Gastroesophageal Reflux Disease GERD| Causes, Symptoms, Diagnosis, and Treatment

Originally posted on September 22, 2022 @ 6:21 pm

When stomach acid runs back into the tube that connects your mouth and stomach on a regular basis, it causes gastroesophageal reflux disease (GERD) (esophagus). The lining of your oesophagus may become irritated by this backwash (acid reflux). Acid reflux is a common condition that occurs occasionally.

What is Gastroesophageal Reflux Disease GERD?

The ring of muscle between your esophagus and stomach is affected by gastroesophageal reflux disease, also known as GERD. The term “lower esophageal sphincter” refers to this ring (LES). If you have it, you might experience acid indigestion or heartburn. The condition known as hiatal hernia is thought to be the cause in some cases, according to doctors. Most of the time, dietary and lifestyle changes can reduce your GERD symptoms. But some people might require medical treatment or surgery.

Cause of  Gastroesophageal Reflux Disease {GERD}.

The stomach and oesophagus are referred to collectively as “gastroesophageal.” To flow back or return is to reflux. When stomach contents flow backward into the oesophagus, it is called gastroesophageal reflux

Your LES opens during normal digestion to let food enter your stomach. After that, it closes to prevent food and stomach acid from returning to your oesophagus. The LES becomes weak or relaxes when it shouldn’t, which leads to gastroesophageal reflux. This allows food and liquids in the stomach to ascend into the oesophagus.

Risk Factors for Gastroesophageal Reflux Disease {GERD}

Heartburn affects more than 60 million adult Americans at least once a month, and more than 15 million adults, including many pregnant women, experience it daily.

According to recent studies, the prevalence of GERD in infants and children is higher than previously believed. Repeated vomiting episodes may result from it. Coughing and other breathing issues may also result from it.

Some medical professionals think a hiatal hernia could weaken the LES and increase your risk of gastroesophageal reflux. When you have a hiatal hernia, the upper portion of your stomach pushes through a tiny hole in your diaphragm and into your chest (diaphragmatic hiatus).

The muscle separating the chest from the abdomen is called the diaphragm. According to recent studies, the lower end of the oesophagus is supported by the diaphragm.

Many people who have a hiatal hernia won’t experience heartburn or reflux. But a hiatal hernia could make it easier for stomach acid to back up into the oesophagus.

Hiatal hernias can develop as a result of straining, vomiting, coughing, or sudden physical activity. At age 50 and older, many healthy individuals have a small one. Hiatal hernias happen to people of all ages, even though they are most common in middle-aged people.

Treatment for hiatal hernias is typically not necessary. However, it might be required if the hernia is at risk of being strangled or twisted in a way that cuts off blood flow. If you have severe GERD or esophagitis in addition to one, you might also need to treat it (inflammation of the esophagus). Your doctor might perform surgery in order to treat the hernia or avoid strangulation.

In addition, the following factors can increase your risk of developing GERD:

• I have a weight problem.
• Pregnancy
• stomach’s delayed emptying (gastroparesis).
• diseases of the connective tissue, like lupus, scleroderma, or rheumatoid arthritis.
• Acid reflux may worsen if you already have it due to diet and lifestyle choices.
• Smoking
• Several foods and beverages, such as alcohol, coffee, fatty or fried foods, chocolate, and coffee,
• massive meals
• Eating too close to bedtime
• Other medicines, such as aspirin

Symptom of Gastroesophageal Reflux Disease GERD.

Heartburn is the most common GERD symptom (acid indigestion). Typically, it feels like a scorching chest ache that begins behind your breastbone and rises to your throat and neck. Many claim that the acidic or bitter taste they experience is caused by the sensation of food returning to the mouth.

Heartburn symptoms might continue for up to two hours in terms of burning, pressure, or pain. Often, it gets worse after eating. Heartburn can also happen when you lie down or lean over. Many people find that standing up straight or taking an antacid that clears acid from the oesophagus makes them feel better.

There are variations between the pain from heartburn and the pain from a heart attack, which people occasionally confuse. Exercise and rest both have the potential to exacerbate heart disease pain. Physical activity has a lower likelihood of causing heartburn pain than You can’t tell the difference, though, so if you get any chest pain, get in touch with a doctor right away.

• Along with pain, you might also
• Nausea
• Foul breath
• breathing issues
• swallowing difficulties
• Vomiting
• deterioration of tooth enamel
• You experience a throat lump.

If you get acid reflux at night, you might also:

• Coughing that won’t stop
• Laryngitis
• Suddenly developing or worsening asthma
• sleep issues

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Home Remedies for GERD Treatment

Treatment for GERD seeks to reduce reflux or diminish the harm that refluxed substances cause to the lining of the oesophagus.

To manage your symptoms, your doctor may suggest taking over-the-counter or prescription medicine.

• Antacids: These medications can reduce stomach and esophageal acid production and alleviate heartburn. Nonprescription antacids are often found to offer momentary or partial relief to many people. Some people benefit from taking an antacid with a foaming agent. According to researchers, these substances create an acid-blocking foam barrier on top of the stomach. However, prolonged use of antacids may result in adverse effects such as diarrhoea, altered calcium metabolism (a change in how the body metabolize and uses calcium), and an accumulation of magnesium in the body. For those who have kidney illness, consuming too much magnesium might be dangerous. Speak with your doctor if you need antacids for longer than two weeks.
•  H2 Blockers: The doctor may prescribe drugs to lessen stomach acid if you have frequent heartburn or reflux. These medications include H2 blockers, which aid in preventing the stomach’s acid release. These medications are known as H2 blockers: cimetidine (Tagamet), famotidine (Pepcid), and nizatidine.
• Acid pumps, also referred to as proton pump inhibitors (PPIs), prevent a protein required for the production of stomach acid. PPIs include lansoprazole (Prevacid), omeprazole (Prilosec), esomeprazole (Nexium), dexlansoprazole (Dexilant), pantoprazole (Protonix), and rabeprazole (Aciphex).
• Prokinetic: In a few rare instances, these medications aid in faster stomach emptying to reduce the amount of acid that is left behind. Additionally, they might be beneficial for symptoms including bloating, nausea, and vomiting. But they can potentially have harmful side effects. They are difficult for many individuals to take, and those who can should only do so temporarily. Domperidone and metoclopramide are two examples of prokinetics (Clopra, Maxolon, Metozolv, Reglan).

