Gastro-esophageal reflux disease (GERD) is a common condition where the stomach acid leaks out of the stomach and into the esophagus, causing heartburn, an unpleasant sour taste in the mouth, and sometimes difficulty swallowing.
GERD is caused by a number of factors working together. The most important in the improper functioning of the lower esophageal sphincter muscle, which has the primary function of preventing stomach acid from leaking into the esophagus.
Approximately 1 in 5 people experience at least one episode of GERD in a week. It is twice as common in men as it is in women.
Some of the risk factors for GERD include:
being over weight or obese
high fat diet / diet low in fiber
increased caffeine, chocolate or alcohol intake
having a hiatus hernia
Some of the complications of severe GERD may include:
bleeding of the esophagus lining
tooth decay, gum disease and bad breath.
SIGNS AND SYMPTOMS
The common symptoms of GERD are:
- heartburn. It is usually worse when lying down or bending over.
- regurgitation of acid into your throat and mouth. This is the cause of bad taste left in mouth.
- difficulty swallowing. 1 in 3 people with GERD can develop difficulty swallowing, if the acid reflux causes scarring in the esophagus.
- Painful swallowing
- persistent cough
- tooth decay
- hoarse voice due to inflammation of larynx (voice box)
- worsening of asthma symptoms
DIAGNOSIS AND MANAGEMENT
It is fairly easy to diagnose GERD on the basis of a good history alone, but some patients may require further testing for a definitive diagnosis, especially if an underlying serious condition such as cancer is suspected. These may include endoscopy, where a piece of medical equipment with a camera attached may be used to examine your esophagus. if endoscopy doesn’t bear favorable results, manometry may be performed, where functioning of the lower esophageal sphincter is assessed. In some patients, 24 hour pH testing may also be performed, where an NG is inserted into the patient and a probe is connected to a portable recording device that you wear around your waist.
Self care plays a crucial role in identifying and managing your symptoms resulting from GERD. these include:
Losing weight if over weight.
Quitting smoking / cutting down on caffeine and chocolate if you find that it aggravates your symptoms.
Eating smaller, more frequent meals during the day, rather than three large meals
Raising the head of your bed in a safe way
Apart from these changes, in terms of medical treatment, many over the counter medications are available for treatment of GERD. If you take antacids for this purpose, make sure to discuss with your GP any other medications you might be taking, as these can interfere with a number of other medicines, causing them to be improperly absorbed in the body. You may be prescribed PPIs ( proton pump inhibitors) or H2 receptor antagonists which are both very effective.
Surgery may be suggested to a limited number of patients in case the above mentioned treatments fail.