Chapter 25 Gastroesophageal Reflux
INTRODUCTION
Description: The reflux of gastric acid to the sensitive esophagus causes heartburn, the cardinal manifestation of gastroesophageal reflux disease (GERD).
ETIOLOGY AND PATHOGENESIS
Causes: The most common cause is decreased tone of the lower esophageal sphincter (LES). This is complicated in pregnant patients by the reduced gastric emptying and reduced esophageal sphincter tone that occur during pregnancy.
CLINICAL CHARACTERISTICS
DIAGNOSTIC APPROACH
Workup and Evaluation
Imaging: Barium swallow may demonstrate hiatal hernia or esophageal narrowing. For patients who are pregnant, this should be reserved for after completion of the pregnancy.
Special Tests: Upper gastrointestinal endoscopy eliminates other potential causes of gastroesophageal reflux disease that include esophageal motility disorders, erosive esophagitis, and peptic ulcer disease (gastric or duodenal).
