Abstract
Gastroesophageal reflux disease (GERD) is caused by the pathological reflux of gastric contents into the esophagus and pharyngo-laryngeal regions. The long-lasting presence of the refluxed gastric contents stimulates the mucosal sensory nerves and causes inflammation of the mucosal surface. In the gastric contents, hydrochloric acid and pepsin are the most powerful agents causing mucosal damage. For the development of GERD, the following three factors are required: Firstly, the gastric mucosal secretion of hydrochloric acid and pepsin should be normally maintained. Secondly, the normal function of the lower esophageal sphincter to prevent gastroesophageal reflux should be damaged. Thirdly, acid clearance by the peristaltic esophageal motor function and salivary secretion should be damaged. Although the symptoms of GERD-related disease are various, acid suppression by potent proton pump inhibitors is always useful for system control as well as for disease resolution. The possible role of GERD may be considered when treating of cases of resistant pulmonary, nasal, paranasal and pharyngo-laryngo-esophageal diseases.
