Some people suffer from heartburn and acidity. Even a mildly spicy or an extra portion of meals leave them running for an antacid. If you are one of them, then it is time to find the underlying cause and explore a bit deeper into what is medically known as Gastro-Esophageal Reflux Disease (GERD). It is defined as the back-flow of stomach contents into the Esophagus causing undesirable symptoms, potentially resulting in esophageal damage. There is an uncomfortable burning sensation felt in the middle of the upper abdomen and/or lower chest. Here is more about the causes of GERD and the ways to counter it:
What are the causes of GERD?
When the lower esophageal sphincter doesn’t function properly, it causes GERD. It is a ring of muscle that surrounds the junction of the esophagus and the stomach and acts as a valve. When it functions correctly, this valve opens while swallowing to allow passage of food from the esophagus into the stomach. Then the valve closes acting as a barrier to keep stomach contents from refluxing into the esophagus again. In people with GERD, the LES does not close properly resulting in the back-flow of gastric contents. It is the back-flow of gastric contents that cause the symptoms of GERD.
Lifestyle or behavioral factors might cause GERD. These include:
- Obesity
- Smoking
- Alcohol use
- A high-fat diet
- Carbonated beverages consumption
A hiatal hernia can also be the cause behind GERD. It results when the LES moves above the diaphragm, which is a sheet of muscles that separates the abdominal and chest cavities.
How to Counter it?
Here are the ways to counter GERD:
Lifestyle Changes
The treatment of GERD begins with behavioral and lifestyle changes. These include:
- Weight loss
- Avoidance of carbonated beverages
- Abstinence from smoking
- Reducing alcohol and caffeine intake
- Avoiding foods that cause a trigger (spicy foods, citrus or acidic foods)
- Maintaining a low-fat diet
- Avoiding eating or drinking several hours before going to bed
Medications
For severe symptoms, acid-reducing medications include proton pump inhibitors (PPIs) and histamine H2-receptor blockers (H2 blockers). These medications are effective in reducing the amount of acid in the gastric fluid or for treating Esophagitis. Long-term use of more than two weeks should be discussed with a physician since there is an increased risk of osteoporosis and fractures of the hip, wrist, and spine.
Anti-Reflux Surgery
Obesity is a major risk factor for GERD. Weight loss can consistently lead to an improvement in its symptoms. A few patients who are morbidly obese with GERD and fail to get proper medical treatment can see a surgeon to discuss about anti-reflux surgery.
Surgery for GERD involves a procedure called Fundoplication. The goal of this procedure is to reinforce the LES to recreate the barrier that stops reflux from occurring. The procedure involves wrapping a portion of the stomach around the bottom of the esophagus in an effort to strengthen, augment, or recreate the LES valve. The most common type is Nissen Fundoplication, in which the stomach is wrapped 360 degrees around the lower esophagus. This is the most common procedure to control GERD.
Most of the patients, in fact, report a high level of satisfaction, effective reduction of symptoms, and improved quality of life post-surgery.
After surgery, patients are generally admitted to the hospital for 1-3 days for the purpose of observation. Patients are usually discharged on soft, pureed, or a liquid diet with gradual dietary changes in 2-8 weeks’ time.
These are the ways to counter GERD. Do consult your physician for more information on the disease.
