What is GERD?

GERD, short for gastroesophageal reflux disease, is a condition in which the muscle or sphincter that connects your esophagus (food pipe) to the stomach is weakened. This muscle band is called the lower esophageal sphincter and it normally stops stomach contents from traveling back up. When weakened it cannot function normally, increasing the risk of acidity or acid reflux and heartburn. GERD can be effectively managed with diet and lifestyle changes, but it may require medical treatment and surgery in some cases.

Symptoms of GERD?

Frequent attacks of acid reflux are the primary symptom of GERD, which can cause a burning sensation in the chest that is referred to as heartburn.

In addition to frequently regurgitating stomach contents, you may also notice a sour or bitter taste towards the back of the mouth.

Frequent acid reflux can irritate the throat causing difficulty swallowing, chronic cough, and other breathing problems.

If symptoms of GERD are severe and can only be managed with regular use of OTC medications, you should consult a gastroenterologist.

Causes of GERD?

GERD is quite simply caused by the weakening or abnormal relaxation of the lower esophageal sphincter, which allows stomach contents and acids to travel up the esophagus into the mouth. Normally, this sphincter only relaxes to allow food and fluids to enter the stomach but prevents them from traveling back up.

Risks

The causes for GERD are linked to certain risk factors, which include:

• High body weight or obesity resulting in increased abdominal pressure
• Increased pressure from pregnancy
• Use of certain medications that may weaken or relax the lower esophageal sphincter
• Smoking and exposure to secondhand smoke

In some cases, GERD may also develop as a result of an underlying condition called hiatal hernia, which would also require medical treatment.

Complications

If untreated or treated inappropriately, GERD can lead to:

• Esophagitis, which is an inflammatory condition of the esophagus
• Narrowing of the esophagus, termed as esophageal stricture
• Irreversible changes in esophageal lining termed Barrett’s esophagus
• Cancer of the esophagus
• Upper respiratory problems like chronic cough, soreness of the throat, asthma, and breathing problems
• Dental conditions including gum disease and increased enamel erosion

The only effective way to prevent such complications is through timely treatment for GERD.

Diagnosis

Your doctor will be able to make a diagnosis based on your reported symptoms and medical history, but you may also need to undergo certain tests, especially if you do respond to diet and medical interventions as expected. Tests can include:

Upper Endoscopy – flexible endoscope tube with a tiny attached camera is introduced via the mouth to the esophagus in order to examine and collect a tissue sample if required

Barium Swallow – X-ray imaging is used after consumption of a barium solution, allowing doctors to examine the upper digestive tract

Esophageal Manometry – A flexible tube is introduced via the mouth and sent down the esophagus to check the esophageal muscle strength

Esophageal pH Monitoring – A tiny device is inserted into the esophagus, allowing doctors to monitor the frequency and amount of acid that enters it

Treatment For GERD

Aware Gleneagles Global Hospital has a team of skilled gastroenterologists, offering the best possible care for patients. The primary treatment for GERD involves the use of medications like proton pump inhibitors that can reduce acid production. Prescription GERD medications may also include H2 blockers, prescription antacids, and prokinetics. If GERD is severe and cannot be resolved with medications and diet or lifestyle changes alone, surgery may be necessary.

Surgical treatments that are performed by gastroenterologists to treat GERD include:

Fundoplication: A minimally invasive surgical procedure in which the upper part of the stomach is wrapped around the esophagus to increase pressure at the lower end and reduce acid reflux.

Endoscopic procedures: This includes a variety of procedures such as endoscopic sewing in which stitches are used to tighten the sphincter muscle, as well as radiofrequency in which the sphincter is tightened by producing small burns.

Prevention & Diet

Diet and lifestyle interventions are widely used as GERD remedies. These are vital for an effective GERD cure or prevention of symptoms. They include:

• Avoiding food and drinks that aggravate GERD, such as greasy or spicy foods, caffeinated or alcoholic beverages, chocolate, and peppermint.
• Smaller meals and eating dinner at least 2 to 3 hours before going to bed.
• Eating slowly and chewing food properly to ease digestion.
• Maintain a healthy body weight to reduce pressure.
• Use wedge pillows or an elevated bed to sleep at an incline with your head and upper body raised so that gravity can aid the reduction of symptoms.
• Quitting smoking, as this damages the lower esophageal sphincter.

Frequently Asked Questions (FAQ)