Gastroesophageal Reflux Disease GERD

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DRG Category: Mean LOS: Description:

DRG Category: Mean LOS: Description:

083 3 days

MEDICAL: Esophagitis, Gastroenteritis, and Miscellaneous Digestive Disorders Age > 17 without CC 155

3.3 days

SURGICAL: Stomach, Esophageal, and Duodendal Procedures Age > 17 without CC

^Gastroesophageal reflux disease (GERD) is a syndrome that is caused by esophageal reflux, or the backward flow of gastroesophageal contents into the esophagus. Approximately 7% of the U.S. population has symptoms of heartburn each day. GERD occurs because of inappropriate relaxation of the lower esophageal sphincter (LES) in response to an unknown stimulus. Reflux occurs in most adults, but if it occurs regularly, the esophagus cannot resist the irritating effects of gastric acid and pepsin because the mucosal barrier of the esophagus breaks down. Without this protection, tissue injury, inflammation, hyperemia, and even erosion occur.

As healing occurs, the cells that replace the normal squamous cell epithelium may be more resistant to reflux but may also be a premalignant tissue that can lead to adenocarcinoma. Repeated exposure may also lead to fibrosis and scarring, which can cause esophageal stricture to occur. Stricture leads to difficulty in swallowing. Chronic reflux is often associated with hiatus hernia.

Barrett esophagus is a condition thought to be caused by the chronic reflux of gastric acid into the esophagus. It occurs when squamous epithelium of the esophagus is replaced by intestinal columnar epithelium, a situation that may lead to adenocarcinoma. Barrett esophagus is present in approximately 10% to 15% of patients with GERD.

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