1. <3 burn and acid regurg
    1. dmg to esophagus
      1. dt
        1. HCl
        2. pepsin
        3. bile acids
        4. pancreatin
  2. Etiology
    1. LES
      1. functional
      2. mechanical
        1. hypotensive
      3. decreased pressure
        1. drugs
        2. hormones
        3. foods
          1. alcohol, caffeine, fatty meals, chocolate, carminatives
        4. smoking
        5. pregnancy
        6. obesity
  3. Signs and Sx
    1. Typical
      1. <3burn
        1. retrosternal
        2. after eating
        3. upon lying down or bending over
      2. regurg
      3. dysphagia
      4. odynophagia
        1. pain on swallowing
      5. waterbrash
    2. Atypical
      1. coughing/wheezing
        1. dt
          1. aspiration of gastric contents
          2. vagal reflex arc producing bronchoconstriction
      2. hoarseness
        1. esp. morning
        2. dt
          1. acid
  4. Diagnosis
    1. Barium esophagram
    2. EGD
      1. can detect Barrett's
  5. Complications
    1. esophagitis
    2. Barrett esophagus
    3. strictures
    4. respiratory
      1. pneumonia, asthma, laryngitis