الفهرس 
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Abstract
Gastroesophageal reflux disease (GERD) is a digestive disorder that is caused by gastric acid flowing from the stomach into the esophagus. It is a chronic disease that causes mucosal damage by stomach acid coming up from the stomach into the esophagus.
The esophagus, lower esophageal sphincter (LES), and stomach can be described as a simple plumbing circuit. The esophagus functions as an ante-grade pump, the LES as a valve, and the stomach as a reservoir. The abnormalities from any component of this system lead to GERD.
Gastroesophageal reflux disease is a common chronic, relapsing condition that associated with a risk of significant morbidity and the possibility of mortality from complications. GERD estimate about 24% of the population have heartburn daily or more often, while 43% experience heartburn as often as once or twice a week. Moreover, patients can typically experience chronic heartburn for periods ranging from less than 1 year (15%) to more than 10 years (29%).
Gastroesophageal reflux disease, with its main symptoms of heartburn and regurgitation, is one of the most common conditions affecting the esophagus; however, the symptoms in GERD patients are more complex and also extend to extra-esophageal manifestations. GERD also includes subcategories as, non-erosive esophageal reflux disease (NEERD) and the additional pathologies that result as GERD progresses, including esophageal ulcer, esophageal stricture, Barrett’s esophagus, and Barrett’s carcinoma (esophageal adenocarcinoma).
There is no gold standard for diagnosing GERD, although 24-hour pH monitoring (pH probe) is the accepted standard for establishing or excluding its presence. While endoscopy lacks sensitivity for identifying pathologic reflux, it is the gold standard for assessing esophageal complications of GERD. Endoscopy is used to identify Barrett’s esophagus and esophagitis in patients with long-term symptoms or alarm symptoms. It is possible to have severe symptoms of GERD with negative endoscopic findings, while it is also possible to have no symptoms and positive endoscopic findings. Therefore, the absence of symptoms does not indicate the absence of pathology. Barium radiology is seldom useful for diagnosing GERD.