Gastroesophageal Reflux Disease

Gastroesophageal Reflux Disease (GERD) And Esophagitis​ is the medical term for a condition in which the contents of the stomach or duodenum flow into the esophagus. It may occur normally or as a persistent pathological disease.

Gastroesophageal Reflux Disease Definition

Gastro-esophageal reflux disease (GERD)

GERD is the medical term for a condition in which the contents of the stomach or duodenum flow into the esophagus. It may occur normally or as a persistent pathological disease.


Acid reflux from the stomach into the esophagus causes a painful burning sensation behind the breastbone, known as heartburn.


When the esophagus becomes inflamed, it is referred to as esophagitis.Approximately 5–10% of women in wealthy nations suffer with PCOS. An estimated 3% to 12% of women in Western nations have polycystic ovarian syndrome (PCOS), a prevalent endocrine condition with no known etiology.



Four in ten Americans have Gastroesophageal Reflux Disease GERD symptoms monthly; seventeen percent experience them weekly; and seven percent experience them daily in the United States. About 16% of the adult Asian population suffers from Reflux esophagitis (RE).


Gastroesophageal Reflux Disease (GERD)

  • Acid reflux caused by stomach acid
  • Sub-sternal pain associated with heartburn
  • Esophageal spasm causing belching

In children

  • Vomiting
  • Dysphagia
  • Refusal to eat
  • Complaints of abdominal pain


Esophagitis might develop after years of dealing with an erosive condition.

  • Sleep disruption is a common symptom
  • Dysphagia
  • Stricture formation
  • Ulceration

Clinical Presentation Typical/ Esophageal

Typical/ Esophageal

  • Heartburn
  • Acid regurgitation

A typical/Supra-esophageal

  • Chest pain
  • Laryngitis
  • Asthma
  • Sinusitis
  • Chronic cough
  • Aspiration pneumonia
  • Tooth decay

Risk Factors

  • Ingestion of a corrosive agent
  • Viral infection
  • Risk of reflux
  • Hiatal hernia
  • Reduced lower esophageal sphincter pressure
  • Tobacco use
  • Increased abdominal pressure
  • Delayed gastric emptying
  • Recurrent vomiting
  • Pregnancy


  • Eosinophilic Esophagitis
  • Erosive Esophagitis
  • Stricture Esophagitis
  • Barrett’s Esophagus

Eosinophilic Esophagitis (EoE)

Eosinophilic esophagitis (EoE) is a persistent immune-mediated illness characterized by esophageal dysfunction and eosinophil infiltration into the esophageal mucosa.

Erosive Esophagitis

40-60% of acid reflux symptoms are due to the erosive esophagitis. Symptoms of erosive esophagitis are not always proportional to the disease’s severity.

Esophageal stricture

It occurs as a result of healing of erosive esophagitis and may need dilation.

Gastroesophageal Reflux Disease Esophageal stricture

Erosive Esophagitis

In Barrett’s Esophagitis columnar metaplasia of the esophagus occurs which is associated with the development of adenocarcinoma.

Medical Nutrition Therapy

Six-food Group Elimination Diet (SFGED) containing foods which are associated most common food allergies and esophageal eosinophilia

  • Cow’s milk protein
  • Soy
  • Wheat
  • Eggs
  • Peanuts/tree nuts
  • Fish/ shellfish

Adults also showed improvement up to 50%.

Life-style Modifications:

  • Avoid eating within 3 hours after meal
  • Avoid lying down after meals
  • Avoid wearing tight-fitting garments
  • Avoid Cigarette smoking

Nutritional Recommendations:

    • Additional calories, protein, and/or micronutrients may be required
    • Nutritional supplements should be recommended
    • Carbohydrate intake should provide 45% to 55% of total calories such as whole grains, fruits, and vegetables for nutrients and fiber
    • Wheat often is removed from the diet of children who have erosive esophagitis, necessitating the use of alternate grain sources
    • About 20-25% Fats are usually recommended


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