Encyclopedia of Health and Medicine

50 The Gastrointestinal System
and sometimes have a longer course of illness
than viral gastroenteritis. Treatment for radiation
gastroenteritis focuses on dietary management
(eating frequent small meals and foods high in
fiber) with ANTIDIARRHEAL MEDICATIONS to help control
diarrhea.
Risk Factors and Preventive Measures
Viral gastroenteritis is highly contagious and often
occurs in outbreaks, particularly in group settings
such as schools, day cares, nursing homes, camps,
and contained environments such as cruise ships.
These methods can significantly reduce infectious
gastroenteritis:
• proper food handling and preparation
• frequent and thorough HAND WASHING
• drinking WATER PURIFICATION (boiling, filtration,
chemical)
See also AMEBIASIS; COLITIS; CYCLOSPORIASIS; FOOD-
BORNE ILLNESSES; FOOD SAFETY; GASTRITIS; GIARDIASIS;
LISTERIOSIS; PARASITE; SALMONELLOSIS; SHIGELLOSIS;
WHIPPLE’S DISEASE.
gastroesophageal reflux disorder (GERD) A
chronic condition in which gastric contents leak
back from the STOMACH into the ESOPHAGUS. Because
stomach juices are highly acidic, this backwash creates
chemical BURNS in the delicate tissues of the
esophagus. The lining of the esophagus lacks the
protective mucus that safeguards the stomach from
gastric acid, making it vulnerable to injury. Up to 40
percent of adults in the United States have GERD.
Though GERD can develop in people of any age,
including children, the likelihood of it doing so
increases with age. Treatments to manage GERD
include medical, surgical, and lifestyle methods.
Symptoms and Diagnostic Path
The symptoms of GERD often appear or are more
severe following meals, when lying on the back,
when bending over, and when lifting or straining.
Many people experience more severe symptoms at
night that awaken them from sleep. Typical GERD
symptoms are chronic (ongoing) and include
• PAIN, pressure, or burning sensation in the midchest
• NAUSEA, and less commonly VOMITING, after eating
• regurgitation (reflux) of stomach contents up to
several hours after eating that causes a bitter
taste in the MOUTH and a burning sensation in
the THROAT
• a sense of fullness in the stomach even when
hungry
Some people also experience chronic sore
throat or hoarseness resulting from the persistent
reflux, or HICCUPS, likely due to irritation of the
DIAPHRAGM, where the esophagus and stomach
join, which is the site of the irritation. The diagnostic
path may include BARIUM SWALLOW, gastroesophagoscopy
(endoscopic examination of the
esophagus and stomach), and breath or BLOOD
tests for the presence of HELICOBACTER PYLORI.
Because GERD is so common and the diagnostic
procedures are invasive, doctors often use a trial
of medication, such as H2 ANTAGONIST (BLOCKER)
MEDICATIONS or PROTON PUMP INHIBITOR MEDICATIONS
(PPIs), to suppress gastric acid production and
then assume a diagnosis of GERD if the medication
relieves the symptoms.
Treatment and Outlook
Most people obtain full relief from their symptoms
with a combination of medical treatments and
lifestyle modifications. Many people find lifestyle
modifications (diet, WEIGHT LOSS AND WEIGHT MAN-
AGEMENT, SMOKING CESSATION) combined with
ANTACIDS adequate, while other people require
stronger medications such as H2 blockers or PPIs.
Many H2 blockers are available in over-thecounter
formulas. Reducing gastric acid significantly
reduces the amount reflux that can
backwash into the esophagus.
The most common surgical treatment for GERD
that fails to improve with medication and lifestyle
methods, fundoplication, reinforces the upper section
of the stomach (the fundus) to increase tension
on the lower esophageal sphincter. There are
several fundoplication methods, some of which
the surgeon can perform laparoscopically and others
that require OPEN SURGERY. Another surgical
option is endoscopic gastroplasty to repair or
strengthen the lower esophageal sphincter. The