Gastroesophageal Reflux Disease (GERD)
Gastroesophageal Reflux Disease, also referred to as GERD, is a chronic digestive problem that happens when acid present in our stomach acid or bile starts flowing back into the esophagus. The esophagus is the long tube whose lower end lies in the lower esophageal sphincter (LES), (a muscular valve that helps to prevent the backward flow of fluids). The function of esophagus tube is to connect the throat with the stomach. In GERD, when the LES starts relaxing abnormally or becomes weak, it allows acid to escape upward, resultingin irritation in the lining of the esophagus. Occasional acid reflux is very common and often happens after heavy meals. However, when reflux occurs more frequently and disrupts your daily life, it is considered GERD. If left untreated, this condition can affect your life.
Types of GERD
GERD can appear in different kinds. The right treatment can only be chosen after understanding its type. The major types are:
- Non-Erosive Reflux Disease (NERD): In this type there is no visible damage to the esophageal lining but the patient will experience some symptoms suggesting regurgitation and heartburn.
- Erosive Esophagitis: This condition happens when there is inflammation in the lining of esophagus due to stomach fluid. This inflammation can lead to visible injury, which can be detected through endoscopy.
Silent Reflux (Laryngopharyngeal Reflux – LPR): In this form of reflux you can experience throat symptoms such as sore throat, chronic cough, and hoarseness. - Barrett’s Esophagus: This is a serious type of GERD where if stomach fluid is exposuring for a long time, then cells in the esophagus lining can be changed, which can lead to higher chances of esophageal cancer.
Symptoms of GERD
From mild to severe intensity, the symptoms of this disease are different. Common symptoms are:
- Continuous heartburn, specifically after heavy meals and in the middle of the night.
- Regurgitation of sour fluid or food into the mouth and throat.
- Chest pain
- Difficulty swallowing (dysphagia).
- Chronic cough
- Throat irritation, or hoarseness.
- A sensation of a lump in the throat.
- Bad breath
Not every patient will experience the same symptoms, and in some cases, GERD may present unusually.
Causes of GERD
There are several factors that can cause the development of GERD. The most common causes involves:
- When your lower esophageal sphincter LES is weak or damaged, and it is unable to close properly.
- Hiatal hernia: A condition where the LES becomes weak because part of the stomach pushes upward into your chest cavity.
- Obesity: Due to excessive weight there is increased pressure on the abdomen and stomach.
- Pregnancy: Abdominal pressure and hormonal changes due to pregnancy can also cause this reflux.
- Certain fatty foods, caffeine products, spicy meals and carbonated drinks are another reason fore flux.
- Smoking: Smoking can reduce saliva production and disrupt LES function.
- Medications:Some medicine can also worsen reflux, such as NSAIDs, like aspirin, sedatives, and blood pressure medications.
Diagnosis of GERD
Some medical tests are being performed to diagnose GERD. Common diagnostic methods involve:
- Medical history and physical examination:Doctors often diagnose this disease based on how frequent heartburn and regurgitation are.
- Endoscopy (EGD): A process of checking erosions or inflammation in the oesophagus by inserting a thin tube with a camera.
- PH monitoring: Reflux can be confirmed by measuring acid levels in the oesophagus over 24 hours.
- Esophageal manometry: Assessing the strength and movement of esophageal muscles.
- Barium swallow test: An X-ray examination where barium solution is swallowed by the patient to evaluate any abnormalities.
Risk Factors for GERD
Several risk factors are involved in developing GERD, such as:
- Being overweight
- Pregnancy
- Age (with increasing age, LES muscles weaken)
- Smoking
- Frequent alcohol
- Eating heavy meals and lying down soon after meals.
- Hiatal hernia.
- Long-term use of medications that affect the digestive system
- Family history with digestive problems or reflux.
Cure and Prevention of GERD
GERD symptoms can be controlled and prevented with proper management.
Treatment Options:
- Lifestyle modifications:
- Eat smaller and balanced meals.
- Avoid lying down right after eating.
- Elevate the head of the bed to reduce reflux during nights.
- Avoid foods like spicy dishes, citrus, coffee, and alcohol.
- Maintain a healthy weight.
- Quit smoking.
2. Medications: There are some medicines that are prescribed by the doctor which can help to overcome this disease. These medicines are
- Antacids: (neutralising stomach acid)
- H2 blockers: Reduce acid production
- Proton Pump Inhibitors (PPIs): Reduce stomach acid and help heal the oesophagus
- Prokinetics: They help in emptying the stomach quickly and improve esophageal motility.
3. Surgical options:
- Fundoplication: In this surgical procedure the top of the stomach is wrapped around the LES to strengthen it.
- LINX device: In this surgery reflux is prevented by placing a ring of magnetic beads around the LES.
Prevention Strategies:
- Take a balanced diet.
- Exercise regularly
- Wear loose-fitting clothing to avoid abdominal pressure.
- Reduce stress
- If you are consistently experiencing symptoms, then have regular medical check-ups.