Stomach contents are normally prevented from moving to the esophagus (a tube connecting the mouth with the stomach) by the esophageal sphincter (a valve-like ring of muscle at the end of the esophagus).
When this muscle relaxes or is generally weak, GERD may occur, causing backflow of food and acid into the food pipe. This can occur in healthy people occasionally but is a frequent problem among those with GERD.
Symptoms:
- Because reflux from the stomach consists of acid, the main symptom of GERD is frequent heartburn or a feeling of indigestion.
- A bitter acid taste in the mouth.
- If the stomach fluid reaches the larynx (breathing tube), coughing spells can occur
Other possible symptoms:
Nausea or vomiting
Bad breath
Difficulty or pain when swallowing
Tooth decay
Factors contributing to GERD:
- Being pregnant is a major risk factor for GERD due to
increased pressure on the abdomen and hormonal changes
- Being overweight or obese
- Smoking
- Consuming alcoholic, caffeinated, or carbonated beverages
- Eating large meals
- Sleeping immediately after having food
Taking certain medicines, such as aspirin and certain drugs for asthma, high blood pressure, allergies, depression, sleep disorders, and pain
Complications : if left untreated may cause chronic GERD leading to complications such as
- Esophagitis (inflammation of the esophageal lining)
- Narrowing of the esophagus due to scarring
- Ulcers in the esophagus
- Barrett esophagus (change in the cells of the esophageal lining, with an increased risk of cancer)
Diagnosis and Treatment:
If the symptoms are severe, testing can help in further evaluation.
- Upper Endoscopy (examination of the esophagus and stomach through a flexible tube with a camera)
- Barium (radiological contrast) swallow test.
- In some cases it may be necessary to do a pH-monitoring test (for stomach acidity) and manometry test (to measure the strength of the esophageal sphincter). These tests involve passing a tube up the nose and down the throat to the end of the esophagus.
Based on the severity of the symptoms and the test results your physician may prescribe medications like Antacids , PPIs (proton pump inhibitors) and H2 blockers.
Prevention of GERD:
- The position of your body after eating. (An upright posture helps prevent reflux.)
- The size of the meal. (Smaller meals reduce reflux)
- Avoiding meals up to 2–3 hours prior to bedtime may be helpful.
- Eat food slowly and chew thoroughly.
- Avoiding certain foods, such as chocolate, citrus fruits, onions, peppermint ,tomato, or spicy or fried foods (these substances irritate the esophagus or weaken the sphincter and can cause reflux.)
- Quit or avoid smoking.
- Losing weight can help prevent symptoms.
- Avoid clothing that is tight around the abdomen.
- Sleep at a slight angle with the head slightly elevated.
- Reducing stress
When to see a doctor:
if you have chest pain, especially if you also have shortness of breath, or jaw or arm pain. These may be signs and symptoms of a heart attack.
Heart attack and stomach ulcers may mimic heartburn.
Also if you Experience severe or frequent GERD symptoms
-Dr. Krishna Priya
References:
https://www.medscape.com/index/list_7610_0
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4133436
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