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Gastroesophageal reflux disease (GERD) occurs when stomach acid frequently flows back into the esophagus, causing irritation and inflammation of the esophageal lining. Peptic ulcer disease involves the formation of open sores in the stomach lining (gastric ulcers) or the first part of the small intestine (duodenal ulcers), primarily caused by Helicobacter pylori infection or NSAIDs.
GERD results from dysfunction of the lower esophageal sphincter, allowing gastric contents to reflux into the esophagus, leading to mucosal damage from acid exposure. Peptic ulcers develop when the balance between protective factors (mucus, bicarbonate, prostaglandins) and aggressive factors (acid, pepsin, H. pylori toxins) is disrupted, resulting in mucosal erosion and ulcer formation.
GERD diagnosis is based on typical symptoms (heartburn, regurgitation) and response to acid suppression therapy, with endoscopy reserved for alarm symptoms or refractory cases. Peptic ulcer disease requires evaluation for H. pylori infection through testing (urea breath test, stool antigen, or endoscopic biopsy) and assessment of NSAID use history, with treatment involving acid suppression and H. pylori eradication when indicated.