Gastroesophageal reflux disease

(Redirected from Dyspepsia)


Posterior view of the position and relation of the esophagus in the cervical region and in the posterior mediastinum.
Layers of the GI track: the mucosa, submucosa, muscularis, and serosa.
Esophagus anatomy and nomenclature based on two systems.
  • Abbreviation: GERD
  • Definition: a highly variable chronic condition that is characterized by periodic episodes of backward flow of the gastric contents into the esophagus due to improper functioning of a sphincter at the lower end of the esophagus
    • Usually accompanied by "heartburn" symptoms and histopathologic changes in the esophagus
  • Affects up to 20% of population
  • Assume chest pain is cardiac origin until proven otherwise


Clinical Features

Severe tooth erosion in GERD[1]


  • Pain and discomfort with or right after meals
    • typically described as burning pain
    • often worse when lying flat
  • +/-Dysphagia



Differential Diagnosis

Epigastric Pain


Endoscopic image showing narrowing of the esophagus near the junction with the stomach, a complication of chronic gastroesophageal reflux disease that can cause dysphagia.
  • Avoid GERD exacerbating agents (ETOH, caffeine, nicotine, chocolate, fatty foods)
  • Sleep with head of bed elevated
  • Avoid eating within 3hr of sleep
  • PPI, H2 blocker, bismuth subsalicylate


  • Small frequent feeds, avoid semi-supine position (e.g. carseat, carrier) right after feeds
    • medications only if significant complications


  • Home (outpatient treatment)

See Also


  1. Ranjitkar S, Kaidonis JA, Smales RJ (2012). "Gastroesophageal Reflux Disease and Tooth Erosion". International Journal of Dentistry. 2012: 479850. doi:10.1155/2012/479850. ISSN 1687-8728. PMC 3238367. PMID 22194748.