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Abstract
GERD is defined as the presence of symptoms or lesions that can be attributed to the reflux of gastric juice or gastro duodenal contents into the esophagus. It is one of the most common disorders affecting the gastrointestinal tract. GERD can be defined as a pathologic condition of symptoms or histopathologic injury to the esophagus caused by percolation of the gastric juice or gastro duodenal contents into the esophagus.
Gastro esophageal reflux disease (GERD) is a common condition. It is a foregut disorder which accounts for approximately 75% of esophageal pathology. GERD is a life long condition, and of those who can be healed, over 80% relapse when treatment stopped, even if omeprazole is continued in therapeutic doses, 30% relapse by one year.
The pathophysiology of GERD includes alterations in the volume, composition, or distribution of gastric contents, anatomical and/or motor dysfunction of the antireflux barrier at the gastro esophageal junction, impaired clearance mechanism, and defective resistance to injury at the mucosal level. Acid suppressive therapy addresses one of the pathophysiological mechanisms, In spite of the efficacy of acid suppressive therapy; there have many attempts to target other aspects of GERD pathophysiology, such as basal lower esophageal sphincter (LES) pressure, esophageal body motility or gastric emptying.