GERD (Chronic Acid Reflux)

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 When you have GERD (chronic acid reflux) your stomach acid persistently flows back up into your mouth through your esophagus. You may experience heartburn, acid indigestion, trouble swallowing, feeling of food caught in your throat and other problems.

GERD (gastroesophageal reflux disease, or chronic acid reflux) is a condition in which acid-containing contents in your stomach persistently leak back up into your esophagus, the tube from your throat to your stomach.

Acid reflux happens because a valve at the end of your esophagus, the lower esophageal sphincter, doesn’t close properly when food arrives at your stomach. Acid backwash then flows back up through your esophagus into your throat and mouth, giving you a sour taste.

Acid reflux happens to nearly everyone at some point in life. Having acid reflux and heartburn now and then is totally normal. But, if you have acid reflux/heartburn more than twice a week over a period of several weeks, constantly take heartburn medications and antacids yet your symptoms keep returning, you may have developed GERD. Your GERD should be treated by your healthcare provider. Not just to relieve your symptoms, but because GERD can lead to more serious problems.

What are the main symptoms of GERD (chronic acid reflux)?

The main symptoms are persistent heartburn and acid regurgitation. Some people have GERD without heartburn. Instead, they experience pain in the chest, hoarseness in the morning or trouble swallowing. You may feel like you have food stuck in your throat, or like you are choking or your throat is tight. GERD can also cause a dry cough and bad breath.

What is heartburn?

Heartburn is a symptom of acid reflux. It’s a painful burning sensation in the middle of your chest caused by irritation to the lining of the esophagus caused by stomach acid.

This burning can come on anytime but is often worse after eating. For many people heartburn worsens when they recline or lie in bed, which makes it hard to get a good night’s sleep.

Fortunately, heartburn can usually be managed with over-the-counter (OTC) heartburn/acid indigestion drugs. Your healthcare provider can also prescribe stronger medicines to help tame your heartburn.

How common is GERD (chronic acid reflux)?

GERD is very common. The condition and its symptoms touch a huge number of people: 20% of the U.S. population.

Anyone of any age can develop GERD, but some may be more at risk for it. For example, the chances you’ll have some form of GERD (mild or severe) increase after age 40.

You’re also more likely to have it if you’re:

  • Have overweight/obesity.
  • Pregnant.
  • Smoking or are regularly exposed to second-hand smoke.
  • Taking certain medications that may cause acid reflux.


SYMPTOMS

Acid reflux is caused by weakness or relaxation of the lower esophageal sphincter (valve). Normally this valve closes tightly after food enters your stomach. If it relaxes when it shouldn’t, your stomach contents rise back up into the esophagus.

Factors that can lead to this include:

  • Too much pressure on the abdomen. Some pregnant women experience heartburn almost daily because of this increased pressure.
  • Particular types of food (for example, dairy, spicy or fried foods) and eating habits.
  • Medications that include medicines for asthma, high blood pressure and allergies; as well as painkillers, sedatives and anti-depressants.
  • A hiatal hernia. The upper part of the stomach bulges into the diaphragm, getting in the way of normal intake of food.

Different people are affected in different ways by GERD. The most common symptoms are:

  • Heartburn.
  • Regurgitation (food comes back into your mouth from the esophagus).
  • The feeling of food caught in your throat.
  • Coughing.
  • Chest pain.
  • Problem swallowing.
  • Vomiting.
  • Sore throat and hoarseness.

Infants and children can experience similar symptoms of GERD, as well as:

  • Frequent small vomiting episodes.
  • Excessive crying, not wanting to eat (in babies and infants).
  • Other respiratory (breathing) difficulties.
  • Frequent sour taste of acid, especially when lying down.
  • Hoarse throat.
  • Feeling of choking that may wake the child up.
  • Bad breath.
  • Difficulty sleeping after eating, especially in infants.

Chest pain caused by heartburn may make you afraid you’re having a heart attack. Heartburn has nothing to do with your heart, but since the discomfort is in your chest it may be hard to know the difference while it’s going on. But symptoms of a heart attack are different than heartburn.

Heartburn is that uncomfortable burning feeling or pain in your chest that can move up to your neck and throat. A heart attack can cause pain in the arms, neck and jaw, shortness of breath, sweating, nausea, dizziness, extreme fatigue and anxiety, among other symptoms.

