GASTROESOPHAGEAL REFLUX DISEASE (GERD)

GASTROESOPHAGEAL REFLUX DISEASE (GERD)

WHAT IS GASTROESOPHAGEAL REFLUX DISEASE (GERD)?

Gastroesophageal reflux happens when your stomach contents come back up into your esophagus(food pipe).

WHAT ARE THE CAUSES OF GERD?

When the lower esophageal sphincter (LES), which regulates acid reflux, becomes weaken or relax.

This valve or sphincter generally closes tightly as food reaches your stomach.

If your sphincter relaxes when it shouldn’t, the contents of your stomach might regurgitate again into the esophagus.This is called Gastroesophageal Reflux Disease(GERD).

This can be caused by a variety of factors, such as
When there is excessive abdominal pressure. This increased pressure causes heartburn for some pregnant women practically every day.

Certain food groups such dairy, spicy, or fried foods and eating patterns.

Medications that include painkillers, sedatives, antidepressants, and medications for allergies, high blood pressure, and asthma.

Hiatus hernia-The top portion of the stomach protrudes into the diaphragm, obstructing normal meal intake.

WHO IS MORE LIKELY TO HAVE GERD?

Anyone can develop GERD. You are more likely to have GERD if you

  • 1. are overweight or have obesity
  • 2. are a pregnant woman
  • 3. certain medicines
  • 4. smoke or are regularly exposed to secondhand smoke

WHAT ARE THE SYMPTOMS OF GERD?

  • 1. Heartburn.
  • 2. Regurgitation (food comes back into your mouth from the esophagus).
  • 3. The feeling of food caught in your throat.
  • 4. Coughing.
  • 5. Chest pain.
  • 6. Problem swallowing.
  • 7. Vomiting.
  • 8. Sore throat and hoarseness.

HOW TO DIAGNOSE GERD?

  • Barium swallow
  • Endoscopy
  • Ambulatory acid (pH) probe test
  • Esophageal manometry
  • X-ray of the upper digestive system
  • Transnasal esophagoscopy.

WHAT ARE THE COMPLICATIONS OF GERD?

If GERD is not treated , it can get worse and lead to other issues. These may consist of:

ESOPHAGITIS

This is esophageal inflammation. Additionally, it may result in GI hemorrhage.

ESOPHAGEAL STRICTURE

Constant irritation can restrict the esophagus by scarring the tissue. Swallowing may become difficult as a result.

BARRETT’S ESOPHAGUS

The lining of the esophagus has the ability to transform into cells that resemble the lining of the intestine. It may progress to esophageal cancer.

It may also leads to Various respiratory issues, including chest congestion, hoarseness, asthma, laryngitis, and pneumonia, can be brought on by breathing stomach acid into the lungs.

HOW TO TREAT GERD?

LIFESTYLE CHANGES

Some lifestyle changes can control the GERD symptoms.

  • Avoid bending over soon after eating.Bending at the waist increase pressure on the stomach and can increase heart burn symptoms.
  • Sleep with your head and shoulder elevated,lying flat allows stomach contents to press against the LES( Lower Esophageal Sphincter).Also having the head higher than the stomach allows gravity to keep stomach contents such as acid where they belong.This can be placing bricks below the head end of the bed.
  • Sleep on your left side,studies have shows that this position aids digestion and helps with the removal of stomach acid.Sleeping on the right side has been show to worsen heartburn.
  • Wait atleast two to three hours after eating to go to bed.
  • Make sure your bed cloths are loose fitting.
  • Lose weight,if you overweight,pressure of excess weight can increase the chance stomach acid will backup into your esophagus and throat.
  • Drink plenty of water it helps with digestion.
  • Eat your big meal at lunch instead of dinner.
  • Eat 6 smaller meals each day instead of 3 larger ones.This will help the stomach from becoming too fill and help prevent excessive production of stomach acid.
  • Don’t eat too quickly.
  • Relax,stress may lead to an increase in stomach acid production.It is also known to lead to behaviors that cause heartburn such as overheating.
  • Avoid last night snacking.
  • Get regular exercise ,exercise can also help with digestion.
  • Check your medications can worsen heart burn symptoms so talk to your doctor if you have any concerns.
LIMITS
  • The amount of citrus fruit you eat such as oranges
  • Acidic foods such as tomatoes and oranges.
  • Fried foodsespecially it they are greasy or oily.
  • Tomato based product such as ketchup tomato sauce,pasta and spaghetti sauce.
  • The amount of chocolate you eat.
AVOID
  • Spicy food and cut back on chilli and pepper.
  • Caffeinated drinks such as colas and coffee.
  • Stop smoking ,nicotine can weaken the lower esophageal sphincter.Smoking also stimulates the production of stomach acid.
  • Avoid alcohol,alcohol increase the production of stomach acid.Alcohol also relaxes the lower esophageal sphincter(LES).

