GASTROESOPHAGEAL REFLUX DISEASE

Dyspepsia with mainly heart burn caused by regurgitation of gastric contents into the lower oesphagus (acid reflux).

Predisposing factors

  • Hiatus hernia
  • Increased intra-abdominal pressure
  • Gastric ulcer

Clinical features

  • Heartburn: a burning sensation in the chest. Usually brought about by bending or exertion or lying down
  • Unpleasant sour taste (due to stomach acid reflux)
  • Oesophagitis with pain and difficulty when swallowing
  • Halitosis, bloating and belching
  • Nausea, chronic pharyngitis

Complications

  • Dysphagia
  • Reflux asthma

Differential diagnosis

  • Peptic ulcer, gastritis, pancreatitis

Investigations

  • Gastroscopy
  • Barium meal and follow through

Management

  • Modify diet: avoid precipitating causes and increase milk intake
  • Give an antacid Magnesium trisilicate compound 1-2 tablets every 8 hours

If no response and no alarm signs

  • Omeprazole 20 mg once daily for 4 weeks

If not responding to 4 weeks of omeprazole refer for further management