Gastroesophageal reflux disease (GERD) is a medical term for a group of diseases of the esophagus, the main manifestation of which is a recurring burning sensation behind the sternum (heartburn), which is provoked by the intake of certain foods or a change in body position.
GERD is a common disease that affects 5 to 7% of people. The most common symptom of GERD is heartburn, however, this is not the only symptom of the disease. Other manifestations of GERD may include:
- belching;
- prolonged sore throat;
- difficulty swallowing or pain that occurs when swallowing;
- drooling (sudden appearance of large amounts of saliva in the mouth);
- hoarseness of voice;
- sour taste in the mouth;
- bad breath;
- inflammation of the gums;
- damage to tooth enamel (superficial).
GERD is based on gastroesophageal reflux – a regular reflux of acidic stomach contents (refluxate) into the distal (adjacent to the stomach) part of the esophagus. And in a healthy person, gastric contents can enter the esophagus, but these episodes are short-lived and are not accompanied by heartburn. This is facilitated by protection mechanisms:
- active peristalsis (contraction) of the esophageal wall, returning refluxate back to the stomach;
- a layer of mucus lining the inner surface (mucosa) of the esophagus;
- saliva that neutralizes and flushes refluxate into the stomach.
Frequent and prolonged (months, years) reflux of stomach contents into the esophagus, its large volume and aggressive properties (high acidity, bile admixture) contribute to the “depletion” of defense mechanisms and the appearance of heartburn – the first, and sometimes the only, sign of GERD. In some diseases, there is a primary violation of the defense mechanisms and heartburn can occur even with non-cordial reflux of “normal” gastric contents.
Depending on the nature of damage to the mucous membrane of the lower esophagus, GERD is divided into non-erosive reflux disease (NERD) and erosive esophagitis. In the first case, in the presence of heartburn, examination of the esophagus through an endoscope allows you to detect minimal changes in the mucous membrane, or their absence. In the second, the mucosa of the esophagus is covered with erosions (superficial damage to the mucous membrane) and inflamed.
It should be noted that heartburn can manifest itself as chest pain, which requires an immediate thorough examination for the presence of heart disease.
Sometimes GERD does not show any symptoms at all, and the disease is discovered only when complications develop.