GASTROESOPHAGEAL REFLUX DISEASE

by | Dec 13, 2022 | Uncategorized | 0 comments

{GERD DEFINITION, SYMPTOMS, CAUSES, DIAGNOSIS, COMPLICATIONS, TREATMENT}

WHAT IS A GASTRO OESOPHAGEAL REFLUX DISEASE?

Gastro oesophageal reflux disease (GERD) occurs when stomach acid repeatedly flows back into the tube connecting your mouth and stomach (oesophagus). This backwash (acid reflux) can irritate the lining of your oesophagus. Many people experience acid reflux from time to time. However, when acid reflux happens repeatedly over time, it can cause GERD. The oesophagus is a tube that transports food from the mouth to the stomach. Acids in the oesophagus cause heartburn and other symptoms, as well as possible tissue damage.

Most people are able to manage the discomfort of GERD with lifestyle changes and medications. And though it’s uncommon, some may need surgery to ease symptoms.

Risk factors include obesity, pregnancy, smoking, hiatal hernia, and taking certain medications. Medications that may cause or worsen the disease include benzodiazepines, calcium channel blockers, tricyclic antidepressants, NSAIDs, and certain asthma medicines. Acid reflux is due to poor closure of the lower esophageal sphincter, which is at the junction between the stomach and the esophagus. Diagnosis among those who do not improve with simpler measures may involve gastroscopy, upper GI series, esophageal pH monitoring, or esophageal manometry.

WHAT ARE THE SYMPTOMS OF GERD?

Common signs and symptoms of GERD include:

  • A burning sensation in your chest (heartburn), usually after eating, which might be worse at night or while lying down
  • Backwash (regurgitation) of food or sour liquid
  • Upper abdominal or chest pain
  • Trouble swallowing (dysphagia)
  • Increased salivation
  • Sensation of a lump in your throat

If you have night time acid reflux, you might also experience:             

  • An ongoing cough
  • Inflammation of the vocal cords (laryngitis)
  • New or worsening asthma

WHAT ARE THE CAUSES OF GERD?                                                         

