Gastro Esophageal Reflux Disease (GERD)
Gastroesophageal Reflux Disease (GERD) is a spectrum of digestive disorder that occurs when acidic stomach juices go back up (reflux) from the stomach into the oesophagus causing symptoms. Prevalence of GERD symptoms is around 20% of the population.
Symptoms of GERD
- Heartburn (burning chest pain or discomfort at the stomach which can go up to the throat)
- Regurgitation of food or liquid (sour or bitter taste going up your throat)
- Bloated feeling after meals
- Frequent burping and bad breath
- Persistent sore throat
- Difficulty swallowing
- Disturbed sleep
Most of the time, the cause is due to laxity of the lower esophageal stomach sphincter (known as one-way valve) or hiatus hernia which allows the stomach acid juices to back flow (reflux) from the stomach up the esophagus. Other risk factors include
- Being overweight
- Eating just before sleeping or lying down
- Fatty or spicy foods
- Certain beverages such as alcohol, coffee or carbonated drinks
Click to view MayoClinic video on GERD
The diagnosis of GERD can be made by your doctor using one or more of these tests;
- Oesophageal gastro duodenoscopy
- Barium Swallow X-ray
Treatment of Gastric Reflux
GERD management is NOT merely acid suppression and ‘total reflux management’ needs to be personalised for the each individual to include lifestyle changes, antacids/alginates and Proton Pump Inhibitors (PPI). The goal is to provide complete relief from GERD related symptoms and also prevent future recurrence.
1. Change of Lifestyle to Reduce Symptoms
- Get exercising and aim to lose weight to get to your optimum BMI
- Stop smoking
- Do not eat at least 3 hours before sleeping
- Avoid acidic or spicy foods
- Eat smaller frequent meals and avoid eating a single large meal
- Sleep with your head propped up slightly with a bed wedge pillow may help
- Wear loose nightwear and create a comfortable sleeping environment
Medical treatment involves using one or a combination of the following medication with a view of using the least frequent dosing regime (and also prevent over use) to provide adequate symptom relief;
- Antacids (such as Maalox, Alka-Seltzer) can help neutralise the stomach acidity and provide rapid relief
- Foaming agents (such as Gaviscon) coat the stomach to reduce the effects of the reflux
- H2 blockers (such as Tagamet) reduce acid production by the stomach
- Proton Pump Inhibitors (such as Controloc or Nexium) reduce acid production by the stomach
- Potassium-Competitive Acid Blocker (such as Voncinti) reduce acid production by the stomach
With medication and lifestyle changes, most patients have improvement in their symptoms especially with heartburn and regurgitation relief. Symptoms such as chronic cough or hoarseness may NOT get as much relief compared to heartburn. Those who have poor response to medication or lifestyle changes may require surgery and they include patients with;
- Advance grades of oesophagitis
- Hiatus hernia
- Barrett’s oesophagus
3. Laparoscopic Anti-Reflux Surgery
Surgery may be required if the above treatment options do NOT bring relief to your symptoms or surgery is required to fix a hiatus hernia or to strengthen the lower esophageal stomach sphincter or help you to lose weight;
See your doctor if you experience frequent heartburn symptoms
Disclaimer. TELEME blog posts contains general information about health conditions and treatments. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. The information is not advice and should not be treated as such.
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