Heartburn and gastroesophageal reflux disease (GERD) occur when stomach acid flows back into the esophagus, causing irritation. While occasional acid reflux is common, GERD is characterized by frequent or moderate to severe acid reflux. Most people can manage GERD symptoms with lifestyle changes and over-the-counter medications, but some may require stronger medications or surgery.
Symptoms:
Common symptoms of GERD include chest burning (heartburn), chest pain, difficulty swallowing, regurgitation of food or sour liquid, and a sensation of a lump in the throat. Nighttime acid reflux may also cause chronic cough, laryngitis, asthma, or disrupted sleep. Seek immediate medical care if you experience chest pain, shortness of breath, or other signs of a heart attack. Make an appointment with your doctor if you have severe or frequent GERD symptoms or take over-the-counter medications for heartburn more than twice a week.
Causes and Risk Factors:
GERD is caused by frequent acid reflux due to the abnormal relaxation or weakening of the lower esophageal sphincter, a circular band of muscle that allows food and liquid to flow into the stomach. Risk factors for GERD include obesity, hiatal hernia, pregnancy, connective tissue disorders, and delayed stomach emptying. Aggravating factors include smoking, eating large meals or late at night, consuming trigger foods (e.g., fatty or fried foods), drinking alcohol or coffee, and taking certain medications.
Complications:
Chronic inflammation from GERD can lead to complications such as narrowing of the esophagus (esophageal stricture), esophageal ulcers, and precancerous changes (Barrett’s esophagus) associated with an increased risk of esophageal cancer.
Diagnosis:
A doctor may diagnose GERD based on physical examination and symptoms, but further tests may be recommended. These tests include upper endoscopy to examine the esophagus and stomach, ambulatory acid probe test to measure acid regurgitation, esophageal manometry to assess muscle contractions, and X-ray of the upper digestive system to identify issues like narrowing of the esophagus.
Treatment:
Treatment for GERD usually begins with lifestyle modifications and over-the-counter medications. Lifestyle changes include maintaining a healthy weight, quitting smoking, elevating the head of the bed, avoiding lying down after meals, eating slowly and chewing thoroughly, and avoiding trigger foods and tight-fitting clothing. Over-the-counter medications like antacids and H-2-receptor blockers may provide relief. Prescription medications, including proton pump inhibitors, may be prescribed for stronger acid-blocking and esophageal healing. In severe cases or for those who wish to avoid long-term medication use, surgery such as fundoplication or LINX device implantation may be recommended.
Alternative Medicine:
While no alternative therapies have been proven to treat GERD or reverse esophageal damage, some complementary techniques like herbal remedies (e.g., licorice, chamomile) and relaxation therapies (e.g., progressive muscle relaxation) may provide relief when combined with medical care. Consult with a doctor before trying any alternative GERD treatments.
LPR:
Laryngopharyngeal reflux (LPR) is a condition where stomach acid refluxes into the throat or voice box. Symptoms may overlap with GERD but can also present differently. Infants and children may have distinct signs such as breathing problems, feeding difficulty, choking, or trouble gaining weight. LPR can be evaluated and treated by an ENT specialist (otolaryngologist) through various tests and interventions similar to GERD.
Note: It’s important to consult a healthcare professional for an accurate diagnosis and personalized treatment plan