Hello and welcome to the Zero to Finals podcast.

My name is Tom, and in this episode I'm going to be talking to you about gastroosophageal reflux disease.

If you want to follow along with written notes on this topic, you can follow along at

serodafinels.com slash G-O-R-D or in the gastroenterology section of the zero-definals medicine book.

So let's get straight into it.

Gastroesophageal reflux disease, which is often abbreviated to gourd or g-o-r-d, is where acid

from the stomach refluxes through the lower esophageal sphincter at the bottom of the esophagus and irritates the lining of the esophagus.

Now the esophagus has a squamous epithelial lining which makes it more sensitive to the effects of the stomach acid and the stomach has a columnar epithelial lining that's

more protective against stomach acid. Let's talk about the presentation of gastroesophageal reflux

disease. Dispepsia is a non-specific term that's used to describe the features of indigestion,

and it covers some of the symptoms of gastroesophageal reflux disease.

And these are things like heartburn,

a sensation of acid regurgitation,

or acid coming to the back of their throat.

Patients can get pain in the retraternal or behind the sternum area, in the epigastric area which is at the top of the

stomach they can get symptoms of bloating changes in their bowel habit nocturnal cough so when they're

lying flat at night acid can irritate the back of the throat and cause a dry cough, and they can also develop a

hoarse voice. So these are all things that should make you think about gastroasophageal reflux

disease as a differential. Let's talk about when you would refer a patient for an endoscopy.

And an endoscopy is where they put a camera through the throat, down the esophagus and into the

stomach to investigate for things like peptic ulcers, inflammation of the esophagus, inflammation of the

stomach, Barrett's esophagus, which we'll talk about later, and then any malignancy or cancer

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