الفهرس 
EpidemiologyOnly 14 pages are availabe for public view
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Abstract
Gastroesophageal reflux disease (GERD) is one of the most common diseases in modern civilization, which greatly affects people’s health and quality of life.
GERD is associated with considerable morbidity and complications such as esophageal ulcerations (5%), peptic stricture (4% to 20%) and Barrett’s esophagus (8% to 20%). Furthermore, GERD as a chronic disease significantly impairs quality of life.
Symptomatic RE impairs the quality of life (QOL) of patients with chronic liver disease, so treatment of symptomatic RE should be considered in order to improve the QOL of patients with chronic liver diseases.
Patients with chronic liver diseases, especially those with portal hypertension and liver cirrhosis, have clinical manifestations, such as esophageal varices and ascites which could be factors predispose to GERD.
The present study was conducted to evaluate the frequency of GERD in patients with chronic liver disease and to identify the relationship between different clinical manifestations of patients with chronic liver diseases such as ascites, esophageal varices and portal hypertensive gastropathy in relation to GERD.
In order to fulfill this aim, a prospective study was conducted on one hundred and seventy patients with chronic liver diseases who underwent upper GI endoscopy for different indications were included in this study.
All participants in the study were subjected to the following:
• Full history taking and clinical assessment.
• Routine laboratory investigations.
• Child-Turcotte-Pugh score-classification.
• Abdominal ultrasonography.
• Upper endoscopy, GERD, if present was classified according to Los Angeles Classification.
• Esophageal Biopsies were taken whenever possible.
In our study, high frequency of GERD was demonstrated in patients with chronic liver disease about 24.1 %. The most prevalent was GERD grade (B).
Also symptomatic GERD was highly prevalent in patients with chronic liver disease, reported in about 48% of patients. Heart burn was the chief symptom present with no correlation found between heartburn and the severity of GERD.
There was a significant relationship between GERD and severity of the liver disease as assessed by Child-Turcotte-Pugh scoring system.
A significant relationship between the severity of GERD and the degree of ascites was demonstrated, as GERD grade (C) was present more frequently in patients with marked ascites.
The presence of GERD was significantly associated with the presence of esophageal varices, which could be a mechanical factor contributing to esophageal dysmotility and predisposing to GERD.
A significant relationship between the presence of GERD and the presence of signs of recent variceal bleeding was also demonstrated, so GERD could be a contributing factor leading to rupture and bleeding from esophageal