Gastroesophageal Reflux Disease Jasmine Aratea

INTRODUCTION

GERD cases recorded in Amang Rodriguez Medical Center

Year Gerd Cases Reported

2010

2011
2012 2013

1
3 1

GERD cases recorded in Jose Reyes Memorial Medical Center

Year 2011 2012 2013 Age Range 0-10 11-20 21-40 41-60 61-80 Sex Female Gerd Cases Reported 7 3 5 Cases Reported 2 3 4 2 3 Cases Reported 4

Male

11

 In a survey study based on the US Census Bureau, Population Estimates and International Data Base (2004), statistics shows that the highest grossing extrapolation prevalence rate of GERD was recorded in China with almost 38,965,428 cases reported. Second in line is India with 31, 952, 118 cases reported. In the Philippines, almost 2, 587, 250 GERD cases were recorded in 2004 which is almost 3% of todays population. Today, numerous studies are promoted by health research centers to increase the fight for curing the GERD disease.

PATHOGENESIS OF GERD
Mafe Cabiles

How does gastric acid was produced?

Among the mechanisms thought to contribute to the development of GERD are

Decreased LES resting tone
the normal LES pressure must be higher than the gastric pressure

Impaired Esophageal Acid Clearance Delayed Gastric Emptying or Gastro Paresis Decreased Salivation Impaired Tissue Resistance

Pathological VS. Normal

Bea Antonio

Normal Esophagus
Covered with non-keratinized squamous epithelium

Barretts Esophagus
The squamous epithelium is replaced with goblet cells, called intestinal metaplasia. Columnar Epithelia Major risk factor of GERD About 1 out of 10 patients with GERD are found to have Barretts Esophagus.

Alyzza Khimberly Vergara

 Heart burn and acid regurgitation Dysphagia and Odynophagia Non-cardiac chest pain Extraesophageal symptoms Symptom relapse and chronicity

 Antacids that neutralize stomach acid Prescription-strength medications Surgery and other procedures used if medications don't help.

Bianca Dela Cruz

Conclusion:
The pathophysiology of GERD is clearly multifactorial. While medical therapy can only affect gastric acid production, fundoplication restores the function of the LES and improves esophageal peristalsis. In addition, fundoplication stops any type of refluxate because it restores the competence of the gastroesophageal junction. It seems that fundoplication alone does not cause regression of Barretts esophagus and does not prevent the development of adenocarcinoma. It will be important to study in patients with Barretts esophagus the long-term effect of surgery in association with new treatment modalities such as radiofrequency ablation (RFA) and endoscopic mucosal resection (EMR). The combination should be more effective than monotherapy, because RFA and EMR eliminate the metaplastic or dysplastic epithelium, while fundoplication stops reflux, which is the original cause of Barretts esophagus.

 Successful treatment of GERD in patients whose symptoms are poorly controlled with medical treatment remains a challenge. There is limited evidence from two uncontrolled cohort studies of laparoscopic fundoplication demonstrating symptomatic improvement at 5 years. Despite the large number of medications and interventions available and the numerous clinical trials conducted, GERD remains a significant clinical problem. A number of major questions remain unstudied or, as yet, unanswered.

References
Esophagus: Barrett's esophagus, dysplasia and adenocarcinoma. (n.d.). Retrieved from http://atlasgeneticsoncology.org/Tumors/BarrettsEsophagID5591.html Barrett's Esophagus - National Digestive Diseases Information Clearinghouse. (n.d.). Retrieved from http://digestive.niddk.nih.gov/ddiseases/pubs/barretts/ Ways to Increase Stomach Acid Production [Video file]. (n.d.). Retrieved from http://www.branchbasics.com/learn/ways-to-increase-stomach-acidproduction/ Acid Production in stomach_1.flv [Video file]. (n.d.). Retrieved from http://www.youtube.com/watch?v=Wvpz9m92ZQA Developments in pathogenesis and diagnosis of gastroesophageal reflux disease [Video file]. (n.d.). Retrieved from http://cat.inist.fr/?aModele=afficheN&cpsidt=18800524 [Video file]Retrieved from http://www.cedrugstorenews.com/userapp//lessons/page_view_ui.cfm?l essonuid=&pageid=20E9006810884CADCC67B1249653D55F