GERD

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Overview

GERD (Gastro-Esophageal reflux disease) is a condition in which gastric acid, which is erosive in nature, moves upwards to the esophagus and causes mucosal injury and irritation to the lining of the esophagus. There are several complications which can arise due to this disorder, and this frequent acid reflux can cause significant discomfort to the patient.

Symptoms

Acid reflux from time to time does not imply any disorder. Mild reflux twice a week or severe reflux once a week is known as GERD. Following are some signs and symptoms of this disorder:

  • Burning sensation in chest (heartburn) usually prominent at night and after eating
  • Chest pain
  • Difficulty swallowing
  • Sensation of lump in throat
  • Regurgitation of food or a sour, burning liquid

Nighttime, chronic reflux can also manifest as chronic cough, laryngitis, new or worsening asthma, and disrupted sleep.

Causes

Acid reflux occurs when the sphincter around the area of esophagus that fuses with the stomach does not constrict after food or drink has passed through it. This open passageway allows the backwash of acid. Following are some risk factors associated with GERD:

  • Hiatal hernia
  • Pregnancy
  • Connective tissue disorders
  • Obesity
  • Delayed stomach emptying

GERD can often be exacerbated by smoking or alcohol use, eating large meals and often before sleeping, diet consisting of hot drinks and spicy, fatty foods, and use of aspirin or other drugs.

Esophageal strictures (narrowing), ulcers, and precancerous changes in the esophagus (Barret’s esophagus) are serious complications of GERD.

Diagnosis

After thorough history and clinical examination, endoscopies and other imaging studies such as Barium swallow, Esophageal manometry etc. can be used to confirm the diagnosis.

Treatment

Lifestyle modifications can be advised to improve symptoms of GERD and prevent future episodes. Medication that can be used are:

  • Antacids
  • Proton Pump Inhibitors
  • H2 receptor blockers

Surgical procedures such as fundoplication also exist to relieve symptoms if all other therapies fail.

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