Gastroesophageal Reflux Disease

Gastroesophageal reflux is the retrograde movement of gastric content into the esophagus. The most typical symptoms of gastroesophageal reflux disease (GERD) are heartburn and regurgitation. Nonerosive reflux disease (NERD) patients have reflux symptoms of sufficient frequency/severity to impair their quality of life without esophagitis. Mucosal damage, identified as distal esophageal mucosal breaks on endoscopy, is encountered in 20%-40% of patients with GERD symptoms. Some degree of gastroesophageal reflux is asymptomatic and normal but GERD occurs when reflux elicits tissue injury or troublesome symptoms. Different tests are available to either identify esophageal complications as surrogate markers of GERD or to quantify esophageal acid exposure and determine whether symptoms correlate with reflux events. The principles of GERD management are to minimize reflux and/or the impact of reflux by modifications in lifestyle, pharmaceuticals, or surgery. Hypnotherapy has been proposed as such an alternative therapy, especially for patients with atypical GERD symptoms.