Basics of Gastroesophageal Reflux Disease (GERD)

31 Aug, 16

What is Gastroesophageal Reflux Disease (GERD)?

When we eat, food passes from the throat and intthe stomach through a tube called as the esophagus or food pipe.
GERD (gastroesophageal reflux disease) is a condition in which the acidic contents of the stomach travels upwards and intthe esophagus. This acidic content hurts the esophagus leading tsymptoms and even inflammation in the esophagus.

What are the Symptoms of GERD?

The most easily recognized symptoms of GERD include a burning sensation in the chest known as heartburn and regurgitation. Patients may occasionally have unusual symptoms like chest pain, difficulty in swallowing, dry cough, and sore throat.

Who is at Risk of GERD?

Some people have a higher risk of developing GERD

People with hiatal hernia: Hiatal hernia can weaken the lower esophageal sphincter (muscle between the esophagus and stomach) causing reflux.
Being overweight: This can cause extra pressure on the stomach and diaphragm leading treflux.
Pregnancy: Increased production of female hormone: progesterone during pregnancy loosens the muscles between stomach and esophagus. Als, the growing fetus can exert pressure on the stomach.
Cigarette smoking/Heavy alcohol use: Heavy consumption of alcohol and smoking could irritate the stomach lining and induce reflux.
H. pylori infection: Reflux occurs due tthis infection as the food does not move from the stomach tthe small intestine.
Diabetes: In diabetic patients, the stomach takes longer tempty its contents, which can lead treflux.
Asthma: Reflux maybe due tcontinuous coughing and pressure on the lungs.

How is GERD Diagnosed?

Empiric PPI trial: A short course of PPI (2 weeks) is given and checked for response.
Esophageal pH monitoring: It involves inserting a thin tube intthe nose and down the esophagus. It is left in for 24 hours while it measures how much stomach acid is getting intthe esophagus.
Esophageal manometry: By measuring the muscle contractions in the esophagus, this test can tell the doctor if the lower esophageal sphincter is functioning properly.
Upper GI endoscopy: This allows the doctor tsee the esophagus with an endoscope (camera)

Can GERD be Reversed?

Most people with GERD have mild symptoms and can be treated successfully by lifestyle modifications such as:
- Avoiding chocolate, peppermint, fatty foods coffee, spicy foods, carbonated and alcoholic drinks.
- Reducing the portions at meal times and eating meals 2-3 hours before sleep.
- Elevating the head of the bed t4-6 inches while sleeping.

How can GERD be Treated?

Antacids that neutralize stomach acid: May provide quick relief. But antacids alone won't heal an inflamed esophagus damaged by stomach acid.
Medications treduce acid production: Don't act as quickly as antacids d, but they provide longer relief. E.g. Cimetidine, famotidine, nizatidine or ranitidine.
Medications that block acid production and heal the esophagus: Proton pump inhibitors are strong blockers of acid production and allow time for damaged esophageal tissue theal. E.g. Pantoprazole, Omeprazole, Lansoprazole
Surgery: It can be a very effective treatment in patients whdon't respond tother treatments

What are the Complications of Long Term GERD?

Over time, chronic inflammation in your esophagus can lead tcomplications.

Reflux esophagitis: Damage of esophagus, causing ulcers near the junction of the stomach and esophagus.
Esophageal strictures: Narrowing of the esophagus.
Barrett’s esophagus: Precancerous changes tthe esophagus.
Esophageal adenocarcinoma: Cancer of the esophagus.

References

http://sim.stanford.edu/resources/smg_patient_inf/GERD09-09.pdf Last accessed on 01/08/2016
http://www.patienteducationcenter.org/articles/gastroesophageal-reflux-disease-gerd/ Last accessed on 14/04/2016
http://www.mayoclinic.org/diseases-conditions/gerd/basics/risk-factors/con-20025201 Last accessed on 15/04/2016
http://www.mayoclinic.org/diseases-conditions/gerd/basics/risk-factors/con-20025201 Last accessed on 15/04/2016
https://www.ucsfhealth.org/education/gerd_in_ild_patients/ Last accessed on 15/04/2016
http://www.healthline.com/health/gerd/damage-reversible#Treatment4 Last accessed on 15/04/2016
http://www.mayoclinic.org/diseases-conditions/gerd/basics/treatment/con-20025201 Last accessed on 01/08/2016

This is not a substitute ta doctor's advice and care. Please refer to your doctor for any further queries.