Gastroesophageal reflux disease (GERD) occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach (oesophagus). In other words, Gastroesophageal reflux disease is a chronic, digestive disorder where stomach contents flow back into the oesophagus.
Symptoms include the taste of acid in the back of the mouth, heartburn, bad breath, chest pain and vomiting. Many people occasionally experience gastroesophageal reflux disease. In most cases, GERD can be relieved through diet and lifestyle changes; however, some people may require medication or surgery.
Acid reflux usually causes a burning sensation in the chest. The sensation radiates up from the stomach to the mid-chest or throat. This is also known as heartburn.
Causes of GERD
Occasionally acid reflux commonly occurs due to overeating, immediately lying down after eating, or eating certain foods. However, recurrent acid reflux, diagnosed as GERD, typically has other causes and risk factors and can have more serious complications.
GERD is caused by a failure of the lower esophageal sphincter (LES). The LES is a muscle at the end of the esophagus. It is also a one-way valve. When you swallow, the LES relaxes to allow food and liquid to flow into your stomach and then closes again.
However, if the sphincter relaxes abnormally or weakens, stomach acid and digestive juices can flow back up into your oesophagus. Other factors associated with reflux include conditions such as:
- Obesity due to increased abdominal pressure
- Hiatal hernia – bulging of the top of the stomach up into the diaphragm. It increases the likelihood of GERD due to poor movement of stomach contents.
- Pregnancy also occurs due to increased pressure in the abdomen
- Connective tissue disorders, such as scleroderma
- Delayed stomach emptying
- Eating large meals or eating late at night such as yam, cassava.
- Taking certain medications such as some asthma medications, antihistamines, sedatives and antidepressants.
- smoking and exposure to second-hand smoke.
Signs and symptoms of GERD
The main symptom of GERD is heartburn. It is a 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 such as:
- Chest pain
- Difficulty swallowing
- Regurgitation of food or sour liquid
- Sensation of a lump in your throat
- Bad breath
- Sore throat due to acid reflux
- Nausea and vomiting
Your doctor might be able to diagnose GERD based on a physical examination and history of your signs and symptoms. There are several possible tests to diagnose GERD such as:
Upper endoscopy. A thin, flexible tube equipped with a light and camera (endoscope) is inserted down your throat, to examine the inside of your esophagus and stomach. It may detect an inflammation and also used to take tissue samples.
X-ray of your upper digestive system. X-rays are taken after you drink a chalky liquid that coats and fills the inside lining of your digestive tract. It allows your doctor to see your esophagus, stomach and upper intestine.
Esophageal pH and impedance monitoring. This measures the amount of acid in the esophagus while the body is in different states, such as while eating or sleeping.
Esophageal manometry. This measures muscle contractions in the esophagus during swallowing. It can also measure the strength of the sphincter.
The treatments for GERD include lifestyle modifications, medications, and possibly surgery.
Proton pump inhibitors such as omeprazole are one of the common most basic treatment options for people with GERD. They decrease the amount of acid produced by the stomach. Other options include:
- Antacids can help neutralize acid in the esophagus and stomach and stop heartburn. However, overuse of some antacids can cause side effects, such as diarrhoea or sometimes kidney problems.
- H2 blockers such as ranitidine, famotidine which inhibit acid secretion in the stomach and also provide relief.
Home remedies and prevention
- Maintain a healthy weight to reduce pressure on your abdomen. Excess fat pushes up your stomach and causing acid to reflux into your oesophagus.
- Avoid lying down immediately after food. Wait at least three hours after eating before lying down or going to bed.
- Eat food slowly and chew thoroughly. Put down your fork after every bite and pick it up again once you have chewed and swallowed that bite.
- Do not use pillows to prop yourself up in bed; it only increases pressure on the stomach. Elevate the head end of the bed about 6 to 9 inches.
- Avoid certain foods and drinks that trigger acid reflux. Common triggers include: fried foods, chocolate, mint, garlic, onion and caffeine.
- Do not wear clothing that is tight around the abdomen because it puts pressure on your abdomen and the lower esophageal sphincter.