Involuntary passage of gastric contents into the esophagus may be
physiologic (Gastroesophageal Reflux-GER) or may be associated with troublesome
symptoms (Gastroesophageal Reflux disease-GERD). GER is common in infants and is
related to immature anti reflux mechanisms. On the other hand, GERD needs further
evaluation. Presenting features of both include esophageal symptoms like vomiting and
extra esophageal symptoms such as irritability, reflux laryngitis, pharyngitis and dental
erosions. Upper GI series is not recommended for diagnosing GERD. Traditional pH
probe examinations have been replaced largely by combined multi-channel Impedance
–pH monitoring which helps establish a temporal relationship between symptoms and
pathological reflux, as well as ascertain the acidic versus non acidic, solid versus liquid
or gas nature of the refluxate. Proton pump inhibitors remain the mainstay of treatment,
along with H2 receptor antagonists and prokinetic agents. Surgical intervention should
be reserved for selected severe cases.
Keywords: Antacids, Bravo pH monitoring, Combined Multiple Intraluminal
Impedance (MII) and pH Monitoring, Endoscopy, Esophageal manometry, GER,
GERD, Lifestyle changes, Manifestations, PH monitoring, Prevalence,
Prokinetics, Upper GI imaging.
