Gastroesophageal Reflux Disease – GERD: Information on Causes, Diagnosis & Treatments
Gastroesophageal Reflux Disease (GERD) is a heartburn condition that affects millions of individuals nationwide. Many of these people experience uncomfortable symptoms associated with heartburn, nausea, and difficulty in swallowing. Typically, the condition is both annoying and uncomfortable. However, persistent symptoms might be the signs of a more severe digestive disorder that can cause serious changes in your life.
Currently, doctors have prescribed proton pump inhibitor medications to more than 15 million patients nationwide. Even with taking this inhibiting medication, seven out of ten patients still experience many of the symptoms associated with GERD and heartburn. Unfortunately, protein pump inhibitors only manage symptoms and do not cure the underlying factors involved in acid reflux. Without proper treatment, ongoing symptoms can lead to serious ulcers. Some individuals with chronic gastroesophageal reflux disease have developed esophageal cancer.
Any individual with the common symptoms associated with GERD or heartburn that have not received proper treatment should work with their gastroenterologist to help identify any underlying cause and provide a medical management plan to eliminate the pain and discomfort. The doctor may provide some relief by prescribing protein pump inhibitors or suggest a minimally invasive antireflux surgical procedure.
Gastroesophageal (stomach and esophagus) reflux causes a flow back of the contents of the stomach into the esophagus. Typically, the lower esophageal sphincter opens during the digestive process to create a passageway for food into the stomach. The sphincter closes timely to prevent food mixed with acidic stomach juices from backing up into the esophagus. However, if the sphincter is relaxed or weakened, reflux can occur where the stomach contents back up. Over time, this chronic condition can develop into gastroesophageal reflux disease (GERD).
The dysfunction of the sphincter determines the severity of the condition and the level of acidity and fluid backed up from the stomach into the esophagus. Over time, backed-up stomach contents can neutralize saliva.
Some gastroenterologists believe people that have developed a hiatal hernia also experience a weakened lower esophageal sphincter that elevates the risk of GERD. This type of hernia develops when the stomach’s upper portion moves upward through a tiny opening in the chest diaphragm that separates the chest from the abdomen. However, many individuals with a hiatal hernia never experience the signs or symptoms of gastrointestinal reflux or heartburn.
Sudden physical exertion, including straining, vomiting, or coughing can significantly increase the amount of abdominal pressure that results in a hiatal hernia. Pregnancy and obesity are also contributing factors to serious digestive conditions.
Common GERD Symptoms
Many individuals first recognize that they have heartburn when an acidic taste appears in the mouth, and over time it can cause hoarseness. Doctors can begin an early diagnosis of GERD based on the symptoms of the condition you describe during a physical examination. The doctor may use an endoscopic, a flexible tube with a tiny camera to examine the interior of the throat as a confirmation for the diagnosis.
Some of the common symptoms associated with gastroesophageal reflux disease include:
- Ongoing heartburn that produces a burning sensation in the throat and chest
- Regurgitation of the stomach contents or food
- Chest pain and Dysphagia (difficulty in swallowing)
- Sore throat
- Bad breath
- A lump sensation in the throat
- Vomiting and nausea
Other conditions and symptoms involving respiratory complications of GERD might also be associated with a condition where stomach acid is breathed into the lungs upon regurgitation. Some of the symptoms associated with respiratory complications of GERD involve:
- Chest congestion
- Chronic asthma identified as a sensitivity to lung irritants
- An unrelenting dry cough
- Partial loss of the voice (hoarseness)
- Constricted breathing (wheezing) that produces a high-pitched sound
- Lung infection or pneumonia
- Swelling of the voice box (laryngitis) causing temporary voice loss
When acid reflux occurs during sleeping hours, the patient often experiences disrupted sleeping patterns or an elevated risk of serious respiratory complications associated with gastroesophageal reflux disease.
Common Causes of GERD
Several causal factors elevate the risk of developing acid reflux disease. Some of These Include:
- Pregnancy – Women in all stages of pregnancy have the potential of experiencing acid reflux for the first time. The condition is often the result of elevated hormone levels and the pressure produced by a growing fetus. Typically, the condition is worse in the third trimester. Fourthly, the signs and symptoms of acid reflux diminish after delivery.
