Gastroesophageal Reflux Disease

Acid reflux happens when contents from your stomach move up into your esophagus. The esophagus is the long tube that’s responsible for moving food from the throat to the stomach. If you suffer from frequent heartburn and indigestion, you might have gastroesophageal reflux disease, also known as GERD.

GERD is a digestive disorder that affects the ring of muscle in the lower esophagus that opens up to allow passage between the stomach and esophagus. While many people will experience heartburn and indigestion several times throughout their life, people with GERD encounter it far more often – usually two or three times a week.

While there is not yet a cure for GERD, the symptoms can be managed and treated. Patients need to stay on top of symptom management, as GERD symptoms that are left unchecked can result in more serious problems such as Barrett’s esophagus and esophageal cancer.

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Causes of Gastroesophageal Reflux Disease

GERD is caused by frequent acid reflux. However, other conditions, traits or habits may also play a role in raising your risk for this disease. These conditions are known as risk factors and include:

Non-Modifiable Risk Factors: These factors are irreversible and cannot be changed. The more of these risk factors you have, the greater your chance of developing this disease.

• Pregnancy
• Certain congenital abnormalities (i.e. heart defects, neural tube defects, Down syndrome, among others)

Modifiable Risk Factors: These factors can be modified, treated or controlled through medications or lifestyle changes.

• Obesity or having a body mass index “BMI” of 30 or greater
• Eating certain foods such as fatty or fried foods
• Eating large meals or eating late at night
• Excessive amounts of alcohol consumption over the years
• History of cigarette smoking and/or drug abuse

Other conditions that contribute to GERD:

• Certain medications such as aspirin
• Hiatal hernia
• Autoimmune disease: a condition in which your immune system mistakenly attacks your body (e.g. lupus, rheumatoid arthritis and scleroderma)

Symptoms of Gastroesophageal Reflux Disease

As mentioned earlier, the primary symptoms of GERD are heartburn and indigestion. However, other common symptoms include the following:

• A sour, bitter taste in the back of the mouth.
• Regurgitation (bringing food or liquids back up to the mouth)
• Chest pain
• Burning sensation in the chest after eating.
• Feeling a “lump” in the throat.
• Difficulty sleeping
• Worsened asthma symptoms

Diagnosis of Gastroesophageal Reflux Disease

Your doctor will most likely perform a physical exam, ask about your symptoms, and ask about your risk factors, among others items. After that, your doctor may recommend diagnostic tests. Some of the diagnostic tests and procedures include:

• Endoscopy
• X-Rays (Barium swallow test)
• Ambulatory acid (pH) probe test
• Esophageal manometry

Treatment of Gastroesophageal Reflux Disease

The primary treatments for GERD are lifestyle and diet changes. Avoiding food and activities that cause heartburn can significantly improve a patient’s quality of life. If lifestyle changes and medications are not doing much to stop symptoms, your doctor may recommend surgery. This is a last resort treatment and should only be used when GERD is causing serious symptoms like bleeding and ulcers. Some treatment options include lifestyle changes, medications, and a medical/surgical procedure.

Lifestyle Changes

• Avoid smoking.
• If overweight, talk to your doctor about some weight loss options.
• Remaining upright for three hours after a meal.
• Eat a heart-healthy diet.
• Exercise under the guidance of your doctor.
• Avoiding fried foods, alcohol, chocolate, peppermint, and acidic foods.
• Make and keep appointments to see your doctor for routine check-ups and follow-up tests.

Medications

• Antacids will help neutralize stomach acid.
• H-2 receptors blockers will help reduce acid production.
• Proton pump inhibitors will help block acid production and heal the esophagus.
• Medications to strengthen the lower esophageal sphincter.

Medical and Surgical Procedure

• Fundoplication

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