Editing Gastroenterology (section)

==== Gastroesophageal reflux disease (GERD) ====
{{See also|Gastroesophageal reflux disease}}[[File:GERD.png|thumb|Gastroesophageal reflux]]A condition that is a result of stomach contents consistently coming back up into the esophagus causing troublesome symptoms or complications.<ref name="Kahrilas-2008">{{Cite journal |last1=Kahrilas |first1=Peter J. |last2=Shaheen |first2=Nicholas J. |last3=Vaezi |first3=Michael F. |date=October 2008 |title=American Gastroenterological Association Institute Technical Review on the Management of Gastroesophageal Reflux Disease |url=https://www.gastrojournal.org/article/S0016-5085(08)01605-3/abstract |journal=Gastroenterology |language=English |volume=135 |issue=4 |pages=1392–1413.e5 |doi=10.1053/j.gastro.2008.08.044 |issn=0016-5085 |pmid=18801365 |doi-access=free}}</ref> Symptoms are considered troublesome based on how disruptive they are to a patient's daily life and well-being. This definition was standardized by the Montreal Consensus in 2006.<ref>{{Cite journal |last1=Vakil |first1=Nimish |last2=van Zanten |first2=Sander V. |last3=Kahrilas |first3=Peter |last4=Dent |first4=John |last5=Jones |first5=Roger |last6=Global Consensus Group |date=August 2006 |title=The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus |url=https://pubmed.ncbi.nlm.nih.gov/16928254 |journal=The American Journal of Gastroenterology |volume=101 |issue=8 |pages=1900–1920; quiz 1943 |doi=10.1111/j.1572-0241.2006.00630.x |issn=0002-9270 |pmid=16928254|s2cid=25653840 }}</ref> Symptoms include a [[heartburn|painful feeling]] in the middle of the chest and feeling stomach contents [[Regurgitation (digestion)|coming back up]] into the mouth. Other symptoms include chest pain, nausea, [[Dysphagia|difficulty swallowing]], [[Odynophagia|painful swallowing]], coughing, and hoarseness.<ref name="National Institute of Diabetes and Digestive and Kidney Diseases">{{Cite web |title=Definition & Facts for GER & GERD {{!}} NIDDK |url=https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults/definition-facts |access-date=2022-12-08 |website=National Institute of Diabetes and Digestive and Kidney Diseases |language=en-US}}</ref> Risk factors include obesity, pregnancy, smoking, [[hiatal hernia]], certain medications, and certain foods. Diagnosis is usually based on symptoms and medical history, with further testing only after treatment has been ineffective. Further diagnosis can be achieved by [[Esophageal pH monitoring|measuring]] how much acid enters the esophagus or looking into the esophagus with a [[Esophagogastroduodenoscopy|scope]]. Treatment and management options<ref name="Kahrilas-2008" /> include lifestyle modifications, medications, and surgery if there is no improvement with other interventions. Lifestyle modifications include not lying down for three hours after eating, lying down on the left side, elevating head while laying by elevating head of the bed or using extra pillows, losing weight, stopping smoking, and avoiding coffee, mint, alcohol, chocolate, fatty foods, acidic foods, and spicy foods. Medications include [[antacid]]s, [[Proton-pump inhibitor|proton pump inhibitors]], [[H2 receptor antagonist|H2 receptor blockers]]. Surgery is usually a [[Nissen fundoplication]] and is performed by a surgeon. Complications of longstanding GERD can include [[Esophagitis|inflammation of the esophagus]] that may cause bleeding or ulcer formation, [[Esophageal stricture|narrowing of the esophagus]] leading to swallowing issues, a change in the lining of the esophagus that can increase the chances of developing cancer ([[Barrett's esophagus]]), chronic cough, asthma, [[Laryngitis|inflammation of the larynx]] leading to hoarseness, and [[Acid erosion|wearing away]] of tooth enamel leading to dental issues.<ref name="Kahrilas-2008" /><ref name="National Institute of Diabetes and Digestive and Kidney Diseases" />