Understanding Gastroesophageal Reflux Disease (GERD)

Overview The stomach is referred to as “Gastro-.” The oesophagus, or feeding tube, that connects the mouth to the stomach is referred to as “oesophageal.” Backflow is referred to as “reflux.” Backflow of stomach contents into the oesophagus is referred to as gastroesophageal reflux.

Patients with GERD experience heartburn and acid indigestion, which can sometimes be confused with chest pain from cardiac causes. When food enters the stomach, the lower oesophageal sphincter does not close properly, causing stomach contents to backflow up the oesophagus.

Physiology The oesophagus is where food that is normally swallowed enters the stomach. The lower oesophageal sphincter, or ring of muscle, closes when food enters the stomach. This keeps food from backflowing into the oesophagus while the stomach digests and churns it.

GERD occurs when stomach contents reflux when the lower oesophageal sphincter fails to close properly. Due to the acidic nature of stomach contents, this causes a burning sensation in the chest.

Therefore, the level of dysfunction in the lower oesophageal sphincter, the contents of the stomach, and the pressure that the stomach puts on the back determine the severity of GERD.

Causes

From first standards, anything that builds the back pressure applied by the stomach might possibly cause GERD. These are some:

Lifestyle and diet: GERD during pregnancy has been linked to binge eating, excessive alcohol consumption, smoking, obesity, and certain foods and beverages like coffee.
Abnormalities in the structure, like a hiatus hernia, which causes the stomach to protrude above the diaphragm.
Symptoms Patients frequently describe a burning sensation behind the breast bone that moves up toward the throat and neck as “indigestion” or “heartburn.” The sensation of heartburn can last for as long as two hours and is made worse by lying flat, which is frequently associated with an acidic or bitter taste.

Due to cardiac reasons, heartburn and chest pain are frequently confused. It is essential to distinguish between the two due to the fact that heartburn can be treated, whereas cardiac causes of chest pain carry a significant risk of mortality.

Always consult your doctor when in doubt.

Changes to one’s diet and lifestyle are the mainstay of GERD treatment.

It is suggested that acidic foods like citrus fruits and juices, tomatoes, chocolate, foods that weaken the lower oesophageal sphincter, fatty foods, alcohol, and any foods that are known to irritate particular patients be avoided.

Additionally, portion control and portion reduction will assist in managing GERD symptoms. Reflux will be less prevalent if meals are consumed at least two hours before going to bed. GERD can be alleviated by losing weight and overcoming obesity.

GERD can be alleviated by quitting smoking and cutting back on alcohol consumption.

GERD can be alleviated by altering one’s sleeping posture, such as by sleeping on an incline.

In addition to making changes to one’s diet and lifestyle, taking medications like antacids can help alleviate some of the symptoms brought on by stomach acids. Long-term use of antacids, on the other hand, puts patients with kidney disease at risk for abnormalities in blood calcium and magnesium levels.

Prescription medications like histamine antagonists (such as the widely available Famotidine in Singapore) and proton pump inhibitors (such as Omeprazole).

In some cases, oesophageal manometry, a measurement of pressure along the oesophagus, can help identify if there are abnormalities in the peristaltic movement of the oesophagus, resulting in GERD. Patients with persistent GERD may require more invasive investigations, such as having an endoscopy of the stomach to rule out other issues like peptic ulcers.

For instance, if a patient has severe GERD as a result of a hiatus hernia, surgery may be required to rectify the situation. However, due to the fact that GERD is not life-threatening, your doctor will typically only recommend surgery as a last resort.

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