GERD – Symptoms, causes, types, and treatment

GERD is a condition where stomach acid regularly flows back into the esophagus, causing irritation and inflammation. This backflow of acid can lead to various symptoms and complications if left untreated.

Symptoms of GERD

1. Heartburn: A burning sensation in the chest, often after meals or at night.
2. Regurgitation: Sour-tasting fluid backing up into the throat or mouth.
3. Dysphagia: Difficulty swallowing, often felt as food sticking in the throat.
4. Chronic Cough: Persistent coughing, especially at night.
5. Hoarseness: Changes in voice quality due to irritation of the vocal cords.
6. Chest Pain: Chest discomfort that may mimic a heart attack, often referred to as non-cardiac chest pain.

Causes of GERD

1. Weak Lower Esophageal Sphincter (LES): The LES is a muscle at the bottom of the esophagus that normally closes after food passes into the stomach. If it weakens or relaxes abnormally, acid can flow back into the esophagus.
2. Hiatal Hernia: When part of the stomach protrudes into the diaphragm, it can weaken the LES and contribute to GERD.
3. Dietary Factors: Spicy foods, citrus fruits, caffeine, alcohol, and fatty foods can trigger GERD symptoms in some individuals.
4. Obesity: Excess weight can put pressure on the stomach and LES, leading to acid reflux.
5. Pregnancy: Hormonal changes and increased abdominal pressure during pregnancy can cause or worsen GERD symptoms.

Types of GERD

1. Non-Erosive Reflux Disease (NERD): GERD without visible esophageal damage on endoscopy.
2. Erosive Esophagitis: Inflammation and erosion of the esophageal lining due to acid exposure.
3. Barrett’s Esophagus: Chronic GERD can lead to changes in the esophageal lining, increasing the risk of esophageal cancer.
4. Extraesophageal GERD: Manifests as respiratory symptoms (cough, asthma), throat symptoms (hoarseness, throat clearing), or dental erosion.

Diagnosis of GERD

1. Medical History and Symptoms: A detailed history of symptoms and their duration.
2. Physical Examination: Including evaluation for signs of GERD such as heartburn, regurgitation, and throat irritation.
3. Endoscopy: Direct visualization of the esophagus to assess for inflammation or erosion.
4. Esophageal pH Monitoring: Measures acid levels in the esophagus over a period to confirm acid reflux.
5. Barium Swallow: X-ray imaging after swallowing a contrast material to detect structural abnormalities.

Treatment Options

1. Lifestyle Modifications:
   • Dietary Changes: Avoiding trigger foods, eating smaller meals, and not lying down immediately after eating.
   • Weight Management: Losing excess weight can reduce pressure on the stomach.
   • Elevating the Head of the Bed: Sleeping with the upper body raised to prevent acid reflux during sleep.
2. Medications:
   • Antacids: Provide immediate relief by neutralizing stomach acid.
   • H2 Blockers: Reduce acid production in the stomach.
   • Proton Pump Inhibitors (PPIs): Block acid production more effectively than H2 blockers and promote healing of esophageal damage.
3. Surgical Options:
   • Fundoplication: A procedure to strengthen the LES by wrapping the upper part of the stomach around it.
   • LINX Device: A magnetic device placed around the LES to prevent acid reflux while allowing food to pass.
4. Alternative Therapies:
   • Acupuncture: Some individuals find relief from GERD symptoms through acupuncture.
   • Herbal Remedies: Certain herbs like chamomile, licorice, and ginger may help alleviate symptoms.

Conclusion

GERD is a common and often manageable condition, but it requires a comprehensive approach that includes lifestyle changes, medication management, and sometimes surgical interventions. Understanding the symptoms, causes, types, and treatment options for GERD empowers individuals to take control of their digestive health and seek appropriate medical care when needed.