What are the differences in diagnosis, symptoms, treatment, and I guess “popularity” between ulcers and GERD?
No medical advice please, that closes threads. Just factual info on the relationship between the two. Thanks.
I did a site related to gerd (for my company) and I’ve read the entire thing 4-5 times looking for typos, errors and function - but I’ll be damned if I know anything about gerd.
But have a look-see. I think it will tell you much of what you need to know.
Ulcers are a complication of GERD, like blindness is a complication of diabetes.
GERD (gastroenterological reflux disease) is a problem caused by a weak or nonfunctioning lower esophageal sphincter–the tight spot that lets stuff stay in your stomach when you get upside down. When it’s not working properly the normal churning of the stomach splashes the yumyum up into the esophagus causing discomfort and various other porblems. The esophagus has no acid-resistant lining like the stomach does, so the acid burns it. This can cause ulcers in the esoph. and can eventually change the esoph. tissue to something more like stomach tissue. Sometimes this in turn can result in the lower portion of the esoph. closing off…so nothing gets into the stomach. Also, the yumyum (ok, it’s called chyme) can flow up the esophagus and into the trachea damaging the vocal chords and yes, waking you up with a throatful of burning vomitus. It’s an entirely unpleasant condition.
It’s caused by a number of different things, some of which are hereditary anomalies to the sphinter itself, hiatal hernia which may be exacerbated by excessive weight…basically any condition that places undue stress on the top opening of the stomach, keeping it stressed to open all the time.
Stomach ulcers, on the other hand, are caused by a failure of the stomach lining, sometimes by a bacterium (h. pylori) which allows the acid to get to work on the actual stomach.
Both conditions suck, but they are different. I don’t know about “veryone seems to have GERD these days”(not like ADD, sheesh) but if there are in fact more cases of it, it wouldn’t surprise me as we are also seeing the general population getting fatter and less healthy in general.
Cite? Esophageal erosions and malignant changes in the esophageal epithelium are complications of GERD, but gastric and duodenal ulcers (by far the most common kind) form independently of whether or not there is reflux of stomach contents into the esophagus, IIRC.
If symptoms are mostly consistant with reflux, I treat the patient’s reflux. If the symptoms change, or don’t respond to GERD treatment, I’ll consider testing for H. Pylori presence. If present, I’ll treat with triple therapy (two antibiotics and one strong acid blocker) for two weeks. If symptoms persist despite that, or if the H. Pylori is negative and symptoms persist, then it may be time for upper endoscopy to see what’s in the esophagus, stomach, and duodenum, and possibly take some biopsies.
Ulcers are common. GERD is more common. Symptoms overlap, but usually not so much that everyone with heartburn needs an automatic ulcer evaluation.
My post is my cite. What would you know about it anyway, sawbones? 
You & I are talking about two different types of ulcers, I imagine. The terminolgy “esophageal erosions” is more like what I had in mind, but my country doc referred to 'em ulcers or ulcerations. He may have been making words up, but the corrective surgery we did was spot on.
And since you know so much, how common is H. Pylori in the U.S. these days? What other conditions lead to :ahem: proper ulcers?
My mother’s doctor told her last week (after she tested positive for H. Pylori, though asymptomatic) that 40-50% of American adults have it. No cite, just what the doctor recently said.
Of all things we took down the gerd webpage today for internal reasons (I can’t go into it here)
But, much of the content on our site was on loan from mayoclinic.com. Here is their GERD site.
Inigo Montoya, I’m sure you meant Gastric-Esophageal Reflux Disease, right? 
dnooman,
The two disorders are related only in that they both occur in the Alimentary Canal, which, according to Gray’s Anatomy, includes the mouth, pharynx, esophagus, stomach. duodenum, jejunun, ileum, cecum, colon, and rectum.
At the distal end of the esophagus is the cardiac sphincter, or orifice, which, like so many of our parts as we age, begins to lose some of the tone it once had.
If the stomach is over filled, or there is excess abdominal fat pressing on the stomach, some of the kine (a mixture of food and HCl, the first phase of digestion) creeps back up the esophagus, causing, “heartburn” or gastric- esophageal reflux. It can be a burning sensation or just a bad taste. GERD is the out come of untreated GER.
Gastro-intestinal ulcers sometimes cause abdominal pain that is relieved eating, but comes back frequently. Sometimes there are no symptoms at all. Sometimes the first indication of a problem is a massive GI bleed.
As has been said, some are caused by Heliobacter Pylori. There isn’t yet proof that all GI ulcers are caused by H. Pylori but it may be. The link is to a fairly readable site, with lots of good and interesting information.
eh…I’m a car insurance punk. I’m happy just to be here.