Gastroesophageal Reflux Disease (GERD): Symptoms, Causes, Diagnosis, Treatment & Prevention

Gastroesophageal Reflux Disease (GERD) is a kind of digestive disorder in which the acid/content of the stomach rushes back to the oesophagus (food pipe). It is also known as gastroesophageal reflux or acid regurgitation ^[1] . Many people experience it occasionally but if it happens more than twice in a week, then the chances of getting diagnosed with GERD increases.

During GERD, the acid or content of the stomach moves in a backward direction towards the oesophagus and cause serious tissue damage. The condition may damage the valve and lining of the oesophagus causing inflammation ^[2] .

According to a report, the prevalence of gastroesophageal reflux is 22% in Southern India and more common among old people and men. The condition occurs more in people residing in urban areas. Also, people who eat a lot of pan masala are at high risk of developing GERD.

Symptoms Of Gastroesophageal Reflux Disease

GERD is noticed by several symptoms in which heartburn is common ^[3] . Usually, after a heavy meal, people feel the acidic content of the stomach rushing to their mouth as they burp. The condition can be tackled easily by drinking a lot of water to digest the stomach content or by taking medications like antacids. But the condition becomes worse when it starts interfering with your daily life.

Other symptoms of gastroesophageal reflux disease are as follows:

• Regurgitation of food
• Chest pain ^[4]
• Difficulty while swallowing
• Sore throat ^[5]
• Nausea
• Bad breath
• Sudden excess saliva secretion
• Chronic cough ^[6]
• Worsening of asthma
• Inflammation of the larynx ^[2]

Causes Of Gastroesophageal Reflux Disease

When we swallow food, the content travels from the oesophagus to the stomach. The oesophagus is a muscular tube that connects the stomach with the throat. The gastroesophageal sphincter is a valve present in the lower end of the oesophagus, just at the junction dividing the stomach and the oesophagus ^[1] .

When we swallow food, the sphincter opens while it remains closed for the rest of the time. When the sphincter relaxes abnormally making the junction open, acids of the stomach rushes up to the throat causing irritation and inflammation.

Other causes of GERD include

• hiatal hernia ^[7] ,
• anxiety,
• asthma,
• empty stomach, and
• defective oesophagal contractions.

Risk Factors Of Gastroesophageal Reflux Disease

Several factors contribute to the risk of GERD which are as follows:

• Obesity
• Pregnancy ^[8]
• Smoking
• Eating heavy meals
• Eating a large number of fried foods ^[9]
• Consuming alcohol or coffee
• Scleroderma
• Medications like aspirin

Complications Associated With Gastroesophageal Reflux Disease

GERD is a common digestive problem that can be managed easily by a few simple tricks. However, if the condition remains untreated for long, it can cause harmful complications which are as follows:

• Respiratory problems when stomach acid enters the lungs
• Esophagitis, a condition defined by inflammation of the food pipe ^[2]
• Barrett's oesophagus, a condition when normal cells of the oesophagus turn into abnormal cells which may result in cancer ^[10] .
• Oesophageal stricture, a condition when the food pipe or oesophagus becomes narrow causing difficulty in swallowing food.

Diagnosis Of Gastroesophageal Reflux Disease

People experiencing GERD for long can walk to a gastroenterologist who will suggest possible tests to diagnose the severity of the condition. The tests are as follows:

• Upper gastrointestinal (GI) endoscope
• Oesophageal pH and impedance monitoring
• Oesophageal manometry
• Upper GI series
• Bravo wireless oesophageal pH monitoring

Treatment Of Gastroesophageal Reflux Disease

The severity of the GERD decides the treatment of the condition. If the condition is mild, it can be treated through

• antacids ^[11] ,
• prokinetics,
• H2 blockers, and
• erythromycin.

In severe conditions, GERD is treated by a surgery that includes fundoplication and other endoscopic procedures.

How To Prevent Gastroesophageal Reflux Disease

Some changes in lifestyle can help prevent GERD.

• Don't eat heavy meals at night.
• A gap of 2-3 hours between night meal and sleeping time is necessary ^[12] .
• Chew food properly before swallowing.
• Lose weight.
• Quit smoking.
• Don't wear clothes which are too tight around the abdomen.

Foods That Trigger Gastroesophageal Reflux Disease Symptoms

There are numerous foods which may trigger GERD. Such common foods are as follows:

• Beverages like tea and coffee
• High-fat foods like eggs, cheese, and fatty fish
• Tomato, garlic, and onion
• Alcohol or soda
• Citrus fruits like lemon and mandarin orange