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GERD

Gastroesophageal reflux disease, or GERD, is a digestive disorder that affects the lower esophageal sphincter (LES), the ring of muscle between the esophagus and stomach. Gastroesophageal reflux disease is a condition where stomach acid persistently and regularly flows up into the esophagus. The esophagus may also be referred to as the food pipe or gullet and is the tube that transports food from the mouth to the stomach. The acid in the esophagus causes heartburn and other symptoms, as well as possible tissue damage.

GERD occurs more commonly in people who are:

  • Overweight or obese because of increased pressure on the abdomen
  • Pregnant, due to the same increased pressure
  • Taking certain medications, including some asthma medications, calcium channel blockers, antihistamines, sedatives, and antidepressants
  • Smoking, and being exposed to second-hand smoke

Hiatal hernia is a condition where an opening in the diaphragm lets the top of the stomach move up into the chest. This lowers the pressure in the esophageal sphincter and raises the risk of GERD.

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Symptoms

The main symptom of GERD is heartburn.

Heartburn is discomfort felt behind the breastbone as a burning sensation. It tends to get worse if the person lies down or bends over, and also after eating food.

However, not all people with GERD experience heartburn, and there are other possible symptoms:

  • Nausea or vomiting
  • Bad breath
  • Respiratory problems
  • Difficulty or pain when swallowing
  • Decay

Complications

GERD can worsen and turn into other conditions if left untreated.

These include:

  • Esophagitis: This is an inflammation of the esophagus.
  • Esophageal stricture: In this condition, the esophagus becomes narrow, making it difficult to swallow.
  • Barrett's esophagus: The cells lining the esophagus can change into cells similar to the lining of the intestine. This can develop into cancer.
  • Respiratory problems: It is possible to breathe stomach acid into the lungs, which can cause a range of problems including chest congestion, hoarseness, asthma, laryngitis, and pneumonia.

Treatment

GERD will often be treated with medications before attempting other lines of treatment.

Proton pump inhibitors are one of the main pharmaceutical treatment options for people with GERD. They decrease the amount of acid produced by the stomach.

Other options include:

  • H2 blockers: These are another option to help decrease acid production.
  • Antacids: These counteract the acid in the stomach with alkaline chemicals. Side effects can include diarrhea and constipation. Antacids are available to purchase online.
  • Prokinetics: These help the stomach empty faster. Side effects include diarrhea, nausea, and anxiety.
  • Erythromycin: Ths is a type of antibiotic that also helps empty the stomach.

Surgical options

If lifestyle changes do not significantly improve the symptoms of GERD, or medications do not have the desired effect, a gastroenterologist may recommend surgery. Surgical treatments include:

  • Fundoplication: The surgeon sews the top of the stomach around the esophagus. This adds pressure to the lower end of the esophagus and is generally successful at reducing reflux.
  • Endoscopic procedures: This is a range of procedures include endoscopic sewing, which uses stitches to tighten the sphincter muscle, and radiofrequency, which uses heat to produce small burns that help tighten the sphincter muscle.

Prevention

Other lifestyle and behavior changes can help relieve GERD include:

  • Eat moderate amounts of food and avoid overeating.
  • Stop eating 2 to 3 hours before sleeping.
  • Quit or avoid smoking.
  • If a person is overweight, losing weight can help prevent symptoms.
  • Do not wear clothing that is tight around the abdomen.
  • Sleep at a slight angle with the head slightly elevated.

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Sir Ganga Ram Hospital
Old Rajinder Nagar, New Delhi
Delhi Laparoscopic Surgery Clinic
Sector 77, Noida, UP
Ahuja Clinic
Pahari Bazar, Roorkee, Uttarakhand
 
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About Anmol Ahuja

DNB (Gen Surgery), FNB (Minimal Invasive Surgery), FMAS, Fellowship in ColoRectal Surgery (Taiwan)

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Copyright by Dr. Anmol Ahuja. All rights reserved.