Page 129 - Community pharmcy practice E-book 2025

02/11/2025, 00:29

Upper GIT disorders

GERD

Etiology
• GERD occurs when stomach contents reflux into the oesophagus (and sometimes beyond)
causing troublesome symptoms and/or complications. +2 +2
Key contributing factors include: Lower oesophageal sphincter (LES) dysfunction and increased
transient relaxations.
Hiatus hernia.
Obesity, high‐fat meals, large meals, eating close to bedtime.
Smoking, alcohol, certain medications (e.g., some antihypertensives, nitrates), pregnancy.

The pharmacist’s role includes taking a history to identify risk factors and triggers; also ensuring
that self-care is appropriate rather than advanced disease requiring referral.

Symptoms
• The classic (oesophageal) symptoms: heart-burn (a burning sensation rising from the
stomach/epigastric region toward the chest or throat) and regurgitation of stomach acid or
contents.
Additional symptoms: Dysphagia (difficulty swallowing)
Chest pain (non-cardiac)
Extra-oesophageal manifestations: chronic cough, laryngitis, hoarseness, dental erosion, sleep
disturbance.
Symptoms may vary in frequency and severity; some patients have intermittent mild episodes,
others have frequent or persistent symptoms that affect quality of life.

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