Diet and Lifestyle Changes

Your doctor may tell you to change a few things about how you live to help with your GERD symptoms.

• Alcohol and Food Beverages: Stay away from foods and beverages that can relax the LES, such as chocolate, peppermint, fatty foods, coffee, and alcoholic beverages. If you experience symptoms, you should also stay away from foods and drinks like citrus juices, tomato products, and peppers that might aggravate an esophageal lining that has been injured.
• Eating fewer portions: Eating fewer meals may also help with symptom control. Additionally, eating meals at least two to three hours before going to bed allows your stomach’s acid to subside and allows your stomach to partially empty.
• Eat gently: Every meal should be taken slowly.
• Chew Food Thoroughly Set your fork down after you take a bite to help yourself remember to chew your food fully. Only pick it back up after you’ve fully chewed and swallowed that bite.
• Quit Smoking Putting an end to your smoking habit will strengthen your LES. The symptoms of GERD can be lessened by quitting smoking.
• Elevate Your Head: By elevating the head of your bed using 6-inch blocks or resting on a wedge with a specific shape, gravity may limit the amount of stomach acid that refluxes into your oesophagus. Avoid using pillows as a support for yourself. That merely makes the stomach feel more pressure.
• Stay at Healthy Weight: Maintain a healthy weight because being overweight often makes symptoms worse. When overweight people lose weight, they often feel better.
• Dress Comfortably. Squeezing your waist puts pressure on your stomach and the lower portion of your oesophagus.
• Acupuncture: According to one study, acupuncture treatment effectively and permanently prevented reflux in the test group better than PPIs. Early findings are encouraging, but larger research is needed to validate them.

Diagnosed with severe GERD.

You might require testing for a more accurate diagnosis if your symptoms are severe or persistent or if they don’t improve with treatment. Your doctor may use any of the following techniques to do this:

• Endoscopy: Your doctor will insert a thin, illuminated tube with a tiny camera on the end into your oesophagus to check for tissue irritation or inflammation (esophagitis). If the results are strange or unclear, they might take a small piece of tissue for further testing (biopsy).
• Upper GI Series: One of the initial examinations your doctor may perform is an upper GI series. Your stomach, oesophagus, and the upper portion of your small intestine can all be seen on this specific X-ray (duodenum). The test can help rule out other problems like peptic ulcers, but only provides limited information regarding potential reflux.
• Esophageal Manometry and Impedance Study: This test looks for esophageal hypotension. It may also reveal problems with the way your esophageal muscles contract.
• PH Testing: If a diagnosis cannot be made with certainty, your doctor may use this test to examine the acid levels in your esophagus. It monitors the amount of acid in your oesophagus while you eat, exercise, and sleep. Because of recent advances in long-term pH tracking, this approach is now more effective.

Severe GERD Operation

You may require GERD surgery if you require frequent high doses of PPIs to manage your symptoms or have a hiatal hernia and esophageal damage that is resistant to treatment. However, you should first give all the other treatments a shot.

• Fundoplication The lower esophagus’s pressure is increased by a technique called fundoplication. Your stomach’s upper portion will be wound by the doctor around the LES. In order to prevent reflux, this tightens the muscles and increases pressure in the lower oesophagus. Either open surgery or a laparoscope (small incisions in the abdomen) will be used to carry out this procedure.
• Transoral incisionless fundoplication (TIF):A more recent kind of this procedure, known as a transoral incisionless fundoplication (TIF), involves wrapping the stomach around the LES with plastic fasteners using an endoscope, a tiny tube with a camera. It involves less surgery than a typical fundoplication.
• Stretta procedure: In the Stretta method, a small tube is put into the oesophagus to heat the LES with low-frequency radio waves.
• The LINX procedure involves your doctor encircling the junction of your stomach and oesophagus with a band of magnetic titanium beads. The beads’ magnetic pull keeps it both tight enough to prevent reflux and loose enough to allow food to pass through into the stomach.

Problems with GERD

Serious consequences might occasionally result from GERD:

• Esophageal Ulcer Stomach acid erodes your oesophagus until an open sore occurs, causing an esophageal ulcer. These lesions frequently hurt and sometimes bleed. They might make it difficult to swallow.

• Esophageal Stricture: Stomach acid erodes and scars the lower portion of the oesophagus. It becomes difficult to swallow food as the esophagus’s interior narrows as a result of the scar tissue’s accumulation.
• Barrett’s oesophagus Acid reflux affects the cells in the lining tissue of your oesophagus, resulting in Barrett’s oesophagus. The lining becomes redder and thicker. Esophageal cancer risk is increased by this condition.
• Lung issues: Reflux can irritate and hurt your throat if it reaches the back. The lungs may then be affected from there (aspiration). Your voice can become hoarse as a result. Additionally, you can experience chest tightness, postnasal drip, and a persistent cough. You may have pneumonia, bronchitis, or asthma if your lungs become irritated.

GERD Prospects

Although it can restrict your daily activities, GERD is rarely a life-threatening condition. You should feel better if you comprehend the issues and receive the appropriate care.