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

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