Gastro-oesophageal reflux disease
Description
- Reflux of gastric contents causing troublesome symptoms or mucosal injury
Phenotypes - they behave differently and respond differently
| Erosive oesophagitis | Visible breaks. Los Angeles grade A-D |
| Non-erosive reflux disease (NERD) | ~70% of symptomatic patients - normal endoscopy with abnormal acid exposure |
| Reflux hypersensitivity | Normal acid exposure, symptoms correlate with reflux events |
| Functional heartburn | Normal acid exposure, no symptom correlation. PPI-unresponsive by definition |
| Barrett oesophagus | Intestinal metaplasia - see separate note |
- *A normal endoscopy does not exclude GORD* - roughly 70% of symptomatic patients have a macroscopically normal oesophagus
- Los Angeles grade C/D is diagnostic of GORD without further testing
6 more sections, plus exam facts
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