Epidemiology

Etiology

Risk factors

• Smoking, caffeine and alcohol consumption
  • All three substances decrease LES tone. Alcohol and caffeine also stimulate gastric acid secretion, which, in combination with frequent TLESRs, increases the risk of esophageal mucosal injury from the gastric refluxate.
• Stress
• Obesity
• Pregnancy
  • GERD is present in up to 80% of pregnancies. The underlying pathophysiology involves increased abdominal pressure, decreased LES tone (due to high estrogen and progesterone levels during pregnancy), and prolonged gastric emptying as a result of reduced gastric motility.
• Scleroderma
• Sliding hiatal hernia: ≥ 90% of patients with severe GERD
• Asthma

Pathophysiology

Clinical features

Diagnostics

• Biopsy
• X-ray: the esophagus courses between the trachea and vertebral bodies and is typically collapsed with no visible lumen.

Treatment

• PPIs: standard dose of PPI for 8 weeks