Gastroesophageal reflux disease (GERD)
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Gastroesophageal reflux disease (GERD)
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Gastrointestinal system pathology review
Congenital gastrointestinal disorders: Pathology review
Esophageal disorders: Pathology review
GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review
Inflammatory bowel disease: Pathology review
Malabsorption syndromes: Pathology review
Diverticular disease: Pathology review
Appendicitis: Pathology review
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Gastroesophageal reflux disease (GERD)
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0 / 7 complete
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0 / 3 complete
High Yield Notes
13 pages
Flashcards
Gastroesophageal reflux disease (GERD)
of complete
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USMLE® Step 1 style questions USMLE
of complete
| Laboratory value | Result |
| CBC, Serum | |
| Hemoglobin | 11.2 g/dL |
| Hematocrit | 33.6% |
| Leukocyte count | 10,100 /mm3 |
| Platelet count | 149,000/mm3 |
| MCV | 72 fL |
| RDW | 11.5-14.5% |
| Iron Studies, Serum | |
| Serum Iron | 90 μg/dL |
| Ferritin | Ferritin 170 ng/mL |
| Total iron binding capacity | 220 μg/dL |
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First Aid
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Acid reflux
esophageal pathology and p. 386
H2 blockers for p. 407
proton pump inhibitors for p. 408
Asthma p. 698
gastroesophageal reflux disease p. 386
Cough p. 148, 572
gastroesophageal reflux disease p. 386
Gastroesophageal reflux disease (GERD)
esophageal cancer and p. 387
presentation p. 386
Hoarseness
gastroesophageal reflux disease p. 386
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Transcript
Content Reviewers
Contributors
Elizabeth Nixon-Shapiro, MSMI, CMI
Evan Debevec-McKenney
Gastro- refers to the stomach, esophageal stands for esophagus, and reflux means “to flow back”.
So gastroesophageal reflux disease, or GERD, is when stomach acid flows back into the esophagus.
The presence of acid in the esophagus can lead to Barrett’s esophagus, a serious complication of GERD where the normal mucosa of the esophagus is replaced by one that’s similar to that of the intestines.
Barrett’s esophagus poses a higher risk of developing esophageal adenocarcinoma.
Normally, the wall of the entire gastrointestinal tract is made of 4 layers: the inner mucosa, the submucosa, a muscular layer, and an outer layer called the adventitia.
The mucosa is further divided into three layers - an innermost epithelial layer, a middle layer called the lamina propria, and an outermost layer, in contact with the submucosa, called the muscularis mucosae, which is made up of smooth muscle that contracts and helps with the breakdown of food.
Now, the stomach mucosa is different from the esophageal mucosa.
Inside the stomach, the epithelial layer is made up of cylindrical cells, which dive into the lamina propria, forming pits.
These pits are the gastric glands, and there are many of them scattered throughout the stomach.
Distributed among the cylindrical gland cells, there’s different types of secretory cells.
First, there’s G cells, which are a type of neuroendocrine cells that secrete a hormone called gastrin in response to food entering the stomach.
Gastrin stimulates another type of cells, the parietal cells, to release hydrochloric acid.
And then, there’s chief cells, which secrete an enzyme called pepsinogen.
Hydrochloric acid and pepsinogen are useful for digestion, but they can be quite aggressive for the delicate mucosa.
Luckily though, the stomach also has some defense mechanism in place.
First, the gastric glands also have foveolar cells, also called surface mucus cells, because they are closer to the surface of the stomach, and they secrete mucus.
Mucus is mostly made up of water and glycoproteins, and also bicarbonate ions which are also secreted by foveolar cells.
Sources
- "Robbins Basic Pathology" Elsevier (2017)
- "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
- "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
- "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
- "Objective Documentation of the Link between Gastroesophageal Reflux Disease and Obesity" American Journal of Gastroenterology (2007)
- "Guidelines for the Diagnosis and Management of Gastroesophageal Reflux Disease" American Journal of Gastroenterology (2013)
- "Overprescribing proton pump inhibitors" BMJ (2008)
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