  1. SPINCTER: Our stomachs contain digestive juices that are slightly acidic enough to help us to break down the food that we eat. Because they can dissolve organic matter, our digestive juices can dissolve our own bodily tissues, but our stomachs are protected against its caustic nature. While our stomachs are protected, our esophagus is not. This is not usually a problem because a circular muscle known as the esophageal sphincter closes tight to prevent the juices from escaping. If this muscle does not close tight enough, then stomach juices are able to escape from the stomach and into the unprotected esophagus.
  2. MEDICATIONS: There are various possible reasons you have GERD, and medication is one of them if you are taking any. Some types can irritate the digestive system, while others can relax the esophageal sphincter, both of which can result in our digestive fluids passing out of the stomach and into the esophagus. Medications that can do this include muscle relaxants, and medication for treating high blood pressure. Some painkillers such as ibuprofen and aspirin can also cause the problem. If you do suspect that medication is causing the problem, and it is too uncomfortable, you should speak with your doctor.
  3. CERTAIN FOODS: Different people are able to handle different types of food in different ways to others. Some people, for example, can handle very spicy food no problem. Others will have some very uncomfortable side effects even after eating a mildly spicy food. We tend to know which ones we can handle, and we also tend to know which ones cause GERD. Spicy foods can cause GERD in quite a lot of people. Other people will have problems with onions and/or tomato, and chocolate can cause the symptom for some unfortunate people. Keeping a diary of what you eat can help you to recognize which food you should avoid.
  4. SOME CERTAIN DRINKS:  If GERD is a problem for you then you might need to avoid drinking certain drinks as well as foods. The wrong types can cause symptoms that are just as bad, or even worse. For example, caffeine can irritate the stomach lining and this can result in digestive juices passing through the esophageal sphincter. Thus, caffeinated beverages like tea and coffee should be avoided by some people. Alcoholic drinks are also a problem for some people, while different types of alcoholic beverage can cause different levels of symptoms than others. As with food, keeping a diary of which drinks you consume can help you identify which ones are problematic for you.
  5. SMOKING: If you are a smoker then there are numerous reasons why you should try and quit the habit. It can cause considerable health problems in the short term anin the long term, and potentially shorten the patient’s life considerably. One of the many symptoms that smoking can cause is GERD. When we smoke, nicotine is sent surging through our blood stream, and nicotine is a relaxant. Its relaxing properties can cause our muscles to relax, and the esophageal sphincter is no exception. With the muscle released, digestive juices are able to leak out, and this can result in heartburn.
  6. PREGNANCY: During pregnancy, a woman’s body will be undergoing a number of changes in order to help nourish and protect the developing fetus. One of the changes includes a change in hormonal levels. In some pregnant women, the changes in hormonal levels can result in the esophageal sphincter relaxing. This can result in heart burn. In addition, as the uterus expands as the fetus develops, it can begin to push up on the stomach, encouraging digestive juices to be forced through the sphincter. Medication is available that will help to relieve the symptoms, but pregnant women should always be careful about which medication they are using.
  7. HIATAL HERNIA: The hiatus is a hole in the diaphragm that allows the esophagus to pass through so it can connect to the stomach. In a small number of cases, the stomach can be forced through the hiatus, in what is known as a hiatal hernia. The condition is not usually serious and a lot of people will not even be aware that they have it. In a hiatus hernia, the top part of the stomach can be forced through the hiatus. This can result in pressure being put on the esophageal sphincter, and this can cause digestive juices to be forced through.
  8. OBESITY: People that are obese are likely to experience a number of unwelcome symptoms involving the digestive system. For a lot of obese people, one of these symptoms is GERD. It is thought that the reason for this is that excess belly fat causes pressure to be placed on the stomach. This pressure can then force the digestive juices through the esophageal sphincter, where they will cause the burning sensation. Regardless of whether or not you experience GERD, it is a good idea to try and reach a healthy weight if you are obese. Doing so can give you a considerable health boost both in the short term and in the long term.

HOW DO WE DIAGNOSE GERD IN OUR FACILITY?

The diagnosis of GERD is usually made when typical symptoms are present.Reflux can be present in people without symptoms and the diagnosis requires both symptoms or complications and reflux of stomach content. Diagnosis can also be done by a combination of clinical symptoms, response to acid suppression, as well as objective testing with upper endoscopy and esophageal pH monitoring. The most utilized diagnostic test for the evaluation of GERD and its possible complications is the upper gastrointestinal endoscopy, or esophagogastroduodenoscopy (EGD). The primary benefit of endoscopy is direct visualization of the esophageal mucosa.

WHAT ARE THE COMPLICATIONS OF GERD ?

  1. Inflammation of the tissue in the esophagus (esophagitis). Stomach acid can break down tissue in the esophagus, causing inflammation, bleeding, and sometimes an open sore (ulcer).
  2. Narrowing of the esophagus (esophageal stricture).
  3. Precancerous changes to the esophagus (Barrett esophagus).

WHAT ARE THE TREATMENT OPTIONS IN OUR FACILITY?

Treatment options include lifestyle changes, medications, and sometimes surgery for those who do not improve with the first two measures.

  1. Lifestyle changes: Include not lying down for three hours after eating, lying down on the left side, raising the pillow/bedhead height, losing weight, and stopping smoking.
  2. Avoid some certain foods that may precipitate GERD symptoms e.g coffee, alcohol, chocolate, fatty foods, acidic foods, and spicy foods.
  3. Medications: Includes; Antacids that neutralize stomach acid, Antacids containing calcium carbonate, such as Mylanta, Rolaids and Tums, may provide quick relief, Medications to reduce acid production, Medications that block acid production and heal the esophagus.
  4. Surgery:  The procedure is called Nissen fundoplication. In this procedure, the surgeon wraps the top of the stomach around the lower esophagus. This reinforces the lower esophageal sphincter, making it less likely that acid will back up in the esophagus.

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