Gastroesophageal reflux disease

(Redirected from Dyspepsia)

Background

  • Abbreviation: GERD
  • Definition: a highly variable chronic condition that is characterized by periodic episodes of backward flow of the gastric contents into the esophagus due to improper functioning of a sphincter at the lower end of the esophagus
    • Usually accompanied by "heartburn" symptoms and histopathologic changes in the esophagus
  • Affects up to 20% of population
  • Assume chest pain is cardiac origin until proven otherwise

Causes

Clinical Features

Severe tooth erosion in GERD[1]

Typical

  • Pain and discomfort with or right after meals
    • typically described as burning pain
    • often worse when lying flat
  • +/-Dysphagia

Atypical

Pediatric

Differential Diagnosis

Epigastric Pain

Management

Endoscopic image showing narrowing of the esophagus near the junction with the stomach, a complication of chronic gastroesophageal reflux disease that can cause dysphagia.
  • Avoid GERD exacerbating agents (ETOH, caffeine, nicotine, chocolate, fatty foods)
  • Sleep with head of bed elevated
  • Avoid eating within 3hr of sleep
  • PPI or H2 blocker

Infants

  • Small frequent feeds, avoid semi-supine position (e.g. carseat, carrier) right after feeds
    • medications only if significant complications

Disposition

  • Home (outpatient treatment)

See Also

References

  1. Ranjitkar S, Kaidonis JA, Smales RJ (2012). "Gastroesophageal Reflux Disease and Tooth Erosion". International Journal of Dentistry. 2012: 479850. doi:10.1155/2012/479850. ISSN 1687-8728. PMC 3238367. PMID 22194748.