GERD

Gastroesophageal reflux disease (commonly known as GERD) is a digestive disorder characterized by backing up of stomach acid and food into the food pipe.

This reflux affects the lining of the esophagus resulting in this condition. Although heartburn is a common among people, symptoms occur more frequently and affect the daily activities of the patient in GERD.

It can be seen in different age groups including children and adults. This digestive disorder can be controlled by appropriate changes in lifestyle and medications.

In some cases, surgery may be required to control the symptoms.

The most common symptoms of GERD are:

• Heartburn
• Difficulty in swallowing food
• Backing up of food into the food tube
• Cough or coarseness of mouth, particularly during early morning

Some patients complain about food coming back into the mouth giving a sour taste. In general only a small quantity of liquids back up into the food tube or mouth.

But in some cases, a large quantity of liquid along with food may back up into the throat. Some patient may also have nausea very frequently.

Multiple causes lead to GERD. Different causes may affect the same individual or on the other hand, one cause may specifically cause GERD in a patient.

Some of the common causes of the disorder are

• Abnormalities of the valve in the esophagus at the opening to stomach
• Impaired contractions of food tube
• Inconsistent emptying of stomach
• Conditions like hiatal hernia

These conditions cause backing up of stomach juice into the esophagus resulting in typical symptoms. Reflux of stomach acid irritates the esophageal wall resulting in inflammation.

As the disease progresses, the lining of esophagus wear off leading to complications like bleeding and narrowing of food tube.

Diagnosis of GERD is based on typical symptoms of the disorder like heartburn.

Gastrointestinal endoscopy of the upper region is another method for diagnosing GERD. This method helps to visualize the inner lining of esophagus, duodenum and intestine.

Ambulatory acid test is used to assess the duration, frequency and extent of acid reflux into esophagus. In this method probe present in the catheter transmits signals related to acid content.

Examination of throat and larynx helps to identify the cause of coarseness of voice and sore throat.

Esophageal motility test detects the functioning of esophageal muscles.

A catheter inserted into the esophagus sense the pressure changes in the food tube. This helps to identify the abnormalities in the functioning of esophageal muscles. 

Lifestyle changes, particularly in diet, are the simplest form of treatment for GERD. Small portion size in the evening helps to reduce the distention of stomach, reducing the chance of reflux. Further, eating early would help to empty the stomach content before sleeping. Foods that trigger acid reflux should be consciously avoided.

One of the first medications for controlling GERD control the production of acid in stomach. Heartburn can be controlled by:

• Antacids – these medications neutralize stomach acid that cause heart burn.
• H-2 –receptor blockers – acid production in the stomach is reduced by the use of these receptor blockers.
• Proton pump inhibitors – they block the production of acid and helps in the healing of esophagus

When heartburn persists doctors recommend medications to strengthen the esophageal valve to reduce reflux. Surgery is suggested when symptoms do not respond to any of the regular medications.

• Fundoplication – this surgical method is used to tighten the valve muscle by tightening the diaphragm around the esophagus. Upper part of the stomach is then wrapped around the lower part of the food pipe.
• Endoscopy – endoscopy is now used to stitch the area of lower esophageal sphincter, which helps in tightening the valve.
• Using Linx device – Linx is a small titanium bead with magnetic properties, used to wrap around the upper part of the stomach. The magnetic attraction prevents reflux of acid into the food tube.

Symptoms of GERD is prevented by lifestyle changes.

Some of the common ways to prevent GERD include reviewing the medications to avoid those that cause GERD, losing weight, quitting smoking, cutting down alcohol use, and having a GERD diet. 

Nux vomica is one of the most commonly used homeopathic remedies for GERD.

Heart burn is controlled by Arsenicum album.

Phosphorous and Pulsatilla are also recommended for heartburn and reflux.

Chest discomfort and heartburn is reduced with carbo vegetabilis.

Cutting down on alcohol, eating smaller meals, keeping head elevated while sleeping, avoiding fatty foods, and curbing caffeine are simple home remedies for controlling this condition.

Herbal remedies including licorice, chamomile and elm are used in the treatment of heartburn.

Relaxation techniques that help to avoid stress also goes a long way in controlling GERD. 

Lifestyle changes are the best way to control symptoms of GERD. These include:

• Maintaining optimal body weight
• Avoiding triggers of heartburn
• Elevating head during sleep
• Eating smaller meals
• Quitting smoking

Obesity, pregnancy, smoking, asthma, diabetes, and delayed stomach emptying increases the risk of GERD.

Prolonged GERD may lead to scarring of tissue in the esophagus leading to difficulty in swallowing.

Ulcers form in the esophagus causing pain. GERD may also lead to cancer-like changes in the food tube, increasing the risk of esophageal cancer.