Last updated on: August 2nd, 2023

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Gastroesophageal Reflux Disease


Gastroesophageal reflux disease (GERD)

GERD is a medical condition characterized by symptoms in the upper gastrointestinal (GI) tract and airway secondary to the movement of acidic stomach contents into the esophagus or mouth. It affects both children and adults.

GERD Subtypes

GERD subtypes are categorized endoscopically. These include erosive reflux disease (ERD), non-erosive reflux disease (NERD) and asymptomatic erosive esophagitis (AEE). ERD is defined as reflux symptoms (e.g., heartburn and regurgitation) with endoscopic evidence of esophageal erosion. NERD is the presence of reflux symptoms in the absence of esophageal damage. AEE is defined as esophageal mucosal erosions without reflux symptoms. NERD has been linked to refractory GERD (rGERD).


Multiple factors contribute to GERD. These include physiological factors such as transient lower esophageal sphincter relaxation, low lower esophageal sphincter (LES) pressure, inadequate churning of chyme and stomach acid, increased gastroesophageal junction distension and delayed gastric emptying. Pathological factors include sliding hiatal hernia, obesity and obstructive sleep apnea (OSA). Modifiable lifestyle factors include lying flat when sleeping and having meals under 2 to 3 hours before bedtime.


Globally, GERD has a prevalence of up to 40%, and affects both males and females equally. Also, while study data varies, roughly 50% of infants under the age of two months are thought to suffer from gastroesophageal reflux (GER) and about 5% by 12 months of age.

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