Gastroesophageal reflux disease is a
chronic condition in which there is a backflow
(reflux) of stomach acid into the food pipe
(esophagus).
GERD is a This constant backwash of acid can irritate
the lining of your esophagus, causing it to be
irritated and inflamed. It occurs when the LES
muscle is very weak or, more commonly, when it
inappropriately relaxes causing heartburn. Heartburn
is the burning sensation in the throat or chest
caused by the backwash of the stomach contents. Almost everyone occasionally experiences a reflux
of acid from their stomach into their esophagus. In
most people, reflux symptoms are mild and do not last
long.
With GERD, however, reflux occurs more frequently and
causes enough discomfort that the person affected is
aware of the condition.
Causes
Various lifestyle and dietary factors can
contribute to heartburn by relaxing the lower
esophageal sphincter and allowing it to open,
increasing the amount of acid in the stomach,
increasing stomach pressure, or by making the
esophagus more sensitive to harsh acids. These
factors include:
- Eating large portions.
- Eating certain foods, including onions,
chocolate, peppermint, high-fat or spicy foods,
citrus fruits, garlic and tomatoes or tomato-based
products.
- Drinking certain beverages, including citrus
juices, alcohol and caffeinated and carbonated
drinks.
- Eating before bedtime.
- Being overweight
- Smoking
- Wearing tight fitting clothing or belts
- Lying down or bending over, especially after
eating
Stress
Symptoms
The most common symptoms of GERD are heartburn and
regurgitation.
These symptoms are most likely to occur 30 to 60
minutes afte meals. The heartburn is usually
intensified by eating, lying down and bending over.
Additional, atypical symptoms may include
regurgitation of acidic materials, chest pain, asthma,
chronic cough, chronic bronchitis, chronic sore
throat, morning hoarseness, swallowing difficulty,
bloating, belching, nausea and weight loss.
Treatment
For patients with mild GERD, doctors recommend
simple lifestyle changes, such as quitting smoking,
dietary changes and taking over-the-counter (OTC)
antacids.
Physicians suggest eating smaller meals and avoiding
acidic foods, fatty foods, peppermint, chocolate and
alcohol. Most importantly, it is recommended to avoid
eating three hours prior to bedtime or to lying down.
For mild cases, your doctor may prescribe antacids to
take after meals and at bedtime. Antacids have long been a mainstay of
treatment of gastroesophageal reflux. But
antacids alone won't heal an inflamed esophagus
damaged by stomach acid.
When patients with mild to moderate symptoms of
GERD fail to improve with lifestyle changes and
antacids, the next step is to try other medications.
Doctors may suggest a Histamine2 (H2) receptor
antagonist, such as cimetidine (Tagamet), ranitidine
(Zantac), famotidine (Pepcid) or nizatidine (Axid),
each if which has a moderate ability to suppress
acid.They don't act as quickly as antacids, but they
provide longer relief. Take these medications before a
meal that you think may cause heartburn because it
takes them about 30 minutes to work.
Surgery is only recommended if the symptoms
don’t respond to other treatments. Surgery
is called a Nissen fundoplication. With the advent of
the proton pump and inhibitor medications, surgery is
now rarely needed
