What is GERD?
Gastro-oesophagal reflux disease, popularly called acidity or heartburn, affects 20 out of 100 people globally. It is the most common gastrointestinal issue, requiring treatment not just to resolve symptoms but also to treat the cause.
What causes acid reflux?
The food we swallow goes into the food pipe or oesophagus and reaches the stomach, crossing a muscular valve called the lower oesophageal sphincter at the base of the oesophagus. The sphincter closes after the food reaches the stomach to prevent the backflow of stomach contents into the oesophagus.
Reflux involves backflow or regurgitation of stomach contents into the oesophagus due to improper functioning of the sphincter. Regurgitation happens when the sphincter either opens frequently, relaxes improperly or constantly remains open.
Weakness in the diaphragm, a sheet of muscles that separates the chest from the abdomen, can also affect the oesophageal sphincter’s functioning. The food pipe joins the stomach through the diaphragm. A gap in the diaphragm near the oesophageal-stomach opening can make some of the stomach bulges into the chest cavity in a condition called a hiatus hernia. It causes the oesophageal sphincter to remain wide open, causing reflux.
What causes the symptoms of heartburn?
The inner lining of the oesophagus is different from that of the stomach, which is gastric acid-resistant. When the same gastric acid refluxes into the oesophagus, the inner lining, which is extra sensitive to the acid, produces a burning sensation in the chest.
What is chronic acidity or GERD?
Although some amount of reflux happens in everybody, more frequent episodes (2-3 times a week) accompanied by symptoms can be considered chronic acidity. An expert gastroenterologist explains GERD, its symptoms, diagnostic tests, complications, foods to avoid, and tips to manage acidity.
What are the symptoms of GERD?
The two hallmark symptoms of GERD are:
- Heartburn is a burning sensation behind the chest bone, which typically worsens after meals while lying down or bending forward.
- Regurgitation is a backsplash of gastric juices with a sour taste from the stomach into the mouth.
Other symptoms include:
- Cough, especially at the night
- Chest pain mimicking the pain coming from the heart with a burning sensation. Oesophagus quickly clears the backflow of stomach contents through squeezing movements leading to spasms and chest discomfort.
- Vomiting
- Swallowing problems because of scarring in the oesophagus due to damage caused by acid reflux.
- Changes in the voice
- Bad breath
- Constant feeling of a lump in the throat or neck
- Asthma flareups
Uncommon symptoms of GERD:
- Pharyngitis
- Laryngitis
- Dental erosions
How can GERD be diagnosed?
Symptoms experienced by a patient are considered for diagnosing GERD. However, some patients who experience symptoms frequently that don’t respond to medicines and lifestyle changes may require tests.
- Endoscopy: It involves an examination of the food pipe, stomach and duodenum, the first part of the small intestine. A small, flexible tube fitted with a camera at one end is sent through the mouth to visualize any structural changes in these parts and damage caused by acid. A numbing agent is sprayed into the back of the throat to numb pain and prevent choking. It takes 5 to 15 minutes.
- 24-hour pH testing: Some people may have normal endoscopic findings and still experience severe reflux symptoms. Such people may need this test. It accurately measures the amount of reflux and the number of reflux episodes in a 24-hour period. It involves inserting a tiny plastic tube or catheter through the nose to the bottom of the oesophagus. The other end of the tube is connected to a monitor tied around the waist. The patient will be sent home and allowed to carry on with everyday activities. The pipe constantly records the episodes of acid reflux, and it will be removed after 24 hours to analyse the results.
- Manometry: It assesses the functioning of muscles in the food pipe in clearing the acids refluxed from the stomach.
What are the foods that worsen GERD?
- Fried foods: Foods rich in fats remain in the stomach for longer periods, which affects the valve opening, causing reflux.
- Coffee and tea: Too many cups of coffee and tea can affect valve opening, as caffeine can relax or keep the valve open frequently.
- Alcohol: It affects valve functioning, food pipe lining and the amount of gastric acid secretion.
- Chocolate: Methyl xanthin in chocolate has effects similar to caffeine, which affects valve functioning.
- Carbonated drinks: Fizzy drinks and colas release carbon dioxide in the stomach to make it distended and put pressure on the valve to open
- Citrus fruits: Lemons, oranges, tamarind, tomatoes, and grapefruits, which are acidic in nature, can contribute to or worsen acidity.
- Mint, onions, and garlic: They can affect the valve's functioning.
- Spicy foods: Consuming foods loaded with spices can contribute to acidity.
How to fix GERD at home without medicines?
- Avoid trigger foods: Identify the foods or drinks that trigger the reflux symptoms and remove them from your diet.
- Avoid large meals: Stop eating large meals at a time. Instead, eat small meals frequently.
- Stop eating before bed: Avoid eating snacks or meals 3 hours before bed.
- Elevate your head on the bed: Sleep in an inclined position or use an extra pillow while lying down.
- Lose weight: Follow a healthy diet and active lifestyle to lose weight, especially if you have weight accumulated in the centre.
- Avoid tight clothes: Tight clothing and body shapers can put extra pressure on the abdomen, triggering reflux.
- Quit smoking: Smoking can contribute to reflux symptoms
- Avoid alcohol intake: Do not drink alcohol or try to keep it minimal.
What are the health complications caused by GERD?
GERD is not a serious health problem, but it might cause severe complications if left untreated, leading to the following complications:
- Oesophagitis: Acid reflux can change the lining of the food pipe, causing inflammation with irritation, ulcers, difficulty swallowing, chest pain, and rarely bleeding in the oesophagus.
- Barrett's oesophagus: Severe oesophagitis causes Barrett's oesophagus, characterized by changes in the oesophageal lining
- Cancer: Changes in the lining of the food pipe is a risk factor for oesophageal cancer, especially in people with other health conditions
- Stenosis: Scarring of the oesophagus after healing of oesophagitis can cause narrowing of the food pipe. It leads to swallowing issues and requires treatment.
Who needs to seek medical help?
Not everybody with GERD needs medical help. It can be managed with lifestyle and diet modifications. However, people experiencing the following symptoms should seek a doctor’s help.
- Persistent symptoms: Reflux symptoms experienced continuously for weeks and months
- Symptoms affecting sleep: Reflux symptoms that wake you up from the sleep
- Vomiting: Vomiting stomach contents
- Symptoms not resolving with medicines: Symptoms that are not relieved with lifestyle changes and medicines
- Difficulty in swallowing: Swallowing issues that worsen gradually
- Weight loss: Unexplained weight loss and changes in general health
- Chest pain: Pain that mimics pain coming from the heart
Takeaway points:
- GERD is the most common digestive system problem affecting people globally.
- Most patients can effectively manage their symptoms at home with lifestyle changes and simple medications.
- Persistent reflux symptoms should be treated with doctors' help to avoid other complications.
If you are suffering from a burning sensation in the chest and acid reflux, consult a gastroenterologist to know why it is happening and how to stop it before it causes serious complications. If you are looking for the best gastro doctor or the best gastro centre in Bangalore, visit Bangalore Gastro Centre Hospitals in HSR Layout. It is a state-of-the-art facility with world-class testing equipment to perform oesophageal manometry tests, 24-hour pH tests, and endoscopic ultrasound tests.
