Gastro-Esophageal reflux disease (GERD)


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.


  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


  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)


  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

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