GERD or acid reflux โ€“ OUCH! it makes my heart burn!


Gastroesophageal reflux disease (GERD) also known as acid reflux occurs when the contents of the stomach (including gastric acid!) comes back up into the esophagus (and sometimes up to the mouth). This can happen in people of any age who are even healthy, but is more common in individuals who are obese, pregnant, smoke, drink alcohol or excessive amounts of caffeine.ย 

Typically, people with GERD complain of heartburn, feeling of discomfort rising in the chest and sometimes even difficulty swallowing. Some might even have hoarseness of voice, sense of lump in the throat and even persistent cough which doesnโ€™t get better. While for some people itโ€™s just limited to symptoms, some can get considerable damage to their esophagus due to the reflux of this acid

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Why does it happen?

There is a circular muscle at the junction of the esophagus and stomach that usually contracts and relaxes in a coordinated way to allow passage of food into the stomach. However, when this muscle starts relaxing inappropriately, stomach contents have unaided access to start flowing back (remember the time when they said donโ€™t lie down right after you eat! They probably had GERD!)

When should you worry?

While not all GERD is problematic and can be managed with some antacids, it is always a good practice to discuss with your doctor. Particularly, if you notice pain with swallowing, loss of appetite or pain, bleeding (vomiting up or passing in stools) especially if you are over the age of 60.ย 

How will I get diagnosed?

While typically the history of symptoms as mentioned is good enough to diagnose someone with GERD. Doctors might order additional test like endoscopy (drive a camera through your mouth into the esophagus and stomach), 24-hr pH monitoring (measure how much acid is being refluxed in a day) or manometry (to measure pressure changes in the esophagus) if your GERD is not being controlled easily or if you have risk factors (see โ€œWhen should you worry?โ€)

Million-dollar treatment?

The real answer is.. not really. Most of the time, itโ€™s a simple lifestyle modification โ€“ quit smoking, reduce spicy (yesโ€ฆ less teeka is better!), fatty foods, lose weight etc. Other things like not sleeping right after meals, using a pillow/wedge to keep the head end elevated when lying down are some tricks that might help. Most patients get some relief with antacids (like Digene,, Gelusil etc). Medications like H2 blockers (e.g. famotidine) or proton pump inhibitor (e.g. omeprazole, esomeprazole, lansoprazole, pantoprazole etc) are also commonly used. A short course of these medications also usually help. Talk to your doctor since stopping these medications abruptly can also worsen your GERD. In some patients who have severe esophageal damage or are extremely obese, surgery might be the only option to help heal and prevent further acid related damage.

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Disclaimer

Views expressed above are the author’s own.



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