Definition:

GERD is not a disease but a heterogeneous syndrome resulting from esophagus reflux. Most cases are attributed to the inappropriate relaxation of the lower esophageal sphincter (LES) in response to unknown stimulus.

Etiology:

1. Common cause is Hiatus Hernia
2. Increases intra-abdominal pressure (Obesity, Pregnancy)

Clinical features:

1. Heart burn
2. Wheezing
3. Hoarseness
4. Dysphonea
5. Nausea
6. Vomiting
7. Regurgitation
8. Dysphagia
9. Odynophagia
10. Bleeching

Investigations:

1. Gastro-esophagealscopy
2. Barium swallow
3. Biopsy

Medical Management:

1. Antacids (to relieve heart burn)
2. Histamine 2 receptors
3. Prokinetic drugs (to increase LES)
4. Proton pump inhibitor (to inhibit the enzymatic activity)

Surgery:

1. Anti-reflux surgery

Nursing Management:

1. Patient should be encouraged to eat 4-6 small meals daily
2. Follow a low-fat, adequate protein diet
3. Eliminate alcohol, beverages and tobacco
4. Avoid constrictive clothing over the abdomen
5. Elevate the bed at least 6-8 inches
6. Never sleep flat on the bed