Gastroesophageal Reflux Disease: Causes, Symptoms and Treatment
Gastroesophageal Reflux Disease (GERD) is a chronic condition where stomach acid or bile irritates the food pipe (esophagus). The main symptom is heartburn, a burning feeling in the chest, but other symptoms may include regurgitation of food or sour liquid, difficulty swallowing, coughing, wheezing, and chest pain. GERD occurs when the lower esophageal sphincter (LES), which is supposed to prevent stomach contents from rising back up into the esophagus, weakens or relaxes inappropriately.
Symptoms of GERD
The following are some of the most common GERD indications and symptoms:
- Heartburn: A burning sensation in the chest or throat, usually caused by eating food or during the night.
- Regurgitation: The feeling of acid coming up into the throat or mouth, causing a sour or bitter taste.
- Chest Pain: Some people feel chest pain that is sharp or tight and is mistaken for a heart-related issue.
- Difficulty Swallowing: A sensation of food caught in the throat or chest.
- Cough: Persistent dry cough, especially at night, caused by irritation from the acid.
- Wheezing: GERD may cause asthma like symptoms, including wheezing (making a whistling or rattling sound in your chest) or shortness of breath.
- Sore Throat: Ongoing irritation or inflammation from stomach acid can lead to a sore throat or hoarseness.
- Frequent Bad Breath: Acid reflux can cause persistent bad breath (halitosis).
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Get A Second OpinionCauses of GERD
- Lower Esophageal Sphincter (LES): The LES may relax prematurely, and the tone may be very weak, permitting stomach contents to enter the oesophagus.
- Hiatus Hernia: Condition in which a part of the stomach pushes up through the diaphragm, stretching the LES.
- Obesity: Extra weight, especially in the abdomen, puts pressure on the stomach, which can lead to acid reflux.
- Pregnancy: Hormonal fluctuations, as well as pressure from the expanding uterus, can relax the LES and heighten the chance of GERD.
- Smoking: Smoking can relax the LES and decrease saliva secretion, which usually neutralises stomach acid.
- Alcohol Intake: Alcohol acts as a muscle relaxant, so it can loosen the LES, which leads to gastroesophageal reflux and irritates the lining of the oesophagus.
- Large or Fatty Meals: Eating large meals or foods that are high in fat can increase stomach pressure and the likelihood of acid reflux.
- Certain Medications: Some prescription medications, including certain blood pressure drugs, antidepressants and pain relievers, can relax the LES and cause GERD.
- Delayed Stomach Emptying: If food stays in the stomach longer than it should, it can lead to more acid reflux.
- Eating Close to Bedtime: Eating meals just before lying down increases the risk of acid backing up into the esophagus.
- Gastric Disorders: Disorders such as gastroparesis (slowed gastric emptying) and Zollinger-Ellison syndrome (excess acid production) can raise the risk of GERD.
Risk Factors of GERD
The following conditions can raise your risk of GERD:
- Obesity
- Hiatal hernia in which the stomach bulges up into the diaphragm
- Pregnancy
- Scleroderma and other connective tissue disease
- When stomach emptying takes longer than usual
Complications of GERD
Chronic esophageal inflammation can lead to the following symptoms over time:
- Esophageal stricture : It is a condition in which the esophagus narrows. Scar tissue forms when stomach acid damages the lower esophagus. The scar tissue narrows the food channel, causing swallowing difficulties.
- Esophageal ulcer : It is an esophageal sore that hasn't healed. Stomach acid can eat away at esophageal tissue, resulting in an open sore. Bleeding, pain and difficulty swallowing are all symptoms of an esophageal ulcer.
- Barrett's esophagus : It is a precancerous alteration in the esophagus. Acid damage can lead to abnormalities in the tissue that lines the lower esophagus. These modifications have been linked to a higher risk of esophageal cancer.
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Book an AppointmentDiagnosis of GERD
Based on a physical examination and a history of your signs and symptoms, your doctor may be able to diagnose GERD. Your doctor may suggest the following tests to confirm a diagnosis of GERD or to check for complications:
- Endoscopy of the upper intestine : A thin, flexible tube with a light and camera (endoscope) is inserted down your throat by your doctor to inspect the inside of your esophagus and stomach. When reflux is present, test results may be normal, but an endoscopy may reveal esophagitis (inflammation of the esophagus) or other consequences. An endoscopy can also be used to take a biopsy of the tissue to check for issues like Barrett's esophagus.
- Ambulatory acid pH probe test : A monitor is inserted into your esophagus to determine when and how long stomach acid regurgitates. The display is connected to a little computer that you carry around your waist or over your shoulder with a strap. A tiny, flexible tube (catheter) put through your nose into your esophagus, or a clip placed in your esophagus during endoscopy and passed into your stool after about two days, could be used as a monitor.
- Manometry of the esophagus : When you swallow, this test monitors the rhythmic muscular contractions in your esophagus. The coordination and force exerted by the muscles of your esophagus are also measured using esophageal manometry.
Treatments of GERD
Lifestyle Changes:
- Weight Loss: Shedding extra pounds can relieve pressure on the stomach and decrease the frequency of reflux.
- Dietary Changes: Steer away from irritating foods such as spicy foods, citric acid, caffeine, and greasy or fried foods.
- Avoid Big Meals: Eating smaller, more frequent meals allows the stomach to work correctly without too much pressure.
- Avoid Laying Down After Eating: Give at least 2–3 hours after eating before laying down to let your stomach empty.
- Elevate the Head of Your Bed: Elevating the head of your bed by 6–8 inches may help to avoid reflux from occurring from overnight acid production.
Medications:
- Antacids: These neutralize stomach acid and can provide quick relief for mild GERD symptoms.
- H2 Blockers: Drugs such as ranitidine or famotidine decrease acid production and aid in the long-term management of symptoms.
- Proton Pump Inhibitors (PPIs): These include omeprazole and lansoprazole, which reduce stomach acid production significantly and help heal the oesophagus.
- Prokinetics: Drugs that speed the emptying of the stomach and improve LES function.
Treatments Involving Surgery and Procedures:
- Surgery: Wrapping the top of the stomach around the LES (referred to as a fundoplication).
- LINX Device: A small ring of magnetic beads is placed around the LES to help it stay closed and prevent acid reflux.
- Endoscopic Procedures: In certain instances, less invasive methods like endoscopic suturing may be employed to strengthen the LES.
Frequently Asked Questions
How long does GERD cure?
It may take up to 8 weeks for GERD to improve with medication and lifestyle modifications that work. These actions won't, however, completely treat GERD. Medication and lifestyle modifications may be used in conjunction as treatments.
Is GERD serious?
Yes, GERD, or gastroesophageal reflux disease, may be dangerous, particularly if ignored or inadequately controlled. Acid reflux disease (GERD) is a chronic illness that causes stomach acid and occasionally stomach contents to reflux back into the esophagus, causing a range of symptoms and possible problems.
Can GERD affect children?
Yes, GERD can also affect children, causing symptoms like chronic cough, vomiting, or difficulty feeding. Treatment for children usually includes a combination of medication and lifestyle changes.
Can GERD lead to cancer?
In some cases, untreated GERD can lead to complications like Barrett's esophagus, which increases the risk of esophageal cancer. Regular monitoring and early treatment can reduce this risk.
What are the prevention tips for Gastroesophageal Reflux Disease?
Preventing GERD involves avoiding triggers like spicy foods, alcohol, and smoking, eating smaller meals, avoiding lying down after eating, maintaining a healthy weight, and elevating the head while sleeping to reduce acid reflux.
