GERD, gastroesophageal reflux disease, occurs both as an independent pathology, and as a symptom of other diseases of the upper gastrointestinal tract. Sometimes GERD is accompanied by unusual symptoms, and it is not easy to recognize it.
With GERD, food enters the stomach and/or the duodenum back into the esophagus (reflux), which leads to damage to its mucous membrane.
Different types of GERD affect up to 60% of adults. 10% have pronounced GERD symptoms.
Causes of GERB
The mechanism of development and causes GERBER consist of three groups of factors.
- Reflux is not enough for the development of GERD. The reverse abscess of food in the esophagus occurs with an increase in intraabdominal pressure and/or with the relaxation of the lower sphincter of the esophagus, which does not adequately cover the transition from the esophagus to the stomach. Spontaneous physiological reflux (bloating) occurs when overeating, abdominal tension or involuntary relaxation of the lower esophageal sphincter. It does not necessarily lead to the development of GERD.
- Increasing the acidity of the contents of the stomach in combination with persistent gastroesophageal reflux is the most common cause of GERD. Therefore, stomach illness with high acidity (hyperacid gastritis, peptic ulcer disease) is often complicated by GERD.
- Reduced resistance (resistance) to the esophagus mucus after regular reflux attacks with acidic stomach contents occurs later but always preceded by damage to the esophagus.
How does GERB progress?
- Non-peripheral GERD develops at the onset of the disease and manifests itself as a catarrhal inflammation of the lower esophagus. Difficulties with the passage of food at this stage of the disease do not affect patients.
- Erosive-ulcerative GERD is characterized by deep damage to the mucous membrane and submucosal layers of the esophagus. It is often complicated by narrowing of the esophagus and trophic ulcers of the lower parts.
- Barret's esophagus is a precancerous epithelium of the esophagus.
Esophageal GERD Symptoms
The expressiveness of clinical manifestations of GERD depends on the degree of damage to the mucous membrane and corresponds to the stages of disease development.
Heartburn and pain in the epigastric region, behind the sternum are the classic symptoms of GERD, which are manifested at all stages. They are associated with food intake and are usually purchased by taking antacids.
In the erosive-ulcer form of the disease, which is complicated by narrowing of the esophagus, patients begin to experience difficulties with the passage of solid food. They complain of "lump in the throat" that "food is in the stomach", often there are attacks of nausea and vomiting.
Unusual symptoms of GERD
GERD is often manifested by symptoms of damage to other organs and systems, which in some patients, in the absence of heartburn, causes difficulty in diagnosing.
- Abdominal symptoms of GERD are most closely related to the esophagus. Among them: fast saturation, abdominal weight, nausea, vomiting, flatulence.
- Respiratory symptoms GERD: shortness of breath in the lying position, frequent bronchitis and pneumonia, chronic cough.
- Cardiac manifestations of GERD are most dangerous in the absence of heartburn. In all cases, an overgrowth of the ECG is mandatory.
- Otorhinolaryngologic displays of GERD are most often observed. These include: pain in swallowing, perspiration, lack of voice (obesity), pain in the ears, laryngitis, pharyngitis.