MEDICAL MANAGEMENT

Antacids are given to provide quick relief by neutralizing stomach acids.

H-2 receptor blockers are given to decrease acid production.

Proton pump inhibitors which is a stronger acid blockers that also help heal damaged esophagus tissue.

Baclofen is a prescription drug used to reduce the relaxation of the lower esophageal sphincter which allows acid backwash.

SURGICAL MANAGEMENT

The doctor may advise surgery if GERD symptoms do not improve significantly with lifestyle modifications and medication.

FUNDOPLICATION

To tighten the muscle and stop reflux, the surgeon wraps the top of your stomach over the lower esophageal sphincter.

This increases pressure on the lower esophageal sphincter and typically reduces acid reflux.

Typically, a minimally invasive (laparoscopic) method is used to do fundoplication. Partial or full wrapping of the upper portion of the stomach is possible (Nissen fundoplication).

Best option is for GERD practicing the lifestyle modifications.

DR.KUMAR has the experiences with treating with innumerable number of patients with GERD and he is an expert in LAPAROSCOPIC FUNDOPLICATION

Frequently Asked Questions

What is GERD?

GERD, or gastroesophageal reflux disease, happens when stomach contents flow back into the food pipe. This backward flow can irritate the oesophagus and cause heartburn, regurgitation, chest discomfort, throat irritation, cough, or swallowing problems. We evaluate GERD carefully because long-standing reflux can affect daily life and, in some cases, lead to complications if ignored.

What causes GERD?

GERD often happens when the lower oesophageal sphincter becomes weak or relaxes at the wrong time. This allows stomach acid to move upward into the oesophagus. Factors such as obesity, pregnancy, smoking, certain foods, heavy meals, some medicines, and hiatus hernia may contribute to reflux symptoms. We assess the likely cause before suggesting lifestyle, medical, or surgical treatment.

What are the common symptoms of GERD?

Common GERD symptoms include heartburn, sour burps, food or acid coming back into the mouth, chest burning, bloating, throat discomfort, chronic cough, hoarseness, and difficulty swallowing. Some patients may feel symptoms after heavy meals, spicy food, fried food, lying down after eating, or late-night meals. We recommend evaluation when symptoms are frequent, severe, or affecting sleep and routine life.

Can GERD be controlled with lifestyle changes?

Yes, many patients improve with lifestyle changes. We may suggest eating smaller meals, avoiding late-night eating, reducing spicy and fried foods, limiting caffeine and alcohol, stopping smoking, losing weight if needed, and sleeping with the head elevated. These changes can reduce reflux pressure and improve symptoms. However, persistent GERD may need medicines or further evaluation.

What medicines are used for GERD?

GERD may be managed with antacids, H2 blockers, proton pump inhibitors, and other medicines depending on symptom severity and doctor evaluation. These medicines help reduce acid, relieve symptoms, and allow irritated tissues to heal. We do not advise long-term self-medication without consultation because persistent symptoms may need proper diagnosis and treatment planning.

When is surgery needed for GERD?

Surgery may be considered when GERD symptoms do not improve with lifestyle changes and medicines, when reflux is severe, or when complications are present. Laparoscopic fundoplication may be advised for suitable patients. In this procedure, the upper part of the stomach is wrapped around the lower oesophageal area to reduce reflux.

What is laparoscopic fundoplication?

Laparoscopic fundoplication is a minimally invasive surgery used for selected GERD patients. It aims to strengthen the valve mechanism between the stomach and oesophagus, reducing acid reflux. Since it is performed laparoscopically, patients may benefit from smaller cuts, less pain, and faster recovery compared to open surgery. We recommend it only after proper evaluation.

Can untreated GERD cause complications?

Yes, untreated GERD may lead to oesophagitis, narrowing of the oesophagus, Barrett’s oesophagus, swallowing difficulty, bleeding, chronic cough, hoarseness, asthma-like symptoms, or repeated throat and chest irritation. Not every patient develops complications, but frequent reflux should not be ignored. We advise timely consultation when symptoms continue despite basic care.

Is every acidity problem GERD?

No, occasional acidity after heavy or spicy food is common, but GERD usually involves frequent or recurring reflux symptoms. If heartburn, regurgitation, cough, throat irritation, or chest burning happens often, especially after meals or while lying down, it may need medical evaluation. We help differentiate simple acidity from GERD and other digestive conditions.

How do we help GERD patients?

We help patients by reviewing symptoms, lifestyle triggers, medical history, and previous reports. Based on evaluation, we may advise lifestyle changes, medicines, investigations, or laparoscopic surgical treatment for suitable cases. Our aim is to reduce reflux, prevent complications, and improve digestive comfort with a safe and personalised treatment plan.

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