Gastrointestinal Diseases

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Gastroesophageal Reflux Disease (GERD)

Overview:

Gastroesophageal reflux disease (GERD), or just ‘reflux’, occurs due to the reflux of stomach acid to the esophagus causing a burning pain behind the chest bone.
Lifestyle changes help ease the symptoms.
Antacids are effectives but the recurring burning sensation requires medical care.
Maintaining a healthy lifestyle and healthy weight are key to prevention of reflux.
It is important to treat persistent heartburn as it harms the esophagus with time.

What is GERD?

Gastroesophageal reflux disease (GERD) is a digestive disorder that affects the lower esophageal sphincter (LES), the ring of muscle between the esophagus and stomach. Many people, including pregnant women, suffer from heartburn or acid indigestion caused by GERD.

Other names:

Reflux, acid reflux, heartburn, gastroesophageal reflux disease, GERD

Cause:

In the normal digestion process, the lower esophageal sphincter (LES) opens to allow food to pass into the stomach and closes to prevent food and acidic stomach juices from flowing back into the esophagus. Gastroesophageal reflux occurs when the LES is weak or relaxes inappropriately, allowing the stomach's contents to flow up into the esophagus, causing a burn sensation.

Risk factors:

Obesity
Smoking
Pregnancy
Hiatal he:rnia
Medications that weaken the function of the sphincter

Symptoms:

Pain and burning in the chest that could reach the throat and cause larynx infection and congestion
Pain and difficulty when swallowing
An acidic taste in the mouth, gingivitis, bad mouth smell
Dry cough
Hiccups
burping
increased saliva

Symptoms may worsen when bending or laying down or after excessive eating.

Reflux triggers:

Anxiety and stress
Large meals
Spicy food
Acidic food
Tomato products (e.g. ketchup and tomato sauce)
Greasy and fried food
Chocolate
Onion-containing food
Caffeinated drinks (e.g. soft drinks, coffee, etc.)
Mint or minted beverages

When to see a doctor?

If the burning sensation occurs for two or more days in a week;
If there is difficulty swallowing food or fluids;
Persistent nausea or vomiting;
Weight loss due to the loss of appetite;
If the symptoms persist despite taking medications.

Complications:

Esophagitis
Digestive ulcers
Narrowing of the esophagus
Barrett's syndrome (abnormal cells are form due to chronic inflammation)

Diagnosis:

Barium X-ray
Esophagoscopy
Acidity level test

Treatment:

Simple antacids (to offset acidity)
Acid-blockers (H2-receptor antagonists)
Proton pump inhibitors (PPIs)

Prevention:

Avoid GERD-stimulating foods and drinks.
Quit smoking.
Maintain healthy weight.

Tips for easing symptoms:

Make some lifestyle changes, such as:

Avoiding laying down immediately after eating;
Avoiding eating 2-3 hours before going to bed;
Dividing meals to small proportions to be eaten along the day;
Avoiding tight clothes;
Using a 15-20 cm pillow for sleeping.

FAQ:

When is GERD considered a medical condition?

When you experience a burning sensation for two days or more per week, or severe heartburn for more than one day a week.

Does drinking milk treat GERD?

Drinking milk may ease the burn in the beginning but the effect is temporary and later leads to stimulating the production of stomach acids, especially if it is full-fat milk.

Does eating cucumbers ease the burn?

There is no scientific evidence, but cucumber is not an irritant. The effect varies from one individual to another; some patients find it helpful, others don’t.

Does wearing corsets cause acid reflux and heartburn?

Yes, for those who are susceptible, or have more than one risk factor.

Myths & Truths:

Reflux in pregnant women is the result of the baby's hair growth.

Truth: GERD in pregnant women is caused by several factors, including:

Increase in pregnancy hormone which relaxes the stomach muscle;
Growth of the womb pressures the stomach and causes the burn, and the baby's hair has nothing to do with it;

Smoking reduces stomach acidity.

Truth: Smoking is among the key causes of stomach and esophagus diseases, and doesn't ease the burn. Also, nicotine causes relaxation of the stomach muscle