- Stomach Abnormality – Hiatal hernias and other stomach abnormalities can be the main cause of gastrointestinal reflux. The disease can develop when the diaphragm works incorrectly and allows acid to rise into the esophagus. Any stomach abnormality can make it significantly easier for the acid to back up into and out of the stomach.
- Smoking – Inhaling smoking products might contribute to the development of acid reflux by causing damage to mucous membranes, increasing acid secretion, impairing throat muscle reflexes, reducing the lower esophageal sphincter muscle functioning in neutralizing the acid in saliva.
- Consuming Acid Reflux Foods – Consuming large meals or lying down after a heavy meal can trigger many of the symptoms associated with acid reflux, including difficulty in swallowing and a dry cough. Foods to avoid to reduce the potential acid reflux include alcohol, chocolate, carbonated drinks, fried or fatty foods, tea or coffee, oranges, lemon or lime fruits, onions and garlic, tomato products including pizza, salsa, and spaghetti sauce, mint, and spicy foods like curry or chili.
- Other Factors – Obesity, being overweight, consuming heavy meals, snacking close to bedtime, taking ibuprofen or aspirin, or using blood pressure medications that are known to elevate the risk of acid reflux.
Medical science understands that drinking alcoholic beverages elevates the potential risk of developing esophageal cancer. The more alcohol consumed, the greater the risk. Coupling drinking alcohol with smoking can elevate the risk of developing cancer even higher, compared to smoking tobacco or drinking alcohol alone.
Diagnosing and Treating Gastroesophageal Reflux Disease
If you believe you are experiencing acid reflux heartburn, it is essential to see your doctor. Self-diagnosis and self-treatment could cause significantly more severe health issues than letting your doctor examine you to verify your condition and offer an effective treatment.
- Physical Examinations – Your doctor will likely perform a comprehensive physical examination and ask questions about your medical history, including the types and amount of food you eat and when you first began developing the symptoms.
- Ambulatory Acid Probe Test – Your doctor will want to know the activity in your stomach over twenty-four hours. To do this, the doctor threads a catheter (thin, long, flexible tube) through the nose and into the esophagus. The small device will track the level of acid that comes into the throat and the stomach.
- X-Ray Testing – All patients undergoing a GERD x-ray will swallow a chalky barium solution that coats the interior of the throat, upper intestines, and stomach. The barium provides better x-ray results to identify any problems in the digestive tract.
- Endoscopic – Using a tiny, thin, long tube with a camera inserted into the digestive tract can quickly identify any serious problems associated with GERD or other digestive tract issues.
- Manometry – This esophageal motility test requires a thin, long tube that is threaded into the esophagus to measure esophageal movement and its ability to push acid upward.
Generally, most individuals use over-the-counter (OTC) medications, including antacids, to help rid the digestive tract of uncomfortable regurgitating stomach acid that causes mild heartburn conditions. Some of these over-the-counter medications include Maalox, Mylanta, Rolaids, and Tums. Unfortunately, these OTC drugs do not fix the damage or heal the ulcer if the condition is chronic. Recently, some of the OTC medications such as Zantac or (ranitidine) have been contaminated with NDMA, a known carcinogen. Read more about Zantac cancer lawsuits here.
Other individuals take H2 receptor blockers that help ease the symptoms associated with GERD. Unfortunately, these drugs do not last any longer than twelve hours. Finally, proton pump inhibitors may offer better acid relief while reducing acid reflux and healing damage to the throat.
Other effective treatments include:
Prescribed medications – If OTC drugs are ineffective, the doctor may suggest a stronger dose of proton pump inhibitors or H2 receptor blockers. Also, you may be prescribed prokinetic medications that help the stomach empty faster and strengthen the esophagus. However, these drugs can cause serious side effects, including anxiety, depression, fatigue, diarrhea, or nausea.
Surgical Options – A surgical procedure might be your only effective option to control your acid reflux or tighten your esophagus. The doctor may recommend a LINX surgery that uses a band of tiny beads around the esophagus or a Nissen fundoplication technique where the top part of the stomach is wrapped around the lower part of the esophagus.
Effective lifestyle changes can help minimize the potential complications associated with GERD. Some of these changes include quitting smoking, maintaining a healthy weight, reducing stress and anxiety, avoiding triggers including alcoholic beverages and challenging foods, consuming smaller meals, raising the bed, and sitting up after eating.