Medicine an Surgery notes

Apr 25th, 2015
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Gastroesophagealreflux disease(GERD)Dr kibaru1IntroductionPathophysiologyepidemiology and natural historyClinical featuresDiagnosisTreatmentprognosis2IntroductionGERD is the most common esophageal disorder inchildren of all ages Gastroesophageal reflux (GER) signifies theretrograde movement of gastric contents across thelower esophageal sphincter (LES) into the esophagus occasional episodes of reflux are physiologic,exemplified by the regurgitation of normal infants3Gastroesophagial reflux becomes pathologic (GERD)in children who haveepisodes that are more frequent or persistent, and thusproduce esophagitis or esophageal symptoms or in those who have respiratory sequelae4Factors determining the esophageal manifestationsof refluxthe duration of esophageal exposure (a product ofthe frequency and duration of reflux episodes) the causticity of the refluxatethe susceptibility of the esophagus to damage.5PathophysiologyThe LES, supported by the crura of thediaphragm at the gastroesophageal junction,together with valvelike functions of theesophagogastric junction anatomy form theantireflux barrier6the frequency of reflux episodes is increased by insufficient LES tone by abnormal frequency of LES relaxations by hiatal herniation that prevents the LES pressure frombeing proportionately augmented during abdominalstraining7The duration of r

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