Michal Demeter, Janka Božíková, Rudolf Hyrdel
Gastroesophageal reflux disease (GERD) occurs when reflux exposes the patient to the risk of physical complications, or when symptoms lead to a significant impairment of well-being or quality of life. Main pathogenic factors of GERD are transient lower esophageal sphincter relaxation, its defective basal pressure, hiatal hernia, esophageal peristaltic dysfunction, reflux juice composition, gastric motility and failure of local protective mechanisms. GERD symptoms include: heartburn, regurgitation, chest pain, dysphagia, painful swallowing, cough, sore throat, hoarseness, nausea, non-specific dyspepsia, hematemesis, melena, choking night attacks and weight loss. For an early diagnosis of GERD a careful history, physical examination and some additional tests (endoscopy, esophageal barium meal, 24-hour pH monitoring, scintigraphy and therapeutic PPI test, impedance measurements) are helpful. Several specific therapies for GERD can be indicated. These range from lifestyle modifications, medications to surgical and endoscopical interventions.