If your heartburn medication doesn’t help and your chest pain is accompanied by these symptoms, call for medical attention right away.

GERD isn’t life-threatening or dangerous in itself. But long-term GERD can lead to more serious health problems:

  • Esophagitis: Esophagitis is the irritation and inflammation the stomach acid causes in the lining of the esophagus. Esophagitis can cause ulcers in your esophagus, heartburn, chest pain, bleeding and trouble swallowing.
  • Barrett's esophagus: Barrett's esophagus is a condition that develops in some people (about 10%) who have long-term GERD. The damage acid reflux can cause over years can change the cells in the lining of the esophagus. Barrett’s esophagus is a risk factor for cancer of the esophagus.
  • Esophageal cancer: Cancer that begins in the esophagus is divided into two major types. Adenocarcinoma usually develops in the lower part of the esophagus. This type can develop from Barrett’s esophagus. Squamous cell carcinoma begins in the cells that line the esophagus. This cancer usually affects the upper and middle part of the esophagus.
  • Strictures: Sometimes the damaged lining of the esophagus becomes scarred, causing narrowing of the esophagus. These strictures can interfere with eating and drinking by preventing food and liquid from reaching the stomach.

TREATMENT

Many over-the-counter (OTC) and prescription medications relieve GERD. Most of OTC drugs come in prescription strength too. Your provider will give you a prescription for these stronger drugs if you’re not getting relief from the OTC formulas.

The most common GERD medications:

  • Antacids 
  • H-2 receptor blockers 
  • Proton pump inhibitors 
  • Baclofen is a prescription drug used to reduce the relaxation of the lower esophageal sphincter which allows acid backwash.

Is there surgery to treat GERD (chronic acid reflux)

GERD is usually managed with medications and lifestyle changes (like eating habits). If these don’t work, or if you can’t take medications for an extended period, surgery may be a solution.

  • Laparoscopic antireflux surgery (or Nissen fundoplication) is the standard surgical treatment. It’s a minimally invasive procedure that fixes your acid reflux by creating a new valve mechanism at the bottom of your esophagus. The surgeon wraps the upper part of the stomach (the fundus) around the lower portion of the esophagus. This reinforces the lower esophageal sphincter so food won’t reflux back into the esophagus.
  • LINX device implantation is another minimally invasive surgery. A LINX device is a ring of tiny magnets that are strong enough to keep the junction between the stomach and esophagus closed to refluxing acid but weak enough to allow food to pass through.

Approaches may include one or more of the following:

  • Advice on avoiding triggers (certain types of food, changing formulas in infants) that may be causing GERD symptoms or making them worse.
  • Over-the-counter medications.
  • Prescription medications.
  • Information on proper body positioning, e.g., maintaining an upright position after eating meals/feedings.
  • Surgery (reserved as a last resort, or for when certain surgical correctable causes are identified).

PREVENTION

Here are 10 tips to help prevent GERD symptoms:

  1. Achieve and maintain a healthy weight.
  2. Eat small, frequent meals rather than huge amounts a few times a day.
  3. Reduce fat by decreasing the amount of butter, oils, salad dressings, gravy, fatty meats and full-fat dairy products such as sour cream, cheese and whole milk.
  4. Sit upright while eating and stay upright (sitting or standing) for 45 to 60 minutes afterward.
  5. Avoid eating before bedtime. Wait at least three hours after eating to go to bed.
  6. Try not to wear clothes that are tight in the belly area. They can squeeze your stomach and push acid up into the esophagus.
  7. When sleeping, raise the head of the bed 6 to 8 inches, using wooden blocks under the bedposts. Extra pillows don’t work.
  8. Stop smoking.
  9. Your healthcare provider may prescribe acid-reducing medications. Be sure to take them as directed.
  10. Cut out possible trigger foods.

OUTLOOK / PROGNOSIS

You can manage the symptoms of GERD. If you adjust your eating and sleeping habits and take medications when needed, you should be able to get your GERD symptoms to a manageable level.

If you experience acid reflux/heartburn more than twice a week over a period of several weeks, constantly take heartburn and antacids and your symptoms keep returning, call your healthcare provider.

  • From

    Medical Help Desk

    contact:- 7898892146

    email :- medindia14@gmail.com               

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