Author Affiliation, Ana.
University Health Centre
Gastroesophageal Reflux Disease, a Nightmare. Is it the Patient's or the Physician's?
West Indian Medical Journal
Date of Publication
Gastroesophageal Reflux Disease (GERD) is a common disorder requiring effective management. It accounts for 15-20% of all consultations in a gastroenterological practice. This effortless movement of gastric contents from the stomach to the oesophagus normally occurs multiple times per day but becomes pathological when there is an incompetent anti-reflux barrier referred to as the Lower Oesophageal Sphincter (LES). This is an association with the irritant effect of potent refluxed material, alterations in gastric clearing or emptying and a failure of defensive factors (eg, decreased saliva production) contribute to the aetiology of GERD. Gastroesophageal Reflux Disease is not age dependent. It becomes chronic if oesophagitis is present. The quality of life is reduced considerably in patients with long-standing disease. Negative Endoscopy Reflux Disease (NERD) should be reserved for individuals who satisfy the definition of GERD but who do not have either Barrett's oesophagus or definite endoscopic oesophageal mucosal breaks. The management of GERD involves primarily life-style changes and medical interventions. Acid supression using H2antagonist remains the principal therapy. Anti-reflux surgery is used only if medical management fails and the patient fulfils the strict criteria for this procedure.....