GERD: What you Need to Know

Gastrointestinal Reflux Disease, commonly known as Acid Reflux or GERD is a disorder of the digestive system, specifically affecting the oesophagus and the stomach. The lining of the food pipe or oesophagus gets disrupted due to stomach acid, travelling backwards into the mouth. This can leave a bitter taste in the mouth, and can also cause heartburn, difficulty in swallowing, or shortness of breath. GERD can be mild, moderate or severe, depending on its frequency of acid reflux. Usually, patients can manage its symptoms but in some cases, emergency treatment or surgery may be advised by the doctor. GERD in adults can be life-threatening and may turn into cancer if not treated at the right time.

Symptoms of GERD

The acid indigestion due to GERD may cause the following symptoms.

• Sour or bitter taste in the mouth
• Heartburn and pain in the chest
• Difficulty in swallowing
• Regurgitation
• Vomiting
• Bad breath
• A lump like sensation in the throat
• Respiratory difficulties
• Tooth decay
• Wearing of enamel (topmost layer of teeth)

In case one has acid reflux in the night, they may experience a disruption in their sleep pattern, laryngitis and chronic coughing. If one has asthma, it may worsen with time.

Risk Factors for GERD

When we talk about risk factors, internal, as well as external factors play a major role in the occurrence of GERD and its severity. These risk factors include

• Obesity
• Pregnancy
• Hiatal hernia, which involves the bulging of the upper part of the stomach, into the diaphragm.
• Scleroderma, lupus or other connective tissue diseases
• Gastroparesis

Many a time, dietary habits and lifestyle choices can also increase the risk of having acid reflux. These may include heavy smoking, excessive stress, eating food that contains a lot of oil and fat, high consumption of alcohol, high consumption of coffee, certain medications like aspirin, and consuming large meals at dinner time or right before sleeping.

Special note on Infants with GERD

Spitting out food and subsequently, vomiting can be commonly seen with infants between the age of 3 months to 1.5 years. What is important to notice is its frequency. Many times, GERD in infants goes unnoticed. Some symptoms new parents should keep in mind while noticing the infant's eating habits include

• Choking or gagging
• Refusing to eat
• Hiccups or wet burping
• Weight loss
• Frequent coughing
• Pneumonia
• Irritable nature of the infant while feeding or post feeding
• Slow growth
• Difficulty in sleeping
• Medical condition like a tongue-tie

If parents notice any such symptoms, they should immediately consult with an infants doctor about immediate care. Online healthcare portals like credihealth.com can help parents connect with the right doctor, and also assist with doctor appointment bookings, ordering medicines, and other homecare services. Also Read : GERD (Gastroesophageal Reflux Disease) Symptoms and Treatment

Diagnosis of GERD

A gastroenterologist is usually consulted for the diagnosis and treatment plan for acid reflux. The doctor takes a detailed medical history, which also includes taking into consideration all the signs and symptoms. Post that, the doctor recommends the following tests

• Barium Swallow to check the oesophagus and the upper part of the digestive system, through X-ray
• Endoscopy to check the oesophagus and stomach region. An endoscope is an instrument with a camera which is inserted through the mouth, into the stomach, through the oesophagus. It gives a clear picture, and can also help with taking biopsies.
• Ambulatory acid pH test. The monitor in the test can be clipped in the oesophagus during endoscopy or maybe in the form of a thin catheter, through the nose, into the oesophagus.
• Oesophageal manometry

Treatment of GERD

Medical management of GERD includes the use of various over the counter drugs.

• Antacids can help neutralize stomach acid, but they are not a permanent solution. Overuse of antacids can cause kidney issues and diarrhoea, so it is always advisable to consume it after a doctor prescribes them.
• H-2 receptor blockers help with reducing stomach acid production.
• Prokinetics help with emptying the stomach faster but may have side effects like anxiety, lightheadedness and nausea.

If surgical intervention is required, a doctor recommends Fundoplication, which is a surgery that involves sewing the upper part of the stomach around the oesophagus. Other surgeries like LINX device placement and TIF can be done, depending on the patient's condition. Endoscopic procedures or minimally invasive procedures is another option to stop or reduce GERD.

Changes to adopt to reduce GERD

One can opt for various lifestyle and dietary changes pre, during or post GERD treatment.

• Reducing and eventually stopping smoking, consumption of alcohol, reducing consumption of coffee or other acidic beverages can help reduce acid reflux.
• Avoid spicy food, citrus fruits, mint, garlic, and high-fat food items.
• One can opt to eat slowly, chew the food properly, and consume smaller meals in a day.
• Exercising and maintaining a balanced diet are essential to staying fit and GERD free.
• It has also been noted that avoiding wearing tight fitted clothes and acupuncture has benefitted patients with GERD.

Conclusion

GERD or Gastrointestinal Reflux Disease can be seen in children as young as 3 months or may get triggered in adults in the age groups above 40 years. From the evidence gathered through various studies, it can be determined that lifestyle and dietary habits play a major role in the occurrence of the disease. Simply curbing the habits in the initial stage of the disorder can help relieve patients early and help them save money on hefty hospital bills. In case the disorder is chronic, medical advancements have brought temporary and permanent solutions, which are easily accessible at hospitals with Gastroenterology speciality such as Aig Hospital Gachibowli, Asian institute of Gastroenterology, paras hospital gurgaon, Medanta hospital ranchi. Incase one find themselves or their near ones suffering from symptoms mentioned above, they should immediately consult a doctor.

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