Gastroesophageal Reflux Disease (Gerd)
What is Gastroesophageal Reflux Disease (GERD)?
Gastro Oesophagal Reflux Disease (GERD) is a digestive disorder where the stomach contents flow back upwards or ‘reflux’ back into the oesophagus, which is the passage that connects the mouth to the stomach.
Heartburn is a common symptom of GERD, where a burning chest pain sensation can be felt as it moves upward to the neck and throat.
It can also feel like food is coming back into the mouth, leaving an acid or bitter taste. The bitter taste in the mouth comes from the acid in the stomach.
You can also experience nausea, vomiting, cough, hoarseness of voice, difficulty in swallowing, the feeling of having a lump at the back of your throat or worsening of your asthma.
If symptoms of GERD persist and cannot be relieved by simple over-the-counter antacid or with lifestyle and dietary modifications, it is advisable to seek medical help. You may require specific medications or a thorough diagnostic evaluation through a variety of tests and procedures conducted by a specialist.
There is a particular muscle that holds the junction between the oesophagus and stomach known as the lower oesophageal sphincter (LOS). This muscle acts as a one-way valve which allows food to enter the stomach from the oesophagus, but prevents stomach contents from flowing back up.
GERD occurs in people where the LOS muscle is weak or relaxes inappropriately.
Certain foods and beverages such as coffee, fried or fatty foods, spicy foods and chocolate may trigger reflux and heartburn.
Cigarette smoking can also be a factor as studies show it relaxes the LOS.
Pregnancy is also a well-known risk factor for GERD. It is typically mild and the symptoms also tend to resolve after pregnancy.
If you are obese, you are three times more likely to develop acid reflux than people within the healthy BMI range.
Hiatal hernia can weaken the LOS thus increasing the risk for GERD. This happens when the upper part of the stomach protrudes through the oesophageal hiatus into the chest. Furthermore, pregnancy and obesity can contribute to this condition.
In most cases, GERD specialists diagnose GERD by reviewing your symptoms and medical history. If your symptoms suggest you have GERD, the GERD specialists may recommend medications and lifestyle changes.
Your doctor may order tests to help diagnose GERD and check for GERD complications or problems other than GERD that may be causing similar symptoms. The main diagnostic tests carried out include gastroscopy to see the lining of the oesophagus, stomach and duodenum and 24 hours pH monitoring to detect stomach acid in the oesophagus.
Lifestyle and dietary changes are recommended for people seeking treatment for GERD.
- Elevating your upper body – If you are sitting or lying down, having an upright posture can prevent stomach acid from rising into your oesophagus.
- try eating smaller portions during mealtime and avoid eating 3 hours before bedtime
- Avoiding foods and beverages such as citrus fruits and juices, fatty foods, chocolate, tomato products, spicy foods, and alcoholic beverages as they can weaken the LOS or delay stomach emptying.
Acid suppressing medications such as antacids, H2 blockers or proton pump inhibitors (PPIs) may be prescribed for chronic reflux and heartburn in addition to lifestyle changes.