ACID REFLUX
Have you ever felt something astringent or acidic backwashing into your mouth from your stomach? It must have happened at some point or may I say it keeps happening once in a while.
Well, this acid reflux is termed as Gastroesophageal reflux in medical science.
It is totally normal if you experience this once in a while. But, if it keeps bothering you more than twice a week for several weeks or months, then it is alarming. It indicates that you have GERD.
WHAT IS GERD?
Gastroesophageal reflux disease also known as GERD in short, is a digestive disorder in which the acidic stomach content refluxes or rushes upwards into your esophagus and then into mouth. This acid reflux irritates the esophageal lining and the person complains of having heartburn.
WHY DOES GERD OCCUR?
The ring of muscle that is oesophageal sphincter guards the border between esophagus and stomach to prevent the backflow of food and other content passed down through the mouth. When this ring or sphincter is affected by some causative factors, it stays relaxed and fails to shut and stomach content backlashes into the oesophagus, ultimately causing irritation and inflammation.
WHAT ARE THE CAUSES OF GERD?
- Pregnancy
- Obesity
- Hiatal hernia (the top part of stomach bulges into the diaphragm)
- Delayed stomach emptying
- Indigestion
- Connective tissue disorders
Some lifestyle factors are responsible for aggravating the acid reflux like:
- Alcohol consumption and smoking
- Eating large portion meals
- Eating late night and sleeping right after
- Eating spicy, fried or fatty foods
- Excessive caffeine intake
- Certain medications like aspirin
WHAT ARE THE SYMPTOMS OF GERD?
- Regurgitation of gastric content
- Difficulty swallowing
- Chest pain
- Heartburn, generally after having a meal, even worse at nighttime- can even last for 2 hours.
- Nausea
- Difficulty breathing
- Lump-like sensation in throat
In some episodes, especially at night, you can also experience:
- Chronic cough
- Acute or worsening asthma
- Laryngitis
- Disrupted sleep
HOW IS GERD DIAGNOSED?
At first, the general practitioner asks about the patient’s history and does a physical examination. He might be able to diagnose GERD based on those signs and symptoms along with the history. But to be certain, some tests are also performed like:
- Ambulatory Acid pH probe testing – Acid levels inside the esophagus of the patient are measured.
- Esophageal manometry – To measure the rhythmic or peristaltic muscle contractions in the esophagus while swallowing the food.
- Upper endoscopy – A thin and flexible tube with a light and camera fitted in, is passed down the patient’s throat to examine the insides of esophagus and stomach clearly.
- X-Rays – The patient is asked to drink a chalky liquid that coats the inner lining of the gastric tract and then x-rays are taken.
WHAT IS THE TREATMENT OF GERD?
GERD can be easily treated with lifestyle modification and the help of some over the counted medications.
Lifestyle modifications:
- Avoid sour, spicy and salty foods
- Avoid strong triggering beverages
- Eat slowly and keep the servings small
- Have your dinner at least 2 hours before going to bed
- Quit smoking if you do
- Stay hydrated
- Maintain a healthy body weight
Some over-the-counter medications:
- Antacids – To neutralize the excess of acid like Rolaids and Mylanta, etc.
- H2-receptor blockers – provide relief for longer duration than antacids – nizatidine and cimetidine, etc.
- Proton pump inhibitors – block the acid production while helping in esophageal healing, like omeprazole, pentaprazole, etc.
If the patient doesn’t recover within a course of few weeks, then surgery is suggested. Surgery and other procedures include:
- Fundoplication – A laproscopic procedure in which the muscles of the ring or sphincter are tightened.
- Transoral incisionless fundoplication – An advanced form of fundoplication with endoscopy requiring no excision.
- LINX Device – A ring of small magnetic beads is draped around the sphincter to keep the junction closed and guard against the reflux, but loose enough to let the food pass from oesophagus to stomach.