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Gastroesophageal Reflux Disease

Gastroesophageal Reflux Disease

Gastroesophageal reflux disease (GERD) is the backward flow of stomach contents (acid, pepsin, or bile) into the esophagus, causing mucosal inflammation known as esophagitis. It results from failure of antireflux mechanisms, mainly the lower esophageal sphincter (LES), influenced by mechanical and physiological factors.Etiology and Risk FactorsGERD develops when LES function is weakened or when intra-abdominal pressure increases. Risk factors include aging, obesity, and sliding hiatal hernia,...

Gastroesophageal Reflux Disease I: Meaning and Pathophysiology

Gastroesophageal Reflux Disease I: Meaning and Pathophysiology

Gastroesophageal Reflux Disease (GERD) involves the recurrent backflow of the stomach or duodenal contents into the esophagus, leading to troublesome symptoms and potential esophageal mucosal damage. Although GERD is often referred to as a disease, it is more accurately described as a syndrome, as it encompasses a range of symptoms and complications rather than a singular pathological entity, impacting a large number of individuals as the most prevalent upper gastrointestinal problem. Roughly...

Gastroesophageal Reflux Disease II: Clinical Features and Management

Gastroesophageal Reflux Disease II: Clinical Features and Management

Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...

Barrett Esophagus-II: Clinical Manifestations and Management

Barrett Esophagus-II: Clinical Manifestations and Management

Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure entails...

Barrett Esophagus-I: Introduction

Barrett Esophagus-I: Introduction

Barrett's esophagus is a medical condition where the esophageal mucosa is significantly damaged by stomach acid or other digestive fluids, often due to long-term exposure associated with gastroesophageal reflux disease (GERD). In GERD, a weakened or abnormally relaxed lower esophageal sphincter allows stomach acid to flow persistently into the esophagus.
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more similar...

Esophageal Achalasia

Esophageal Achalasia

Esophageal achalasia is a chronic neurogenic disorder characterized by impaired relaxation of the lower esophageal sphincter (LES) and absent or ineffective peristalsis in the distal esophagus. This leads to a functional obstruction without a physical blockage, despite significant disruption of esophageal motility.EtiologyAchalasia is caused by degeneration of the myenteric (Auerbach's) plexus, specifically the loss of inhibitory ganglion cells that produce vasoactive intestinal peptide (VIP)...

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Updated: May 15, 2026

Surgical Models of Gastroesophageal Reflux with Mice

Surgical Models of Gastroesophageal Reflux with Mice

Published on: August 25, 2015

Refractory gastroesophageal reflux disease.

Joaquim Prado P Moraes-Filho¹

¹University of Sao Paulo School of Medicine, Rua Itapaiuna 1165, São Paulo, SP, Brazil. joaquim.prado@uol.com.br

Arquivos De Gastroenterologia

|January 19, 2013

Summary

Refractory gastroesophageal reflux disease (GERD) affects 20%-42% of patients. Causes include functional heartburn, poor adherence, incorrect dosage, or misdiagnosis, necessitating further investigation beyond standard proton pump inhibitor treatment.

Area of Science:

Gastroenterology
Internal Medicine

Background:

Gastroesophageal reflux disease (GERD) is a common condition where stomach contents reflux, causing symptoms and complications.
While most patients respond to proton pump inhibitors (PPIs), 20%-42% experience refractory GERD, persisting despite standard treatment.
Understanding refractory GERD is crucial for effective patient management.

Purpose of the Study:

To review aspects of gastroesophageal reflux disease (GERD) in patients refractory to proton pump inhibitors (PPIs).
To identify potential causes and diagnostic approaches for PPI-refractory GERD.

Main Methods:

Review of literature and consensus-based recommendations for managing refractory GERD.
Discussion of diagnostic steps, including upper digestive endoscopy, to exclude other conditions.

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Main Results:

Some patients diagnosed with refractory GERD may not actually have the condition or may have been undertreated.
Upper digestive endoscopy is recommended to rule out peptic ulcers, cancer, and identify erosions.

Conclusions:

Key causes of refractory GERD include functional heartburn, poor adherence or dosage of PPIs, misdiagnosis, and comorbidities.
Other contributing factors include pill-induced esophagitis, genotypic differences, nonacid reflux, autoimmune diseases, and eosinophilic esophagitis.