Gastro Esophageal reflux disease (GERD) is a constant digestive disorder in which abdomen contents (food or liquid) leak back into the esophagus (the tube leading from the mouth to the abdomen). Most of people suffer from this situation, making it is the most familiar diagnosis of all presenting gastrointestinal complaints. Gastro esophageal Reflux Disease, known as GERD, is more than ordinary heartburn. It occurs when a person suffers frequently from stomach acid entering the esophagus.
It is a chronic and long term disease. Most of the GERD theories focus on malfunctioning of valve-like tissue joining esophagus and stomach. Impairment in the functioning of the valve can no longer protect the reflux of stomach acid into esophagus causing inflammation. Other contributing factors include Hiatal Hernia, lower esophageal sphincter abnormalities, and smoking and Blocker medicines. If untreated, it can cause stomach ulcers which may progress into strictures. In a disease called Barrett’s esophagus, there is growth of cancerous cells in the esophagus. Lungs, throat and Larynx may also get affected.
GERD is commonly a nocturnal disease. When the person is sitting upright, gravity works against the reflux. Similarly, constant swallowing of saliva which contains bicarbonates neutralizes the acid in esophagus. It prevents the restlessness. However, when the person is lying supine and asleep, these bodily security mechanisms no longer work and the person feels burning sensation in the stomach and chest.
Symptoms:-
The symptoms of Gastro esophageal reflux disease are as follows :
* Heartburn (Chest pain)
* Regurgitation
* Nausea
* Uneasiness
Tests: –
* Endoscopy
* Biopsy of esophageal patch,
* Esophagram-X-ray of esophagus (not much in use)
* Throat and larynx Checkup
* Inserting pH testing-catheter/capsule
* Esophageal motility testing to check working capacity of esophageal muscles
* Gastric emptying studies-to study how well stomach is emptying with the help of some radioactive substance
Treatment of GERD:-
Gerd can be easily managed by trial of medical therapy including use of OTC medicines such as pepcid, Zantac , prilosec or prevacid and life-style modifications.
* Lifestyle changes
* Avoiding alcohol, chocolate, caffeine
* Raised bed to keep upper body level higher
* Smaller meals to facilitate emptying of stomach
* Proton pump inhibitor (PPI) (e.g. Omeprazole) to block secretion of acid into stomach by acid-screening cells.
* Minerals based antacids
* Histamine antagonists to prevent Histamine from stimulating acid secretion e.g. Famotidine Ranitidine
* Pro-motility drugs to stimulate muscles of gastro-intestinal tract e.g. Metoclopramide
* Endoscopic treatments
* Foam Barriers
* Surgery(Fundoplication)
Physicians, after taking into consideration all the factors, decide the course of action. With proper treatment GERD can be managed easily.