Pathophysiology & Risk Factors
This lower esophageal sphincter dysfunction is a key factor in GERD pathogenesis
What is transient LES relaxation (TLESR)?
The most common symptom of GERD, often described as a burning retrosternal sensation
What is heartburn?
The first-line diagnostic test for uncomplicated GERD is a trial of this therapy.
What is a PPI (proton pump inhibitor) trial?
First-line lifestyle modification for GERD, especially at night
What is elevating the head of the bed (or avoiding late meals)?
Chronic GERD can lead to this metaplastic change in the esophagus
What is Barrett’s esophagus?
Obesity, hiatal hernia, and this medication class increase GERD risk by reducing LES pressure
What are calcium channel blockers (or anticholinergics, nitrates)?
This atypical GERD symptom may mimic cardiac chest pain but lacks EKG changes
What is non-cardiac chest pain?
This 24-hour pH monitoring test is the gold standard for confirming GERD
What is esophageal pH monitoring (or Bravo pH study)?
This class of drugs provides rapid but short-term relief by neutralizing gastric acid
What are antacids (e.g., Tums, Maalox)?
The most concerning complication of Barrett’s esophagus
What is esophageal adenocarcinoma?
This gastric secretory product is most responsible for esophageal mucosal damage in GERD
What is hydrochloric acid (or pepsin)?
GERD can cause this chronic respiratory symptom due to microaspiration
What is chronic cough (or asthma-like symptoms)?
This endoscopic finding suggests erosive esophagitis in GERD
What are mucosal breaks (or Los Angeles Classification grades A-D)?
The most effective long-term pharmacologic therapy for GERD
What are proton pump inhibitors (PPIs)?
Alarm symptoms that warrant endoscopy in GERD
What are dysphagia, odynophagia, weight loss, or GI bleeding?
Delayed gastric emptying, seen in conditions like diabetes, exacerbates GERD due to this mechanism
What is increased gastric volume/pressure leading to reflux?
This dental finding may suggest long-standing GERD due to acid erosion
What is enamel erosion (or tooth decay)?
A motility test that assesses LES pressure and esophageal peristalsis
What is esophageal manometry?
This surgical option is considered for refractory GERD or hiatal hernia
What is laparoscopic Nissen fundoplication?
This stricture-preventing measure is important in chronic GERD
What is long-term PPI therapy (or dilation for existing strictures)?
This type of hernia, involving upward displacement of the stomach, is strongly associated with GERD
What is a sliding hiatal hernia?
A GERD complication presenting with dysphagia and intermittent food impaction
What is esophageal stricture (or Schatzki ring)?
This scoring system assesses GERD symptom frequency and severity
What is the GERD-HRQL (GERD Health-Related Quality of Life) questionnaire?
A newer endoscopic treatment involving magnetic sphincter augmentation
What is the LINX device?
A rare but severe GERD complication involving perforation
What is an esophageal ulcer with perforation?