It’s that time of the year again, the time when we attend parties, family reunions, and other holiday celebrations left and right. And of course, with these celebrations come great food and drinks we could hardly resist.
During these kinds of events wherein we are less mindful of what and how much food we are eating, uncomfortable digestive issues like acid reflux are highly likely to happen. This is generally not a serious problem, especially when it happens only once in a while. However, if acid reflux happens frequently, it could be indicative of a more serious form of a digestive issue called Gastroesophageal Reflux Disease (GERD).
What is GERD?
Gastroesophageal reflux (GERD) is a condition that occurs when the stomach contents (acidic juices, food, and fluids) persistently flow back up the esophagus. An acid reflux that occurs after a session of binge eating or drinking is totally normal. But if the reflux occurs more than twice a week over a period of several weeks, you may have developed a chronic form of reflux which is GERD.
What causes GERD?
Gastroesophageal reflux occurs when the lower esophageal sphincter (a muscular valve that connects the esophagus to the stomach) does not close properly after the food you ate arrives in the stomach.
Normally, the lower esophageal sphincter remains tightly closed. It only opens when you swallow food to let the food you ate pass through to the stomach but closes immediately after the food reached the stomach.
When the sphincter fails to close properly, the acid-containing contents of the stomach can travel back up the esophagus. This acid irritates the esophagus which can cause a number of uncomfortable symptoms.
What are the risk factors for GERD?
Several factors increase the risk of reflux. The following are the most common ones:
- Increased pressure on the abdomen due to being overweight or obese, pregnancy, or chronic bending at the waist area.
- Hiatal hernia – A condition in which a part of the stomach protrudes above the diaphragm. This makes it easier for stomach acid to come up the esophagus.
- Eating certain types of food that relax the esophageal sphincter (i.e., fatty foods, mints chocolate alcohol, coffee, tea)
- Smoking and drinking alcohol.
- Taking certain medications for asthma, hypertension, and allergies as well as painkillers, sedatives, and anti-depressants.
What are the symptoms of GERD?
The classic symptoms of GERD include heartburn (burning sensation in the chest) and regurgitation (sour or bitter liquid to the throat or mouth). Sometimes these symptoms worsen when lying down or after eating a full meal.
In some cases, however, heartburn may not be present with GERD. Instead, you may experience atypical (less-common) symptoms such as asthma, a persistent cough, laryngitis, hoarseness, a persistent sore throat, dental erosions, and noncardiac chest discomfort.
What are the possible complications of GERD?
If GERD is left untreated, the constant backward flow of acid can damage the sensitive lining of the esophagus and lead to further complications over time. The possible complications of GERD are as follows:
- Esophagitis: a condition wherein the lining of the esophagus becomes inflamed or irritated.
- Esophageal stricture: a condition characterized by narrowing of esophagus. Long-term irritation by stomach acid can result in scarring in the esophagus. When scar tissue form and builds up, it can narrow the esophagus, eventually causing swallowing difficulties.
- Barrett’s esophagus: a rare disorder that causes abnormal cells to develop in the lining of the esophagus. This increases the risk of developing esophageal cancer.
How is GERD diagnosed?
A physical examination is the first step in the diagnosis of GERD, during which you discuss your symptoms and medical background with your doctor. Sometimes, you may be prescribed treatment if you have heartburn and regurgitation, which are telltale symptoms of GERD, without doing any special diagnostic procedures.
However, in some cases, further tests may be needed. The following are the common tests that can be used to confirm diagnosis of GERD or check for complications:
- Endoscopy: An endoscope – a long, flexible tube equipped with a light and camera - is used to look at the esophagus. This can detect inflammation of the esophagus or other complications related to GERD.
- Ambulatory acid (pH) probe test: This test involves inserting a flexible tube into your nose and advancing it into the esophagus to help identify when, and for how long, stomach acid regurgitation occurs.
- X-rays of the upper GI tract: In this test, you will be asked to drink a liquid called barium that moves through your GI tract as the X-ray tech takes pictures.
- Esophageal manometry: This test involves the insertion of a small flexible tube with sensors into your nose down to the esophagus. The sensors measure the strength of your sphincter, muscles, and spasms as you swallow.
How to treat/manage GERD?
The goals of GERD management are to minimize discomfort, reduce the recurrence of symptoms, and prevent complications.
Initially, your doctor may advise you to do certain lifestyle modifications and take nonprescription medicines to relieve symptoms. But if your symptoms don’t improve after a few weeks, prescription medicines and additional tests may be required.
Medications along with lifestyle modifications are typically effective at treating GERD. But if these treatments still don’t help or you experience side effects from medicines, you have a large hiatal hernia, or you just simply want to discontinue long-term medical treatment, your doctor may recommend surgery instead.
What are the lifestyle modifications that you can do to manage GERD?
The following are ways to manage GERD:
- Lose weight if you are overweight or obese.
- Avoid eating large meals. Instead, eat smaller, more frequent meals throughout the day.
- Avoid lying down within 3-4 hours after a meal.
- Elevate your head by about 6-8 inches when sleeping.
- Limit intake of reflux triggers such as fatty foods, chocolate, garlic, raw onions, citrus fruits, spearmint and peppermint, coffee (both caffeinated and decaffeinated), and tea. It is important to remember that the foods that trigger reflux vary for everyone, though.
- Avoid smoking and drinking alcohol.
- Avoid bending over and wearing tight-fitting garments.