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Gastroesophageal reflux disease (GERD) or gastro-oesophageal reflux disease (GORD) is a chronic upper gastrointestinal disease in which stomach content persistently and regularly flows up into the esophagus, resulting in symptoms and/or complications.
Symptoms include burping, abdominal and stomach bloating, along with pain and discomfort. Heavy meals, lying down or bending over after eating should be avoided to help prevent reflux from occurring. The stomach bloating experienced with reflux is intense and will remain until the food is digested all the way.
Jamie A. Koufman is a physician and researcher on the topic of acid reflux.She coined the terms "laryngopharyngeal reflux" and "silent reflux".[1]Koufman is the founder and director of the now defunct Voice Institute of New York, [2] a comprehensive voice and reflux treatment center, and Professor of Clinical Otolaryngology at New York Medical College.
Patients that continue to have reflux symptoms or that have had uncontrolled reflux symptoms for more than 5 years are also candidates for surgical management. [6] Complications that arise from long term GERD such as severe esophagitis, stricture formation, and ulcer development, all of which can be seen on endoscopy, warrant surgical intervention.
Laryngopharyngeal reflux (LPR) or laryngopharyngeal reflux disease (LPRD) is the retrograde flow of gastric contents into the larynx, oropharynx and/or the nasopharynx. [4] [5] LPR causes respiratory symptoms such as cough and wheezing [6] and is often associated with head and neck complaints such as dysphonia, globus pharyngis, and dysphagia. [7]
Pepsin remains in the larynx following a gastric reflux event. [16] [17] At the mean pH of the laryngopharynx (pH = 6.8) pepsin would be inactive but could be reactivated upon subsequent acid reflux events resulting in damage to local tissues. Pepsin exhibits a broad cleavage specificity. Pepsin will digest up to 20% of ingested amide bonds. [18]
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Reflux esophagitis Although it usually assumed that inflammation from acid reflux is caused by the irritant action on the mucosa by hydrochloric acid , one study suggests that the pathogenesis of reflux esophagitis may be cytokine-mediated.