Gastroesophageal

Reflux
A Presentation By:
Aimen Malik
Haiqa Sadaqat
Haleema Mazhar
Abdul Hadi Ahsan
Hassaan Afzal
Hassan Irshad Chaudhary
Asaif Khalid Khan
Hamza Ahmed
Signs and Symptoms
Burning sensation in the chest (heart burn) ,sometimes spreading to
the throat ,along with a sour taste in the mouth
Chest pain
Dysphagia
Dry cough
Hoarseness or sore throat
Regurgitation of food or sour liquid (acid reflux)
Sensation of lump in the throat
SYMPTOMS IN KIDS
• Vomiting often
• A cough that wont go away
• Refusing op eat or trouble eating
• crying during or after feeding
• Heart burn
• Gas
• Belly pain
Diagnostics
• Monitoring the amount of acid in the esophagus:
Ambulatory acid probe test use a device to measure acid for 24 hours

If there is a GERD patient and he/she is a candidate for surgery, you may also have other
tests, such as:
• An x-ray of the upper digestive system
• Endoscopy which uses a flexible tube to look inside the esophagus
• Esophageal motility testing( manometry) which measures the movements of the
esophagus
Pathophysiology
• Any condition with increased presence of HCL (High blood calcium)
• Lower esophageal sphincter malfunction (can occur in obesity and
hiatal hernia)
• Impaired esophageal clearing
• Delayed gastric emptying
• Increased gastric pressure
C
A
U
S
E
S
GERD is caused by the failure of the lower oesophageal sphincter(LES). This results in the
contents of the stomach(such as stomach acid and enzymes) going back up the oesophagus.
Diet:Food that cause LES to relax such as:
Alcohol, spicy foods, chocolate ,citrus fruits and their by products ,coffee and caffeinated
drinks ,and foods carrying gluten protein e.g. barley and wheat
These foods may or may not cause heartburn. It depends mainly on the quantity ingested
and the time of consumption(particularly before bedtime).
Hiatal Hernia :Causes weakening of LES making it easier for acid to move up the esophagus.
Pregnancy :Due to hormones and pressure exerted by the growing fetus. Worsens during
the third trimester
Scleroderma : deposition of collagen on the muscles of esophagus making LES incompetent
Smoking :Damaging mucus membranes ,Impairing muscle reflexes in the throat ,Increasing
acid secretion ,Reducing LES muscle function ,Reducing salivation, which neutralizes the
effect of acid
Drugs :Anticholinergics ,bronchodilators ,Ca channel blockers ,dopamine-active drugs
,certain sedatives ,tricyclic antidepressants ,aspirin
Others : Lying down right after taking a meal ,exercise, obesity
Prevention
Extra stomach fat places pressure on abdomen ;Lose weight if you are
obese
Reduce consumption of foods known to cause acid reflux
Eat smaller meals to avoid putting extra pressure on LES
Wait nearly 3 hours before lying down after a meal
Review your medication and consult the doctor to switch to an
alternative if a certain drug is increasing the risk of GERD
Quit Smoking
Reduce alcohol intake
Wear loose-fitting clothes
Try a gluten-free diet
Treatment
Watching your eating habits
-decreased intake of spicy food
-decreased intake of fats
-decreased intake of alcohol and caffeine

Medication
-proton pump inhibitors (PPIs)

Surgery
-Antireflux surgery (laparoscopy)