What is GERD?
Gastro-esophageal disease is more commonly known as GERD. The keyword is “reflux” or the unintentional backflow of stomach contents into the esophagus. The stomach has powerful acids and digestive enzymes to break down the food that we eat. The inside walls of the stomach have a lining unique from the rest of the gut. This protects it from harmful acids and enzymes. The esophagus up to the throat and mouth do not. So repeated contact with the stomach contents over a long time will cause injury including erosion of the wall lining the same as with an ulcer in the intestine. Normally there is a muscular part between the esophagus and stomach that functions as a valve to prevent the backflow of stomach contents. In certain conditions, this “valve” relaxes and widens the passageway back into the esophagus, leading to problems.
It affects millions of people and among the usual cases encountered by doctors. This could be a recent phenomenon possibly caused by the stress of “modern-day living.” The disease is closely related due to hyperacidity which in turn is caused by unhealthy living.
This sickness can be easily diagnosed. The symptom associated with GERD is called “heartburn.” This is a burning sensation or pain in the chest (around the area of the heart). The sensation goes up to the mouth and the throat area is caused by the leakage which is quite acidic. The patient will experience a sour taste.
Heartburn is similar to chest pains suffered from a heart attack. The patient must be aware of this especially if his cardiovascular health is weak or has suffered a heart attack before. It is also what the doctor also watches out for during the physical examination to be able to distinguish from GERD.
There are other symptoms that result when other parts around the throat and lungs are affected. Some of the acid reflux can get into the “voice box” or larynx which produces a person’s voice. The result of this is hoarseness or sore throat. The reflux can even get into the lungs producing problems with respiration. Cases of asthma can happen due to GERD. Extreme conditions because of the continued irritation can lead to inflammation and swelling of the esophagus. It can even lead to cancer.
GERD can seriously affect daily living if it is treated. Diagnosis and early treatment are important in order to prevent complications. Making changes to a patient’s lifestyle to prevent and counteract hyperacidity is the priority of effective treatment and management of the disease.
Normally, cases of GERD can be diagnosed by doctors just by observing their symptoms. The diagnosis is confirmed when the condition of the patient improves after taking drugs commonly prescribed for hyperacidity. Heartburn is the typical “smoking gun” even if there is no regurgitation (accidental backflow of some stomach contents into the throat and mouth). Many cases are uncomplicated. It means that these cases can be easily treated with anti-hyperacidity drugs. No further treatment is usually needed.
But GERD can become more complicated. If the symptoms happen again and again for a long time, there will be a risk that the usual drugs will no longer have any effect. For these cases, more technological diagnostic tests may be needed to find out the other possible causes and complications. Even if the esophagus or throat areas do not look injured when examined physically, the illness can still have become more serious.
- The most commonly used diagnostic test for GERD is through endoscopy. This flexible “rubbery” tube with a camera at the end is inserted down the patient’s throat while under anesthesia. It can reach down to the inner walls of the esophagus, stomach, and even the near part of the small intestine. The doctor can see any injury done by the stomach acid if it had leaked back up into the esophagus. The damage will look like the affected parts were burned by the acid, which is basically what happens. This results in inflammation (swelling and redness) of the affected parts after a time. Ulcers can also appear on the lower inner parts of the esophagus.
- A barium swallow (esophagram) is another to check for ulcers or a narrowing of the esophagus. You first swallow a solution made with barium. The barium looks bright on the x-ray. As it travels down the digestive, it coats the walls of the throat, esophagus, and other organs. This technique provides a contrast between these organs and others like the lungs, liver, etc. on x-ray plates. This will make it easier for the doctor to see any problems.
- The use of pH monitoring can check for acid in your esophagus. The doctor inserts a device into your esophagus and leaves it in place for 1 to 2 days to measure the amount of acid in your esophagus.
- Finally, a biopsy may sometimes be taken during endoscopy to observe samples of the tissue under a microscope for infection or other abnormalities (like cancer cells).
The main approaches for treating GERD through conventional medicine is by neutralizing the effects of stomach acid, or by preventing its production. These effects are brought about by pharma drugs.
- There are many commercially available antacids which may provide quick relief. But antacids are not enough to heal an inflamed esophagus with serious long-term injury due to stomach acid. Abuse of some antacids can also bring about side effects, such as diarrhea or sometimes kidney problems.
- Medications to reduce acid production. These medications — known as H-2-receptor blockers — include cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR), and ranitidine. H-2-receptor blockers don’t act as quickly as antacids, but they provide longer relief and may decrease acid production from the stomach for up to 12 hours. Stronger versions are available by prescription.
- Medications that block acid production and heal the esophagus. These medications — known as proton pump inhibitors — are stronger acid blockers than H-2-receptor blockers and allow time for damaged esophageal tissue to heal. Over-the-counter proton pump inhibitors include lansoprazole (Prevacid 24 HR) and omeprazole (Prilosec OTC, Zegerid OTC).
- Prokinetics. Prokinetics help your stomach empty faster. Prescription prokinetics include:
- bethanechol (Urecholine)
- metoclopramide (Reglan)
Both of these medicines have side effects, including:
fatigue, or feeling tired
depression NIH external link
delayed or abnormal physical movement
Your doctor may recommend surgery if your GERD symptoms don’t improve with lifestyle changes or medicines. You’re more likely to develop complications from surgery than from medicines.
Fundoplication is the most common surgery for GERD. This operation attempts to control the reflux of acid from the stomach. Part of the stomach is tightened around the area where it joins the esophagus between In most cases, it leads to long-term reflux control.
Relationship between GERD and Diet
Recent findings by researchers in medicine and healers who use alternative therapies have found that there is a connection between what and how a person eats and GERD. To be more specific, there is food that was studied to increase the risk of having GERD. How much a person eats and how he eats also influence this.
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