Gastroesophageal reflux disease (GERD) is a condition in which refluxed gastric contents cause troublesome symptoms or visible injury to the esophagus. It ranges from non-erosive reflux disease (NERD), in which symptoms occur without visible mucosal injury, through erosive esophagitis and peptic stricture, to Barrett esophagus, which carries a small but real risk of esophageal adenocarcinoma.
The definition of GERD has shifted from symptoms alone toward documented reflux pathology. The modern standard asks for conclusive evidence of reflux-related injury on endoscopy (direct examination of the esophagus with a camera) or abnormal reflux monitoring, together with compatible troublesome symptoms. Typical symptoms by themselves may be enough to justify a trial of antisecretory (acid-suppressing) medication, but deciding when to test the esophagus, and how to read the results, is a separate question.
GERD is best understood from the cause of reflux, through how it presents and what it damages, to how it is tested and treated.
- Gastroesophageal Reflux Disease: Pathophysiology explains why the barrier at the gastroesophageal junction fails and which factors raise esophageal acid exposure. Start here.
- Clinical Manifestations and Differential Diagnosis describes how reflux presents and which conditions can mimic it.
- Complications covers the damage chronic reflux causes, from esophagitis to Barrett esophagus and adenocarcinoma.
- Diagnosis shows how endoscopy, reflux monitoring and manometry are selected and interpreted.
- Treatment explains how lifestyle change, acid suppression and surgery are used and sequenced.