April 20, 2024

Gastroesophageal reflux disease or GERD is a common disorder. Acid reflux can occur occasionally and lead to medical problems but it is considered chronic and considered a disease if it occurs at least twice a week for several weeks.
From the mouth, food enters the esophagus, a long muscular structure that empties its contents to the stomach. Its wall contains a layer of muscle tissue and undergoes waves of muscle contractions called peristalsis or peristaltic movements to help move food through the esophagus to the stomach. We normally do not feel these unidirectional peristaltic movements. When we begin swallowing food, signals from the brain cause peristalsis to begin. The muscle behind the food squeezes the food forward while the muscle in front of the food relaxes and allows food to move forward.
At the end of the tubular esophagus is a ring-like muscle the lower esophageal sphincter or LES that relaxes to let food pass into the stomach and contracts and closes to prevent food from going back to the esophagus. It prevents reflux of acidic stomach contents back to the esophagus which has a more delicate lining compared to the stomach. GERD occurs when the sphincter becomes weak or relaxes often.
Common symptoms of GERD include the following: heartburn or a burning sensation in the chest felt after eating. It can worsen while lying down; regurgitation of sour or bitter liquid to the mouth or throat; dysphagia or difficulty in swallowing; pain in the upper abdomen or non-burning chest pain;
Dry cough; shortness of breath or worsening of obstructive lung disease, asthma; and sore throat.
Common conditions that lead to acid reflux are cigarette smoking; pregnancy; hiatal hernia; obesity; and diabetes mellitus – nerve damage due to elevated blood sugar can lead to GERD.
Among the medications are calcium channel blockers used for blood pressure control, hormone replacement therapy, and non-steroidal anti-inflammatory agents.
The lining of the esophagus can be damaged by repeated exposure to the acidic content of food from the stomach. Severe reflux can lead to inflammation of the esophagus or esophagitis. Precancerous metaplasia called Barrett’s esophagus can develop. Scarring can lead to esophagial strictures that cause narrowing of the lumen of the esophagus.
To help alleviate the symptoms of GERD these measures can help:
Eat smaller meals;
Shed some weight if you are obese or overweight;
Sleep on your left side;
Antacids or proton pump inhibitors may be taken for temporary relief of symptoms;
Wear loose-fitting clothes;
Smoking cessation; and
Avoid so-called trigger foods like chocolate, mint, acidic drinks like coffee, tomato or orange juice, alcohol, carbonated drinks (soda), and spicy foods.
White bread, white rice, potato chips, fatty meat and baked goods have been linked with GERD symptoms.
Recurrent acid reflux symptoms warrants medical evaluation. Examinations done to assess the condition include esophagram or X-ray of the esophagus, direct visualization through endoscopy, or measurement of the pressure inside the esophagus. For severe GERD, surgical treatment is an option.