Gastroesophageal Reflux Disease (GERD)

CAUSES:

• Weak Lower Esophageal Sphincter (LES): The LES is a ring of muscle at the end of the esophagus that acts as a valve between the esophagus and stomach. If this valve weakens or relaxes abnormally, it can allow stomach acid to flow back into the esophagus.

• Hiatal Hernia: A condition where part of the stomach pushes through the diaphragm into the chest cavity, contributing to acid reflux.

• Lifestyle Factors: Obesity, smoking, and a diet high in fatty or spicy foods, caffeine, and alcohol can increase the risk of GERD.

• Pregnancy: Hormonal changes and increased abdominal pressure during pregnancy can contribute to GERD.

• Medications: Certain medications, such as antihistamines, calcium channel blockers, and painkillers, can relax the LES or irritate the esophagus, worsening GERD symptoms.

SYMPTOMS:

• Heartburn: A burning sensation in the chest, usually after eating, which might worsen at night.

• Regurgitation: A sour or bitter-tasting acid backing up into your throat or mouth.

• Chest Pain: Often mistaken for a heart attack, this pain occurs behind the breastbone.

• Difficulty Swallowing (Dysphagia): A sensation of food being stuck in the throat.

• Chronic Cough: Especially at night or upon waking.

• Sore Throat or Hoarseness: Caused by acid irritating the vocal cords.

• Nausea and Vomiting: Occasional symptoms related to reflux.

• Bloating and Burping: Excess gas and discomfort after meals.

DIAGNOSIS:

• Upper Endoscopy: To examine the esophagus and stomach for damage from acid reflux and to rule out other conditions.
• pH Monitoring: Measures acid levels in the esophagus to confirm acid reflux.
• Barium Swallow: A special X-ray test that shows the shape and condition of the esophagus and stomach.
• Esophageal Manometry: Tests the strength and muscle coordination of the esophagus.

TREATMENT:

Medications:

• Antacids: To neutralize stomach acid.
• H2 Blockers: To reduce acid production.
• Proton Pump Inhibitors (PPIs): To block acid production and heal the esophagus.
• Prokinetics: To help the stomach empty more quickly and reduce acid reflux.

Lifestyle Changes:

• Diet: Avoid trigger foods like fatty, spicy, and acidic foods. Eat smaller, more frequent meals.
• Weight Management: Losing excess weight can reduce pressure on the stomach and LES.
• Quit Smoking: Smoking weakens the LES and increases acid production.
• Elevate the Head of the Bed: Helps prevent nighttime reflux.
• Avoid Lying Down After Meals: Stay upright for at least 2-3 hours after eating.

Surgery:

• Fundoplication: A surgical procedure to strengthen the LES by wrapping the top of the stomach around the lower esophagus.
• LINX Device: A ring of magnetic beads placed around the LES to prevent acid reflux while allowing food to pass through.