Gastroesophageal reflux disease (GERD) – is a clinical symptom complex that develops due to reflux of gastric contents into the esophagus (Reflux) As a result, GERD is currently considered the most common and widespread disease of the gastrointestinal tract in the world, and GERD symptoms are observed in approximately 401% of the population. All this led to the emergence of the following slogan: "The 20th century is the century of peptic ulcer disease, and the 21st is the century of GERD.". 

GERD is considered a multifactorial disorder caused by multiple pathogenic mechanisms: lower esophageal sphincter insufficiency, hiatal hernia, delayed gastric emptying, hypersecretion of gastric juice, duodenogastric reflux, etc. It is noteworthy that in the presence of GERD, 80-90% of cases also have a hiatal (diaphragmatic) hernia.

Risk factors for developing GERD include: obesity, cigarette smoking, alcohol, spicy and acidic foods, and heredity.

GERD is a problem of stomach acid getting into the wrong place!

Symptoms of GERD It is presented in two groups: typical (heartburn, regurgitation, belching, difficulty swallowing, pain) and atypical (non-cardiac chest pain, hypersalivation, laryngitis, chronic cough, chronic obstructive pulmonary disease, etc.).

During chronic GERD, the following complications may develop: esophageal peptic ulcer, esophageal varices, Barrett's esophagus, bleeding, and adenocarcinoma.

The following are used to detect and diagnose GERD: esophagogastroduodenoscopy, lower esophageal sphincter manometry, gastrointestinal tract X-ray examination, 24-hour pH-metry, Helicobacter pylori examination, and histological examination. 

GERD treatment It involves a three-step approach:

I –  Lifestyle changes (weight control, diet correction, limiting smoking and alcohol consumption)

II – Drug therapy (antacids, H2 blockers, PPIs (proton pump inhibitors)

III –  Surgical treatment, which involves performing antireflux operations, so-called fundoplications, by open or laparoscopic methods. However, it should be noted that in recent years, laparoscopic Nissen fundoplication has been considered the “gold standard” and the method of choice for surgical treatment of this pathology, with an effectiveness rate of 90-95%. 

When should you consult a surgeon?

• When GERD symptoms progress and become bothersome
• When medical treatment for GERD is ineffective
• When GERD complications develop