Gastroesophageal reflux disease. Etiopathogenesis and clinical manifestations

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Abstract

Reflux esophagitis is the most common consequence of Gastroesophageal Reflux Disease (GERD), occurring in about 60% of cases. Other manifestations of the disease include chest pain and symptoms related to the respiratory system, oropharynx and larynx. The damage to esophageal mucosa in GERD is primarily due to hydrochloric acid and pepsin and occurs when the mucosa is exposed to gastric refluxate for excessive periods of time. The defective sphincteric mechanism is the primary cause of reflux: it can be either in the lower esophageal sphincter or in crural diaphragm (hiatal hernia). Esophageal contraction abnormalities, resulting in impaired volume clearance, may be primary but most likely are secondary to reflux esophagitis. Salivary neutralization of refluxed acid is also important. Clinical manifestations of GERD are either esophageal or extra-esophageal. Heartburn is the most common and typical manifestation and may occur also in absence of mucosal inflammation; other esophageal symptoms are dysphagia, odynophagia, globus sensation and chest pain. This last one is characterized by episodes of angina-like pain and occurs also in the absence of mucosal or anatomical lesions (functional chest pain). Extraintestinal manifestations of GERD are the consequence either of the tissue injury produced by the gastric content refluxed in the larynx, hypopharynx and trachea (microaspiration), or of a neurally mediated reflex producing bronchospasm and cough.

Original languageEnglish
Pages (from-to)14-17
Number of pages4
JournalGastroenterology International
Volume10
Issue numberSUPPL. 2
Publication statusPublished - 1997

Keywords

  • Gastroesophageal reflux disease
  • Lower esophageal sphincter

ASJC Scopus subject areas

  • Gastroenterology

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