Pathophysiology.
i. Definition
Gastroesophageal Reflux Disease (GERD) is a digestive disorder that occurs
when acidic stomach juices, or food and fluids back up from the stomach into the
esophagus. GERD affects people of all ages—from infants to older adults
(American Academy of Allergy, Asthma & Immunology, 2021)
GERD occurs when the sphincter at the bottom of the esophagus becomes
weak, or opens when it should not. It occurs commonly in people who are
overweight or obese because of increased pressure on the abdomen; pregnant
due to the same increased pressure; taking certain medications including some
asthma medications, calcium channel blockers, antihistamines, sedatives, and
antidepressants; smoking and being exposed to second-hand smoke (MacGill,
M. 2018)
Acid reflux happens when contents from your stomach move up into your
esophagus. It’s also called acid regurgitation or gastroesophageal Reflux. If a
person have symptoms of acid reflux more than twice a week, she/he might have
a condition known as gastroesophageal reflux disease (GERD) if left untreated, it
can sometimes cause serious complications (Weatherspoon, D. 2019)
ii. Etiology
Slow or prolong emptying of ✔️ Prolonged gastric retention
stomach (Predisposing) of food and gastric
distention caused by
delayed gastric emptying
can increase acid levels as
well as affecting lower
esophageal sphincter
function, potentially causing
GERD or exacerbating
existing GERD symptoms
(Fass, R., McCallum, R. W.,
Parkman H. P., 2009)
hiatal hernia(Predisposing) It occurs when the upper
part of the stomach moves
up into the chest through a
small opening in the
diaphragm. It also may
weaken the lower
esophageal sphincter (LES)
and increase the risk for
gastroesophageal reflux
(HealthGuard, 2021)
Eating habits (Precipitating ✔️ Diet plays a major role in
controlling acid reflux
symptoms and is the first
line of therapy used for
people with GERD," (Ekta
Gupta, 2021)
drinking and eating food with ✔️ it is dentified as one of
caffeine those can possibly trigger
heartburn in some people.
BECAUSE caffeine can
relax the LES (Madell, R.,
2018)
Fatty and fried food Fried and fatty foods can
cause the LES to relax,
allowing more stomach acid
to back up into the
esophagus. These foods
also delay stomach
emptying. Eating high-fat
foods puts you at greater
risk for reflux symptoms, so
reducing your total daily fat
intake can help (Madell, R.,
2020)
smoking The nicotine from tobacco
relaxes the valve between
the esophagus and
stomach (lower esophageal
sphincter). This can allow
stomach acid and juices,
the chemicals that break
down food in the stomach,
to back up (reflux) into the
esophagus, which causes
heartburn (Husney, A., and
Vanagunas, A. D., 2019)
overweight or obesity ✔️ The increased risk of
GERD is thought to be due
to excess belly fat causing
pressure on the stomach,
the development of a hiatal
hernia that causes the
backflow of acid or
hormonal changes like an
increase in estrogen
exposure that can occur in
individuals who are affected
by obesity (Kushner, N.,
Kushner, R., 2013)
alcoholism ✔️ Alcoholic beverages directly
contact the esophageal and
gastric mucosae and may
cause direct mucosal
damage (Franke et al.,
2005). Esophageal motor
abnormalities including
peristaltic dysfunction are
frequent in alcoholism in
both humans and cats
(Keshavarzian et al.,
1990a; Grande et al.,
1996).
iii. Symptomatology
Signs/Symptoms Present Justification
A burning sensation in ✔️ usually after eating, which
your chest (heartburn) might be worse at night
Chest pain ✔️ severe chest pain when
taking a deep breath or
coughing.
Difficulty swallowing Difficulty of swallowing can
occur when the stomach
acid flows back cause by
the abnormal or weakening
of the sphincter that leads
to the inflammation of the
esophagus lining.
Regurgitation of food or ✔️ When the lower
sour liquid esophageal sphincter, a
circular band of muscle
around the bottom of your
esophagus fails to relax
preventing the food and
liquid to flow down into the
stomach.
Sensation of a lump in ✔️ You may feel like you have
your throat food stuck in your throat
Sore Throat ✔️ if acid reflux gets past the
upper esophageal
sphincter, it can enter the
throat (pharynx) and even
the voice box (larynx),
causing hoarseness or
sore throat.
