What is gastric reflux disease?
Gastro Esophageal Reflux Disease (GERD), also known as gastric reflux disease, acid reflux disease and “heartburn”, is a painful condition in which the esophagus becomes irritated or inflamed over time from acid or food backing up from the stomach. GERD affects roughly 1/3 of the population and its sufferers include infants and children, as well as adults. Approximately 10% of those with this condition experience bouts of GERD on a weekly – sometimes daily –basis.
What are the symptoms of GERD?
Symptoms may include a burning pain in the stomach and/or throat that may develop even without food consumption. A hoarse voice, a dry cough, wheezing, nausea and a bitter taste that stays in the mouth are also symptoms of GERD.
Some causes of GERD
Although some causes of GERD are complex and even unknown, a few common culprits include hiatal hernia; an esophageal sphincter that becomes separated from the stomach; an abnormality in the stomach’s emptying process; development of esophageal constrictions, and bodily changes due to the normal aging process. Although a small number of GERD sufferers have been found to produce abnormally large amounts of acid, this is no longer considered a main contributing factor to the condition, as previously thought in the past.
Factors that exacerbate GERD
Certain lifestyle habits can exacerbate GERD symptoms and include smoking, drinking alcohol, eating foods that are known to agitate the condition, and being overweight. Eating two or less hours before lying down, and not getting enough exercise are contributors to GERD as well.
How GERD is diagnosed
When a sufferer presents with “GERD-like” symptoms, there are a few things the physician may do to try to diagnose GERD. He may put the patient on the normal “therapeutic trial” for GERD, or order tests for esophageal motility, a study on stomach emptying, take x-rays of the abdomen and esophageal area, or perform acid perfusion tests.
Usually the physician tries the “therapeutic trial” first. This therapy includes encouraging a healthier diet in general and avoiding certain GERD exacerbating items such as chocolate, alcohol, peppermint and caffeine – along with suggestions on sleeping positions and adequate exercise.
Although a few sufferers have actually found immediate relief from their symptoms by change of diet and lifestyle alone, most require the addition of medications commonly used to treat GERD. These include the normal over-the-counter antacids, with the addition of one or more prescription medications like Prilosec, Zantac, and Reglan. If this therapy is successful in relieving the GERD symptoms, the sufferer continues with it as his treatment.
Other treatments to relieve GERD symptoms
When therapeutic trial is deemed unsuccessful, there are other options available that may help.
Fundoplication – a surgical procedure done with minimal two or three incisions via laparoscopy, in which the hiatal hernial sac is pulled through and stitched below the diaphragm. The opening through which the esophagus passes is tightened up, and finally the upper part of the stomach is wrapped around the lower part of the esophagus to make an artificial lower esophageal sphincter.
Endoscopy – An outpatient procedure in which surgeons work on the patient via a camera/tube instrument, which is inserted down the esophagus. Depending on the recommendations of the physician, the purpose of the endoscopy will be to relieve GERD symptoms by either tightening the sphincter with sutures; applying radio waves to the lower part of the esophagus, or increasing the function of the esophageal wall by the injection of certain materials into it.
Summary
Although GERD can be very painful, it is not life threatening in itself. However, it is important to note that other, more serious conditions can occur over time if GERD is allowed to go untreated – including a pre-cancerous condition known as Barrett’s Esophagus; erosion of the stomach lining by acids, and sometimes even esophageal cancer.