Taking the ‘sauer’ out of sauerkraut: a rapid update on the pathophysiology and treatment of gastro-oesophageal reflux disease

Abstract

Gastro-oesophageal reflux disease (GERD), in layman’s terms known as heartburn, is a condition characterised by frequent oesophageal contact with gastric acid. Contrary to what is generally accepted, GERD is not caused by excessive quantities of gastric acid. Rather, symptoms result from any combination of a number of contributing factors, including decreased lower oesophageal sphincter pressure, hiatus hernia (where the stomach protrudes through the diaphragm), reduced oesophageal and gastric clearance and compromised oesophageal mucosa barrier integrity. Although most patients are able to manage GERD symptoms by means of lifestyle changes, chronic and recurrent episodes of reflux may result in erosive oesophagitis, nasal inflammation, dysphagia, i.e. difficulty in swallowing, and even pulmonary complications, e.g. asthma.