Gastroesophageal reflux disease (GERD)

Gastroesophageal reflux disease (GERD) is a chronic condition in which stomach acid repeatedly flows back up into the esophagus, the tube connecting your mouth and stomach. This backwash can irritate the lining of the esophagus and cause uncomfortable symptoms. It's more than just occasional heartburn; GERD is a persistent condition that requires proper management. 

Signs and symptoms

The symptoms of GERD can vary widely among individuals, but the most common ones are heartburn and regurgitation. 

Common symptoms include:

  • Heartburn: A burning sensation in the chest that often occurs after eating and may worsen at night or while lying down.

  • Regurgitation: The backwash of sour liquid or stomach contents into your throat or mouth (esophagitis with acid brash).

  • Chest pain: A non-burning chest pain that should be evaluated by a doctor to rule out more serious issues like a heart attack.

  • Difficulty swallowing (dysphagia): The sensation of food being stuck in your throat.

  • Sensation of a lump in the throat (globus sensation): The feeling that something is caught in your throat.

  • A bitter or sour taste in your mouth (acid brash)

  • . 

Other, less common symptoms can include:

  • A persistent dry cough

  • Hoarseness or a sore throat

  • Nausea

  • Trouble sleeping due to symptoms

  • Worsening asthma 

Diagnosis

In many cases, a doctor can diagnose GERD based on your symptoms alone and your response to lifestyle changes and medication. You might not need specific diagnostic testing unless your symptoms are severe, don't improve with initial treatment, or you have "alarm symptoms" such as difficulty swallowing, bleeding, or unexplained weight loss. 

If further testing is needed, a doctor may recommend:

  • Upper endoscopy: A thin, flexible tube with a camera is inserted down your throat to view the esophagus and stomach. This can check for inflammation, ulcers, or other complications and may involve a biopsy (taking a small tissue sample).

  • pH monitoring: A test that measures the amount of acid in your esophagus over a 24- to 48-hour period. A wireless capsule or a thin catheter can be used to track acid levels and correlate them with your symptoms.

  • Esophageal manometry: This test measures the pressure and movement of the esophageal muscles to see if they are working correctly. It is often used to rule out other conditions and may be helpful if you are considering surgery. 

Treatment

Treatment for GERD usually begins with lifestyle changes and progresses to medication or, in severe cases, surgery if symptoms persist. 

Lifestyle and home remedies:

  • Maintain a healthy weight: Excess weight puts pressure on your abdomen and stomach, which can force acid into your esophagus.

  • Avoid trigger foods and drinks: Common culprits include fatty foods, spicy foods, chocolate, caffeine, alcohol, and acidic foods like citrus and tomatoes.

  • Eat smaller, more frequent meals: Large meals can increase pressure on your stomach.

  • Do not lie down after eating: Wait at least three hours after a meal before lying down or going to bed.

  • Elevate the head of your bed: Raising the head of your bed by 6 to 8 inches can help gravity keep stomach acid down. Using extra pillows is not effective.

  • Quit smoking: Smoking weakens the lower esophageal sphincter, the muscle that keeps acid from backing up into the esophagus.

  • Wear loose-fitting clothing: Tight clothing can put extra pressure on your abdomen. 

Medication:

  • Antacids: Over-the-counter options like Tums, Rolaids, and Maalox provide quick but temporary relief by neutralizing stomach acid.

  • H2 blockers: Medications like famotidine (Pepcid) reduce acid production and provide longer relief than antacids.

  • Proton pump inhibitors (PPIs): Stronger acid blockers like omeprazole (Prilosec), lansoprazole (Prevacid), and esomeprazole (Nexium) block acid production and allow the esophageal tissue to heal. They are available both over-the-counter and in prescription strength. 

Surgical procedures:

For severe GERD that doesn't respond to medication or lifestyle changes, a doctor may recommend surgery to strengthen the lower esophageal sphincter. 

  • Nissen fundoplication: This procedure involves wrapping the upper part of the stomach around the lower esophagus to reinforce the sphincter.

  • LINX device: A ring of magnetic beads is surgically placed around the junction of the stomach and esophagus to keep it closed against reflux

Comments

Post a Comment

Popular posts from this blog

Pink eye

Pink eye, or conjunctivitis, is an inflammation or infection of the conjunctiva, the clear membrane that lines the eyelid and covers the white part of the eyeball. The inflammation causes the small blood vessels in the conjunctiva to swell, making the eye appear pink or red. Pink eye is very common and can affect one or both eyes.  Signs and symptoms The symptoms of pink eye can vary depending on the cause, but common signs include:  Red or pink eye: The whites of the eye become noticeably reddish or pink. Itching or gritty feeling: You might feel an irritating, scratchy sensation, as if sand or dirt is in your eye. Discharge: This can be watery and thin with viral infections, or thick and yellow or green with bacterial infections. Crusting: Dried discharge can form a crust on your eyelashes and eyelids, especially after sleeping, which can cause them to stick together. Excessive tearing: Your eyes may water more than usual. Light sensitivity: Some people experience discomfort...
Read more

Deep vein thrombosis (DVT)

Deep vein thrombosis (DVT) is a serious medical condition where a blood clot forms in a major vein, most commonly in the legs. A DVT is a concern because the clot can break away and travel through the bloodstream to the lungs, causing a potentially life-threatening blockage called a pulmonary embolism (PE).  Common causes A DVT occurs when blood flow slows down or blood becomes more prone to clotting. Risk factors for this include:  Prolonged immobility: Long periods of inactivity—such as being on bed rest after surgery, sitting on a long flight or drive, or having a cast on a limb—can cause blood to pool in the legs and form clots. Recent surgery or injury: Damage to the veins during major surgery (especially to the hips, pelvis, or legs) or from serious muscle injuries and fractures increases the risk of clot formation. Certain medical conditions: People with cancer, heart disease, inflammatory bowel disease, and inherited blood clotting disorders are at higher risk. Pregnan...
Read more

Pulmonary Embolism(PE)

A pulmonary embolism (PE) is a life-threatening medical emergency where a blood clot or other substance, most commonly a clot from the leg, gets stuck in one of the main arteries leading to the lungs. This blockage cuts off blood flow to a part of the lung, which can prevent the heart from pumping properly and lead to a life-threatening lack of oxygen. Prompt diagnosis and treatment are crucial to prevent severe complications or death.  Common causes Most pulmonary embolisms are caused by a blood clot traveling from another part of the body, a condition called deep vein thrombosis (DVT). Risk factors for a DVT developing include:  Immobility: Long periods of bed rest after surgery, a broken bone, or a long plane or car ride can cause blood to pool and clot in the legs. Surgery or trauma: Major surgery, especially on the hips, knees, or abdomen, as well as severe fractures, can increase the risk of clots forming. Cancer and other diseases: Conditions like cancer, heart disease,...
Read more