Esophagus Illness | gutCARE

GERD (Gastroesophageal Reflux Disease)

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June 25, 2018

GERD (Gastro Esophageal Reflux Disease) is a digestive disorder where the stomach contents flow back upwards or ‘reflux’ back into the esophagus, which is the passage that connects the mouth to the stomach. Normally, there is a muscle that holds the junction between the esophagus and stomach known as the lower esophageal sphincter (LES). This muscle acts a one-way valve which allows food to enter the stomach from the esophagus, but prevents stomach contents from flowing back up. 

Causes Of GERD

GERD occurs in people where the LES muscle is weak or relaxes inappropriately. The severity of GERD depends on the dysfunction of the LES as well as the amount of fluid brought up from the stomach. It is believed by some doctors that a hiatal hernia can affect and weaken the LES thus increasing the risk for GERD. This happens when the upper part of the stomach protrudes or pushes through the esophageal hiatus into the chest.

Sudden physical exertion or even coughing, straining, vomiting can cause increased pressure in the abdomen which results in hiatal hernia. Pregnancy and obesity can also contribute to this condition. Many people over the age of 50 have a small hiatal hernia, however it can still affect people of all ages.

Lifestyle and dietary choices can also play a role in GERD. 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 LES.

Symptoms Of GERD

Heartburn is also a common symptom of GERD, where a burning chest pain sensation can be felt as it moves upward to the neck and throat. It also feels like food is coming back into the mouth, leaving an acid or bitter taste. The bitter taste in the mouth is actually the taste of stomach acid. You can also experience breathing problems, nausea, vomiting, difficulty in swallowing and the feeling of having a lump at the back of your throat.

Pregnancy is also a well-known risk factor for GERD. It is typically mild and does not cause damage to the inner lining of the esophagus. The symptoms also tend to resolve after pregnancy on its own without the need for treatment, and there are no long-term implications.

You can try some quick and simple homecare measures to alleviate your symptoms such as:

  • Elevating your upper body – If you are sitting or lying down, having an upright posture will put less pressure on your LES and prevent stomach acid from rising into your esophagus.
  • Wearing loose clothing – Tight clothing can be compressing your stomach and easily cause heartburn to occur
  • Finding remedies in the kitchen – Try ginger in soups or tea to soothe your heartburn condition. You can steep dried ginger root, raw ginger root, or ginger tea bags in boiling water to make ginger tea. Baking soda can also help to calm heartburn episodes by neutralising the stomach acid. In a glass of water, dissolve a teaspoon of it and drink it slowly.

For pregnant patients who continue to have symptoms despite these lifestyle measures, over the counter medications available in Singapore such as antacids may provide quick relief. Avoid antacids containing sodium, as these can lead to excess fluid retention in pregnancy.

Management & Treatment For GERD

Lifestyle and dietary changes are recommended for people seeking treatment for GERD. It can help to decrease the amount of reflux and reduce damage to the lining of the esophagus. Avoiding foods and beverages such as citrus fruits and juices, fatty foods, chocolate, tomato products, spicy foods, and alcoholic beverages as they can either weaken the LES or irritate a damaged esophageal lining.

To manage GERD, try eating smaller portion during mealtime and avoid eating 3 hours before bedtime to allow the acid in the stomach to decrease and reduce the chances of reflux. In addition to dietary and lifestyle changes, antacids and medication treatments may be prescribed. For chronic reflex and heartburn, medications such as H2 blockers  are recommended to reduce acid in the stomach. Another type of drug is the proton pump inhibitor which inhibits an enzyme necessary for acid secretion. Talk to your doctor about the medication options available and their costs. If the symptoms of GERD persist and are not relieved by the mentioned treatments, patients may need a more complete diagnostic evaluation through a variety of tests and procedures conducted by a specialist.

If you suffer from persistent GERD, you should visit a clinic and consult with specialist for further evaluation.  You may require specific medication or procedures for proper treatment. Your doctor will ask about your symptoms, medical history and any taken medications before performing a physical exam or lab work to test for underlying conditions. When GERD is suspected, the main diagnosis tests carried out include 24 hour pH monitoring and gastroscopy available in gutCARE.


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February 1, 2018

The esophagus, otherwise known as the gullet or swallowing tube, is the “pipe” that links the mouth to the stomach, and allows food to pass down after chewing and swallowing into the rest of the digestive tract where digestion and absorption of nutrients occurs.

It’s an important structure, and a number of diseases can affect its function and overall gut health. Some of them are listed below:

GERD (Gastro Esophageal Reflux Disease)

Backflow of stomach contents into the esophagus can cause symptoms such as heartburn a bitterness in the throat and a variety of other symptoms. The diagnosis is made by endoscopy or a special reflux study. Treatment involves lifestyle changes in tandem with medicine and sometimes surgery.  (Click to read more)

Barrett’s Esophagus

Barrett’s is a change in the lining of the esophagus as a result of constant and chronic reflux. This condition needs to be managed and monitored, as there is a small potential for malignancy. (Click to read more)

Esophageal Dysmotility

The movement of food down the esophagus does not happen by gravity but is a result of coordinated contractions involving the nerves and muscles. A disruption of this can result in swallowing difficulties and significantly impair one’s quality of life. Diagnosis involves the use of High-Resolution Esophageal Manometry and a pH-Impedance test, and once the correct diagnosis has been made, effective treatment can be given.

Achalasia

This is one of the most significant disorders of swallowing, where the esophagus movement stops and the valve allowing food to enter the stomach is jammed. The diagnosis and subtyping is confirmed by High-Resolution Esophageal Manometry, and effective treatment can be given.

Pill Esophagitis

This is a common condition when tablets or pills are not swallowed properly and get stuck in the narrowest part of the esophagus, and the medication in the pills get into contacts with the esophagus and results in painful ulcers forming.

Eosinophilic Esophagitis

This condition presents in a variety of ways, and can sometimes mimic a heart attack. It’s a result of an allergic reaction of the esophagus causing allergic type cells to accumulate and cause damage to the lining of the esophagus. Accurate diagnosis by endoscopy and biopsy to see the cells is crucial before treatment can be instituted.  

Esophageal Cancer

Cancer of the esophagus most commonly occurs in an elderly male with a strong history of smoking and drinking alcohol. They usually have symptoms such as difficulty in swallowing and loss of weight.


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