Gastroesophageal Reflux Disease (GERD)

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Dr Saravana.KDigestive Health

By Dr Saravana.K

Consultant Physician, Gastroenterologist & Hepatologist

 

GERD is a common chronic digestive condition that occurs when stomach acid or bile flows back into your food pipe. The backwash of acid irritates the lining of your oesophagus and causes GERD symptoms. These symptoms can interfere with your daily activities.

Symptoms:

  • A burning sensation in your chest (heartburn)GERD-1
  • Chest pain
  • Difficulty swallowing
  • Dry cough
  • Hoarseness or sore throat
  • Regurgitation of food or liquid

When you swallow, the lower esophageal sphincter – a circular band of muscle around the bottom part of your oesophagus – relaxes to allow food and liquid to flow down into your stomach. Then it closes again.

However, if this valve relaxes abnormally or weakens, stomach acid can flow back up into your esophagus, causing frequent heartburn. Carbonated drinks, spicy food and alcohol, fatty food can also cause the valve to relax abnormally thus producing symptoms of GERD.

GERD symptoms can also be aggravated by a number of medications – either through impaired valve function or by damaging the oesophageal surface.

This constant backwash of acid can irritate the lining of your oesophagus, causing it to become inflamed. Over time, the inflammation can erode the oesophagus, causing complications:

  • Narrowing of the oesophagus (stricture). The scar tissue narrows the food pathway, causing difficulty swallowing.
  • An open sore in the oesophagus (ulcer). Stomach acid can severely erode tissues in the oesophagus, causing an open sore to form. The esophageal ulcer may bleed, cause pain and make swallowing difficult.
  • Barrett’s oesophagus. Changes occur to the tissue lining the lower oesophagus which is associated with an increased risk of esophageal cancer.

GERD-2

Risk factors for GERD include:

  • Obesity
  • Pregnancy
  • Smoking
  • Asthma
  • Diabetes
  • Delayed stomach emptying.

Most people can manage the discomfort of heartburn with lifestyle modifications:

  • taking  frequent small meals
  • avoid food that can aggravate the condition including alcohol
  • avoid tight fitting clothes
  • elevate the head of the  bed by 30 degrees
  • to have an interval of 3 hours between meals and bedtime
  • weight loss.

 

When to see a doctor

  • If you take over-the-counter medications for heartburn more than twice per week.
  • Chest pain.
  • Difficulty swallowing.
  • Loss of weight and appetite.
  • Persistent vomiting.

GERD can be diagnosed by doing an endoscopy which involves inserting a scope through the mouth down to the stomach to assess the internal surfaces of the stomach, oesophagus and duodenum. The scope will show any inflammation and enable a biopsy to be done to determine the presence of cancer.