GERD/Acid reflux
GERD (gastroesophageal reflux disease) or acid reflux is a condition in which stomach acid flows back into the esophagus, the tube that connects your mouth and stomach. This happens when the lower esophageal sphincter, a ring of muscle that acts like a valve between the esophagus and stomach, doesn't close properly or relaxes too frequently.
Symptoms
The symptoms of GERD (gastroesophageal reflux disease) or acid reflux can vary from person to person, but the most common symptoms include:
- Heartburn: a burning sensation in the chest that often occurs after eating or when lying down.
- Regurgitation: the feeling of stomach contents coming back up into the throat or mouth, often accompanied by a sour taste.
- Difficulty swallowing: feeling like food or liquids are stuck in the throat or chest.
- Chest pain: discomfort or pain in the chest, especially after eating, which can be mistaken for a heart attack.
- Chronic cough: a persistent cough that is often worse at night.
- Hoarseness or sore throat: a scratchy or irritated throat, which can be caused by the acid from the stomach irritating the vocal cords.
- Asthma-like symptoms: wheezing, shortness of breath, or a feeling of tightness in the chest, which can be triggered by acid reflux.
It's important to note that not everyone with GERD experiences all of these symptoms, and some people may not experience any symptoms at all.
Causes
Several factors can contribute to the development of GERD, including:
- Hiatal hernia is a part of the stomach that pushes up into the chest through the diaphragm, which can cause the LES to malfunction.
- Obesity or being overweight can put pressure on the abdomen, which can cause the LES to open and allow acid to reflux.
- Pregnancy: Hormonal changes and the pressure of the growing fetus on the abdomen can cause the LES to relax, leading to acid reflux.
- Spicy, acidic, or fatty foods, as well as caffeine, alcohol, and carbonated beverages, can trigger or worsen GERD symptoms.
- Smoking: Nicotine can weaken the LES, making it easier for stomach acid to reflux into the esophagus.
- Medications: Certain medications, such as aspirin, ibuprofen, and some blood pressure medications, can increase the risk of GERD.
- Genetic factors: Some people may have a genetic predisposition to GERD.
Diagnosis & Treatment
The diagnosis of GERD (gastroesophageal reflux disease) typically involves a combination of a patient's medical history, physical examination, and diagnostic tests.. Diagnostic tests that can help diagnose GERD include:
- Esophageal pH monitoring: This involves placing a small tube through the nose or mouth into the esophagus to measure the amount of acid present over a 24-hour period.
- Endoscopy: This involves passing a small camera through the mouth and into the esophagus to look for signs of inflammation or damage.
- Upper GI series: This involves drinking a contrast material and taking x-rays to look for signs of GERD.
Treatment for GERD often involves a combination of lifestyle modifications, medications, and in some cases, surgery. Lifestyle modifications may include:
- Avoiding trigger foods and drinks such as spicy, acidic, or fatty foods, caffeine, alcohol, and carbonated beverages.
- Losing weight if you are overweight or obese.
- Elevating the head of your bed.
- Eating smaller, more frequent meals.
- Quitting smoking.
Medications that may be used to treat GERD include:
- Proton pump inhibitors (PPIs): These medications reduce the production of stomach acid, which can help alleviate GERD symptoms and promote healing of the esophagus.
- H2 receptor blockers: These medications reduce the production of stomach acid, but not as strongly as PPIs.
- Antacids: These medications neutralize stomach acid and can provide short-term relief of GERD symptoms.
- Surgery: This may involve reinforcing the LES or creating a new valve to prevent stomach acid from flowing back into the esophagus.
- Newer endoscopic treatments :ARMA-Antireflux mucosal ablation, Stretta and GERDx
What to expect after treatment
With proper treatment and management, most people with GERD can expect to experience relief from their symptoms and an improvement in their overall quality of life.
Lifestyle modifications such as avoiding trigger foods and drinks, losing weight, and elevating the head of the bed can help reduce GERD symptoms and improve overall health.
Medications such as proton pump inhibitors (PPIs) or H2 receptor blockers can also help reduce acid reflux symptoms and promote healing of the esophagus. These medications may be taken for a specific period of time or may need to be continued long-term, depending on the severity of the GERD.
After surgery, patients may need to follow a specific diet or make other lifestyle modifications to promote healing and prevent complications.
