signs of inflammation or injury to the esophagus. This condition is tentatively referred to as non-erosive esophageal reflux disease (NERD). NERD rarely progresses to full-blown GERD. In NERD patients have no signs of inflammation or erosion in the esophagus, but they experience certain symptoms of GERD, such as burning sensations behind the breastbone for at least three months. Researchers suggest that nerves lying near the surface of the lining become exposed to acid that has penetrated the layers. The nerves then trigger prolonged and painful symptoms in response.
Barrett's Esophagus. Although acid is a primary factor in damage caused by GERD, other products of the digestive tract, including pepsin and bile, can also be harmful. In a small percentage of chronic patients, a serious form of GERD called Barrett's esophagus may eventually develop, in which erosion can lead to cancerous changes in the tissue lining of the esophagus.
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