| [ Summary ] |
Acidic gastro-esophageal reflux (GER) causes mucosal damage of the lower esophagus and/or uncomfortable subjective symptoms. When GER causes a state which requires medical treatment, it may be considered to be gastro-esophageal reflux disease (GERD). GERD causes not only typical symptoms, but also extraesophageal symptoms such as non-cardiac chest pain, pulmonary symptoms and/or pharyngo-laryngeal symptoms. Increased acid secretion in the general population, high enough to cause pathological acid exposure in the lower esophagus, is caused by reduced Helicobacter pylori infection, an improved nutritional environment, and a defective anti-reflux barrier, which may be induced by gastric distention with large meals and high-fat meals, through frequent transient LES relaxations which allow the occurence of GER. The rise in the elderly population has also accelerated the number of GERD patients. As the severity of esophagitis may not be an indicator of the severity of patients' subjective symptoms, one of the targets of adequate treatment for GERD is an improvement in patients' quality of life, especially in patients with endoscopy negative GERD. |