Gastroesophageal Reflux Disease ( GERD) is a symptomatic disease caused by acid reflux. or gastric juice into the upper esophagus abnormally Causes symptoms from acid irritation, for example, it can cause inflammation of the esophagus and ulcers. or esophagitis without ulceration or if acid reflux rises above the upper esophageal sphincter May cause extraesophageal symptoms [atypical or extraesophageal GERD].
Types of GERD
- Conventional GERD, or CLASSIC GERD , in which acid refluxes up into the esophagus. does not reflux beyond the upper esophageal sphincter Most will have symptoms of the esophagus only.
- Gastroesophageal reflux disease ( Laryngopharyngeal Reflux: LPR) refers to diseases of the throat and larynx. This is caused by the abnormal flow of stomach acid or gastric juices over the upper esophageal sphincter. causes symptoms of throat and larynx from acid irritation
Early symptoms of gastroesophageal reflux disease
Pharyngeal and esophageal symptoms
– Burning pain in the chest and epigastric region, sometimes radiating to the neck (rare)
– feeling like a lump in the throat or tightness in the throat
Difficulty swallowing, painful swallowing, or intermittent swallowing, as if tripping over a foreign body in the throat
– Sore throat, sore throat or mouth, or persistent burning tongue especially in the morning
-Feels like a bitter taste of bile or acidic taste in the throat or mouth (bile or acid regurgitation)
– There is phlegm in the throat. or irritating the throat all the time
Frequent belching, nausea, as if food or gastric juice refluxes into the chest or throat.
– A feeling of tightness in the chest Similar to indigestion (dyspepsia)
– Excessive saliva, bad breath, sensitive teeth, or tooth decay
Laryngeal and tracheal symptoms
– Chronic hoarseness or hoarseness only in the morning or there is an abnormal sound from the original
– A persistent cough, especially after eating or while sleeping.
– Coughing or feeling choking on saliva or suffocation at night
– Frequent coughing
– Existing asthma symptoms (if any) worsened or not improved by medication
– Chest pain (non-cardiac chest pain)
– Pneumonia comes and goes
Nose and ear symptoms
– Itching, sneezing, nasal congestion, runny nose, or nasal discharge or phlegm flowing down the throat.
– Ringing in the ears that comes and goes or pain in the ears.
When the doctor suspects that you may have gastroesophageal reflux disease In addition to history taking The doctor will thoroughly examine the ears, throat, nose and stomach area. for the differential diagnosis of other diseases that causes symptoms similar to gastroesophageal reflux disease and the doctor may
- Try high-dose proton pump inhibitor (PPI) antacids (PPI Test)
such as omeprazole (miracid®), esomeprazole (nexium®), rabeprazole (pariet®), lansoprazole (prevacid®) for a period of 2 weeks and ask about symptoms. Principles that lead patients to see a doctor or symptoms that annoy the patient the most If such symptoms Better than 50 percent may indicate that the patient has GERD.
- Endoscopy to examine the esophagus, stomach, and duodenum (Esophago-Gastro-Duodenoscopy)
Severe inflammation may be seen. and ulcers in the distal esophagus above the stomach caused by gastroesophageal reflux disease
- Send measurements of pH in the esophagus and lower pharynx ( Ambulatory 24-Hour Double-Probe pH Monitoring).
This method is the standard for the diagnosis of GERD by using a pharyngeal pH meter. lower part It is usually placed about 2 cm above the esophageal sphincter (pharyngeal probe). The esophageal probe is placed about 5 cm above the lower esophageal sphincter (esophageal probe).
When the pH of the pharyngeal probe is less than 5 and the pH of the esophageal probe is less than 4 during or during reflux from the lower esophageal sphincter. And the duration of the changes in the pH value is longer than usual, it may indicate that there is gastroesophageal reflux disease. However, this test is an examination that the patient may feel distressed or annoyed and requires expensive equipment.