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GERD occurs when the stomach contents leak back, or reflux, into the esophagus. When refluxed stomach acid touches the lining of the esophagus, it causes a burning sensation in the chest or throat called heartburn. There may also be sour or bitterness taste in the back of the mouth. Persistent acid reflux can cause inflammation and bleeding in the esophagus (ulcers). If the inflammation becomes very severe, it may cause narrowing of the esophagus or changes in the cells in the esophageal lining, which may eventually lead to cancer (esophageal cancer).
Causes:
| 1. |
Abnormal function of the lower esophageal sphincter (LES) - LES is a ring of muscle at the bottom of the esophagus that acts like a valve between the esophagus and stomach to prevent refluxes. When LES is relaxed or is weak, it can allow stomach contents to reflux. There are several factors that increase the chances of getting GERD, such as drinking alcohol, smoking, and taking certain asthma medication. |
| 2. |
Abnormal contraction of the esophagus - causes food to travel more slowly into the stomach or the stomach content that refluxed back up remained in the esophagus longer than normal. |
| 3. |
The abnormal contraction of the stomach - causes the food to remain in the stomach longer than normal, and thus, increases the chance of it leaking back into the esophagus. In addition, fatty food and chocolate cause a reduction in stomach contraction and increase frequency of the relaxing of LES. 4. Genetics - GERD is found more frequently in fair skin people from the West more than dark skin people from the East and Asian. |
Symptoms:
| 1. |
An important symptom is a burning sensation from the pit of the stomach to the chest and throat. It's usually most severe after consuming a large meal, leaning forward, lifting heavy objects, and/or sleeping on the back. |
| 2. |
Another important symptom is to taste the sour or bitter stomach acid in the back of the mouth, especially after a burp. |
| 3. |
Other symptoms that can occur includes: bloating, fullness in the stomach, nauseous, vomiting after eating, chest pain, stomach cramps, suffocating feeling like something is stuck in the throat and have to cough it out frequently, asthma, dry cough, hoarseness, and throat pain. These symptoms are usually a result of an inflammation of the trachea (windpipe) due to the reflux of the stomach acid. |
Recommendations:
| 1. |
Control your weight or lose weight (if necessary). |
| 2. |
Do not drink alcohol, tea, coffee, soda/soft drinks, and fruit juices. Do not eat spicy food, fried and fatty food, and chocolate. |
| 3. |
Do not smoke cigarette. |
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Eat small meals, but eat frequently. |
| 5. |
Eat moderately for dinner (last meal of the day) and should not lie down for at least 3 hours after a meal. |
| 6. |
Do not wear tight fitting clothes or wear belt too tight. |
| 7. |
Raise the head of your bed at least 6 inches. |
| 8. |
Exercise regularly and try to avoid stress. |
| 9. |
If the heartburn does not improve after changing your lifestyle, then you should try taking liquid antacid to neutralize the acid and coat the esophagus and stomach and medications, while under physician's care, which slow or stop acid production (acid blocker or H2 blockers). |
Diagnosis:
| 1. |
Endoscopic exam of the esophagus and stomach |
| 2. |
Examination of the contraction of the esophagus and measure the pH |
GERD is very common in infants through adolescent, though it can occur at any age. In infants, the symptoms usually includes frequent vomiting after a feeding (e.g. breast milk, formula), anemic, lower than average weight gain and growth, chronic cough, asthma attach at night, and/or chronic lung infection. Children with GERD may also experience extended periods without breathing known as apnea. Children with GERD should get prompt and early treatment to prevent long term damage which can be life-threatening.
Treatment:
| 1. |
Treatment using medicine is very effective if it is taken for an extended period of time (longer than typical duration taken to treat ulcers). However, most adult patients tend to have a recurrence after they stop taking the medicine. |
| 2. |
Surgical treatment is often recommended for patients who has GERD for a long period of time and has been unable to control the symptoms, stop taking medication, or take medication for extended period due to side-effects of the medicine. It is also suitable if the patient is very young and has to take medicine for an extended period of time as well as for those who has other complications associated with the disease. | |
