What is GERD? (Acid Reflux): Symptoms, Treatment, Causes, and More.
What is GERD? (Acid Reflux)
Gastroesophageal reflux disease, or GERD, is a digestive ailment that affects the muscular ring that connects the oesophagus to the stomach. You may get heartburn or acid indigestion if you have it. Doctors believe that certain people may suffer from it as a result of a disorder known as hiatal hernia. In most situations, GERD symptoms can be alleviated with dietary and lifestyle adjustments. However, some individuals may require medicine or surgery.
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Causes
Acid reflux occurs sometimes and is frequently caused by eating a heavy meal, reclining down after eating or consuming certain foods. Recurrent acid reflux, or GERD, on the other hand, generally involves additional causes and risk factors and can result in more serious consequences.
GERD affects people of all ages and is occasionally caused by unknown factors. It occurs when the valve that stops stomach contents from returning to the esophagus gets weakened or opens abnormally.
GERD occurs more commonly in people:
- individuals who are obese or overweight as a result of elevated abdominal pressure
- who are pregnant, impacting between 40%–85% of pregnant women
- who use certain drugs, such as certain asthma treatments, calcium channel blockers, antihistamines, sedatives, and antidepressants.
- Those who smoke, as well as those who are exposed to second-hand smoke
- In addition, a hiatal hernia is a condition in which the top of the stomach protrudes into the chest due to a hole in the diaphragm. This decreases the esophageal sphincter’s pressure, increasing the risk of GERD.
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Symptoms
Common signs and symptoms of GERD include:
- Heartburn is a burning sensation in the chest that occurs after eating and is often worse at night.
- Pain in the chest
- Swallowing problems
- Food or sour liquid regurgitation
- Feeling like you have a lump in your throat
You may also encounter the following symptoms if you have acid reflux at night:
· Chronic cough
· Laryngitis
· New or worsening asthma
· Disrupted sleep
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How Is GERD Diagnosed?
The symptoms you have and how often you have them are used to diagnose GERD, while there is no hard and fast rule regarding how regularly they must occur.
Your physician will collaborate with you to assess whether you have GERD. The following diagnostic tests are available for GERD:
• Upper Endoscopy- This is a procedure in which your doctor puts a tiny tube down your throat with a light and camera attached. This enables an evaluation of your oesophagus and stomach to look for signs of inflammation or other issues.
• Esophageal pH and Impedance Monitoring- This test determines the amount of acid in your oesophagus when you are eating and sleeping normally. At a hospital or outpatient center, your doctor will execute the surgery, which involves inserting a small tube into your stomach through your nose or mouth. The tube is then retracted into the oesophagus and taped to the outside of the cheek. The monitor is worn for 24 hours, and your doctor may ask you to keep a food diary to determine whether there are any trends associated with your symptoms.
• Bravo Wireless Esophageal pH Monitoring-This test also checks the pH of your oesophagus in real-time to detect whether you have GERD. The monitor is a tiny capsule that is inserted into the oesophagus during the endoscopy and transmits data to a receiver worn on the belt or waistband. The test is typically 48 hours long, and the capsule will travel through your digestive tract within a few days.
• Esophageal Manometry- This procedure records the contractions of the muscles of your oesophagus during swallowing. It might help your physician determine whether your symptoms are caused by a weak sphincter muscle.
• X-Ray of the Upper Digestive System- This technique, which is performed after you swallow a chalky beverage, allows your doctor to see a silhouette of your oesophagus, stomach, and upper intestine. Additionally, you may be asked to swallow a barium pill to look for esophageal constriction or other disorders such as Hiatal hernias or ulcers.
Treatment for GERD: Lifestyle and Dietary Modifications
The first step in treating GERD is to make dietary and lifestyle modifications. Certain meals aggravate reflux. Suggestions for relieving symptoms include the following:
- Reduce your weight if you are obese — this is the most beneficial improvement you can make to your way of life.
- Avoid meals and beverages that raise your stomach acid level, such as caffeinated drinks.
- Do not eat items that reduce pressure in the lower esophageal region, such as fatty meals or alcohol.
- Do not eat things that disrupt your digestive tract’s peristalsis (the motions of the muscles in your intestine), such as coffee and alcohol.
- Avoid fatty meals, which slow down stomach emptying.
- Large meals should be avoided.
- Give up smoking.
- After a meal, do not go to sleep right away.
- When you’re lying down, raise the height of your head.
Treatment of GERD with Medication
If lifestyle and nutritional modifications are ineffective, your physician may prescribe certain drugs. There are two types of reflux medications. One lowers the acid level in your stomach, while the other promotes the motility (movement) of the upper gastrointestinal system.
Antacids: Antacids sold over-the-counter are the most effective treatment for symptoms of reflux that occur only intermittently and seldom. Antacids, if taken on a regular basis, may exacerbate the condition. In fact, because they leave the stomach rapidly, your stomach actually boosts its acid production as a result of this.
Histamine blockers: Histamine 2 (H2) blockers are medications that help to reduce the production of acid in the body. H2 blockers are effective in treating esophageal erosions in around 50% of patients.
Proton pump inhibitors: Proton pump inhibitors (PPIs) are medications that work by inhibiting the three key processes that lead to acid generation. PPIs are far more effective in suppressing acid production than H2 blockers. PPIs are effective in treating erosive esophagitis in many individuals, even those who have had a significant esophageal injury.
Agents prokinetic: Prokinetic agents are medications that stimulate the smooth muscle of the gastrointestinal system. These medications are less effective than PPIs. They may be prescribed in conjunction with an acid-suppressing medication by your doctor.
GERD surgery: If lifestyle modifications or medication therapy do not help your symptoms, you may be a candidate for surgery. Certain people prefer surgery over a lifetime of medicine. The purpose of reflux surgery is to reinforce the anti-reflux barrier.
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Your surgeon will wrap the top portion of your stomach around the lower oesophagus during a surgery called a Nissen fundoplication. This strengthens the anti-reflux barrier and may result in lasting reflux relief. Your surgeon may conduct this treatment laparoscopically, which means it will be less invasive and need less recovery time.
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Reference Gastroenterology & Hepatology UCGconferences press releases and blogs
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