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GERD - Causes, effects & treatment

ShyamprofileDr. Shyamprasad

Gerd

What is GERD?

Gastroesophageal reflux disease, or GERD, is a digestive disorder that affects the lower esophageal sphincter (LES), the ring of muscle between the esophagus and stomach. Many people, including pregnant women, suffer from heartburn or acid indigestion caused by GERD. Doctors believe that some people suffer from GERD due to a condition called hiatal hernia. In most cases, GERD can be relieved through diet and lifestyle changes; however, some people may require medication or in extreme cases surgery.

Symptoms of GERD

Chronic heartburn is the most common symptom of GERD. Acid regurgitation (refluxed material into the mouth) is another common symptom. But numerous less common symptoms other than heartburn may be associated with GERD. These may include:

  • Frequent belching
  • Difficulty or pain when swallowing
  • Waterbrash (sudden excess of saliva)
  • Dysphagia (the sensation of food sticking in the esophagus)
  • Chronic sore throat/Laryngitis
  • Inflammation of the gums
  • Erosion of the enamel of the teeth
  • Chronic irritation in the throat
  • Hoarseness in the morning
  • A sour taste
  • Bad breath

Chest pain may indicate acid reflux. Nevertheless, this kind of pain or discomfort should prompt urgent medical evaluation. Possible heart conditions must always be excluded first.

Top foods contributing to GERD:

  • Chocolate
  • Soda
  • Deep fried foods
  • Alcohol
  • Dairy products high in fat content
  • High fat red meats
  • Caffeine
  • Citrus juices
  • Spicy foods
  • Peppermints

Heartburn vs Acid reflux vs GERD

Heart Burn

The heart actually has nothing to do with the pain. Heartburn occurs in your digestive system. Specifically, in your esophagus. Heartburn involves mild to severe pain in the chest. It’s sometimes mistaken for heart attack pain.

The lining of your esophagus is more delicate than the lining of your stomach. So, the acid in your esophagus causes a burning sensation in your chest. The pain can feel like a sharp, burning, or a tightening sensation. Some people may describe heartburn as burning that moves up around the neck and throat or as discomfort that feels like it’s located behind the breastbone. Heartburn usually occurs after eating. Bending over or lying down can make it feel worse. Mild, infrequent heartburn can also be treated with medications like antacids. If you take antacids more than several times a week a doctor should evaluate you. Your heartburn may be a symptom of a more severe problem like acid reflux or GERD.

Acid reflux

A circular muscle called the lower esophageal sphincter (LES) joins your esophagus and stomach. This muscle is in charge of tightening your esophagus after food passes to the stomach. If this muscle is weak or doesn’t tighten properly, the acid from your stomach can move backward into your esophagus. This is known as acid reflux.

GERD

(as per the 1st paragraph)

Treatment goals:

  • To bring the symptoms under control so that the individual feels better;
  • To heal the esophagus of inflammation or injury;
  • To manage or prevent complications such as Barrett's esophagus or stricture;
  • To maintain the symptoms of GERD in remission so that daily life is unaffected or minimally affected by reflux.

Common medications:

Many medications have been used to control of GERD depending on the severity:

·       Proton pump inhibitors (PPI) are the mainstay of treatment. They are potent acid reducers that block the pumps responsible for supplying the acid to the stomach. These    

medications are generally safe and can be taken once or twice per day as per the prescription of the medical professional (half an hour before breakfast or dinner).

·       Antacids neutralize the acidity of the stomach and provide short-term relief.

·       Other medications such as sucralfate provide a barrier that lines the esophageal and stomach mucosa and protect it from the gastric juices, thus providing the needed time to heal.

·       Antihistamines such as ranitidine and famotidine also can be used to decrease the secretion of acid into the stomach lumen.

 

Long-Term Effects of GERD

Untreated gastroesophageal reflux disease can lead to esophagitis - inflammation of the esophagus. Stomach acid is very irritating to the lining of the esophagus and can cause long-term damage. Over time, you could develop a painful ulcer.

Bleeding of the esophagus is a common long-term complication of GERD. Over a long period of time, the continuous loss of blood can lead to anemia. Stools that are very dark in color can be a warning sign of internal bleeding.

A serious, although relatively rare, complication of esophagitis is that scar tissue - known as strictures - can narrow the esophagus, making it difficult to swallow. Strictures may need to be treated by inserting an endoscope into the esophagus and inflating a balloon to dilate the passage so that food can pass through.

 Barrett's esophagus is a serious potential consequence of gastroesophageal reflux disease. In this condition, the cells in the esophageal lining change to become more like cells in the intestines. Barrett's esophagus can develop into esophageal cancer, which can be fatal.

Habits to follow for prevention of GERD:

•      Stop smoking

•      Cut down on alcohol

•      Lose weight if obese

•      Eat smaller more frequent meals

•      Eat meals that are less in fat

•      Don't eat right before bed

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