Gastro Esophageal Reflux Disease (GERD)

Gastroesophagael Reflux, occurs when there is back flow of stomach contents into the food pipe (oesophagus) and/ or mouth.

Causes of the Reflux

At the lower end of the oesophagus is a circular ring of muscle called the lower oesophageal sphincter (LES). After swallowing. The LES relaxes to allow food to enter the stomach and then contracts to prevent the back flow of food and acid into food pipe (Oesophagus).

Sometimes (LES) is weak and allows prolonged exposure of stomach content / juice to the oesophagus. This causes troublesome symptoms and injury to the oesophagus.

Symptoms of GERD

Acid reflux symptoms may include:-
Heartburn.
Back flow of food into the Oesophagus (Regurgitation).
Upper abdominal pain / discomfort.
Chest pain.
Difficulty in swallowing.
Painful swallowing.
Sore throat.
Hoarse voice, cough, asthma.
Lump in throat.
Ginaritis pneumonia.
Waking with a choking sensation.

Diagnosis

Most patients with typical GERD symptoms i.e, heartburn, regurgitation and epigastric pain, are diagnosed on history alone. The doctor may recommend X-ray, Endoscopy, PH studies and manometry.

Reasons (Indications) for Endoscopy in GERD

Persistent symptoms.
Difficulty in swallowing.
Vomiting.
Weight loss.
Anaemia.
Vomiting blood.

Treatment of GERD

Lifestyle measure include:

Take dinner 2-3hours before sleeping.
Raise the head of thebed/additional pillows.
Take small meals in the evening.
Weight loss.
Avoiding certain acid foods, spicy foods, coffee, carbonated drinks.

Medicines

The doctor may prescribe antacids, Zantac, Omeprezole, Pantoprezole Rabeprezole, Esomoprezole.

Antireflux surgery

Anti-reflux surgery is recommended for those who do not respond to medicines, or patients who choose surgery.

What can I do to prevent or reduce reflex?

Limit Caffeine. Limit coffee to 2-3 cups per day. Limiting consumption of other caffeine-containing beverages (tea, soft drinks) may also be helpful.

Avoid tight clothing. Tight belts, tight pants or girdles can increase the pressure on the stomach.

Avoid foods that cause your symptoms. Foods to avoid are: Spicy and fatty foods.

Tomato and citrus juices (such as grapefruit and orange juices) Chocolate, mints, coffee, tea, cola, and alcoholic drinks.

Do not lie down for 2 hours after eating. Allow gravity to work. Also, avoid bending over at the waist to pick up things; instead bend at the knees.

Stop smoking. If you cannot stop, decreasing the number of cigarettes you smoke may help.

Bed blocks. Elevate the head of your bed 2-6 inches with wood blocks or bricks. Using extra pillows is NOT a good substitute. Use of a foam wedge beneath the upper half of the body is an alternative.

Maintain your ideal weight. Excess weight increases the amount of pressure constantly placed on your stomach. Even small amounts of weight loss may help.

Antacids. Can be taken at bedtime and 30-60 minutes after each meal or as directed by your physician.

Acid suppression medications. These medications should be taken 30-60 minutes before meals.

Eat smaller meals. Don’t overfill your stomach.