What is GERD?
Gastroesophageal reflux disease (GERD), or acid reflux, is experienced by most people throughout their lifetime. Commonly referred to as heartburn, occasional episodes are common, but if you have heartburn multiple times a week over an extended period of time, you may have developed chronic GERD.
Left untreated, GERD can lead to more serious problems, but when properly diagnosed and treated, it can heal in less than a month depending on the severity of the case.
GERD is a medical condition in which acidic liquids in the stomach leak up into the esophagus. It happens when the lower esophageal sphincter valve doesn’t close correctly after you eat. The acidic backwash then travels up the esophagus and can reach the throat and mouth. It may even cause a sour taste.
What are the risk factors for GERD?
Risk factors for GERD can include the following:
- Prolonged stomach emptying
- Soft tissue bulging at the top of the stomach into the diaphragm (hiatal hernia)
- Connective tissue conditions
Certain actions can also aggravate the symptoms of GERD:
What are the symptoms of GERD in adults?
The most common symptoms of GERD are:
- Chest pain
- A burning sensation in the chest that sometimes occurs after eating and can get worse at night
- Vomiting sour liquids or foods
- Difficulty swallowing
- Feeling a “lump” in your throat
Though the symptoms of GERD can be experienced at any time, if experienced at night, you may also have:
- Disrupted sleep
- A chronic cough
- A Sore throat
- New diagnosis of (or worsening of) asthma
How is GERD diagnosed?
GERD has to be diagnosed by your doctor. Along with an assessment of medical history and a physical examination, several diagnostic tests can be performed. These tests can confirm the diagnosis, and see if there are any complications.
- Upper Digestive system X-ray: An X-ray may be taken after you drink chalky liquids that will coat and fill the lining of the GI tract. The coating will help your doctor to see the silhouette of your upper intestines, stomach, and esophagus. Additional swallowing of a barium pill may be implemented to assess the narrowing of the esophagus.
- Upper endoscopy: A flexible thin tube with a light and camera is inserted into your throat. It will examine the esophagus and stomach. The endoscopy can find inflammation of the esophagus or other complications. During the endoscopy, your doctor may extract tissue samples to test for complications.
- Ambulatory acid (pH) probe test: A monitor is placed in the esophagus to test for when the acid from the stomach backs up and for how long. This monitor is attached to a small computer worn on the shoulder or waist. The monitor could also be attached to a catheter that goes through the nose into the esophagus, or it could be inserted into your esophagus and exit the body during a bowel movement in about two days.
- Esophageal manometry: This type of test measures muscular contractions of the esophagus as you swallow. It also assesses the force and coordination of the esophageal muscles.
How do you treat GERD?
There are four different ways to treat GERD, including singular treatments and combination treatments.
The treatment approaches are:
- Lifestyle changes
- Endoscopy treatments
Usually, a combination of the first three will yield good results. Minor cases of GERD can heal in less than a month. More moderate cases can require 6 to 12 weeks of treatment.
Some patients do not report good results even after treatment and require surgery. Some may prefer surgery over indefinite medication.
Medications taken include histamine blockers, antacids, proton pump inhibitors, and prokinetic agents. Endoscopic treatments include the endoscopic sewing machine, which places stitches in the stomach to increase the anti-reflux barrier.
One potential surgery is the Nissen fundoplication, in which your doctor wraps the top part of your stomach around the lower esophagus to increase the anti-reflux barrier.
What changes can I make to avoid GERD?
If the condition is caught early on, diet and lifestyle changes can treat GERD. The following are changes recommended to get rid of symptoms:
- Avoid foods that will increase the amount of stomach acid, like caffeinated beverages.
- Avoid foods that affect the movement of the muscles in your digestive tract. This includes alcohol, coffee, and other acidic liquids.
- Lose weight if you are overweight or obese.
- Avoid foods that decrease pressure at the bottom of the esophagus. This includes peppermint and fatty foods
- Avoid extremely big meals.
- Stop smoking.
- When you lay down, elevate your head.
- Wait a few hours before laying down after a meal.
What are GERD complications?
The condition of GERD alone is not dangerous, but untreated, long-term GERD can lead to more serious medical problems, such as:
- Strictures: The damaged lining of the esophagus can become scarred. This can cause the esophagus to narrow. This can cause problems when eating and drinking by preventing items eaten from reaching the stomach.
- Esophagitis: This is the inflammation and irritation of the esophagus caused by stomach acid. It can lead to heartburn, chest pain, ulcers, trouble swallowing, and bleeding.
- Barret's esophagus: This condition is found in people with long-term GERD. The acid reflux damage over the years causes the lining of the esophagus to change. It is a risk factor that can lead to esophageal cancer.
- Esophageal cancer: This is cancer that begins in the esophagus. There are two types. Adenocarcinoma develops from Barret's esophagus and affects the lower part of the esophagus. Squamous cell carcinoma affects the upper and middle parts of the esophagus.
If you experience heartburn more than twice a week over an extended period, you should consider contacting your doctor to test for GERD.
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Cleveland Clinic: "GERD (Chronic Acid Reflux)."
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