Acid reflux occurs when the contents from the stomach move back up into the esophagus and this is medically known as acid regurgitation or gastroesophageal reflux. However, if a person has symptoms of acid reflux more than twice a week, then he may have a condition known as gastroesophageal reflux disease (GERD). If left untreated, it can worsen and cause severe complications.
Symptoms
The primary symptom of GERD is acid reflux, which causes an unpleasant burning sensation in the check, which can go up into the neck and throat and this sensation is often known as heartburn. Some of the other common signs and symptoms of GERD include:
Nausea
Chest pain
Pain when swallowing food or liquid
Difficulty swallowing
Chronic cough
Hoarse voice
Bad breath
Causes
GERD is typically caused by frequent acid reflux. When you swallow food, a circular band of muscles (lower esophageal sphincter) at the bottom of the esophagus relaxes to let food and liquid flow into the stomach and then the sphincter muscle closes again. The stomach acid flow backs up into the esophagus when the sphincter weakens. This persistent backflow of acid irritates the lining of the esophagus and becomes inflamed.
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Risk Factors
Some of the health conditions that can increase the risk of GERD include:
Obesity
Pregnancy
Scleroderma
Delayed stomach emptying
Some of contributing factors that can aggravate acid reflux include:
Eating heavy meals or eating late at night
Eating certain foods (triggers) such as deep-fried foods or fatty foods
Drinking excess amounts of alcohol or coffee
Taking certain medications, such as aspirin
Stages Of GERD
Stage 1: Mild GERD
A person may experience mild symptoms once or twice a month. Lifestyle modifications and taking over-the-counter acid-suppressive medications offer respite from symptoms.
Stage 2: Moderate GERD
In this stage, patients may have more frequent symptoms that need regular prescription medications. If left untreated it may affect normal activities and may lead to esophageal inflammation.
Stage 3: Severe GERD
A person with severe GERD may not show any improvement in their condition even after taking medications. This largely impedes their quality of life and may have erosive esophageal inflammation.
Stage 4: Reflux Induced Precancerous Lesions
Stage 4 is the result of years of untreated severe reflux. About 10% of patients with long-term GERD eventually progress to stage 4. They most develop a precancerous condition called Barrett’s esophagus and this may lead to cancer if left unattended.
Also Read: Gastroscopy: Procedure, Risks And Results
Diagnosis
If the healthcare provider suspects that a person may have GERD, then he will do a complete physical examination and ask about any existing symptoms. The patient may be referred to see a gastroenterologist for further evaluation, where he may suggest certain tests, including:
Ambulatory 24-hour pH Probe:
In this procedure, a small tube is sent via the nose into the esophagus that is attached to a pH sensor at the tip. This measures how much acid the esophagus is exposed to and sends the data to a portable computer. The patient must wear this tube for about 24 hours and this test is considered as the “gold standard” for confirming GERD diagnosis.
Esophogram: The patient is asked to drink barium solution, after which an X-ray is taken to monitor the upper digestive tract.
Upper Endoscopy: A flexible tube with a camera is passed into the esophagus to monitor it and collect a sample of tissue for biopsy if required.
Esophageal Manometry: A stretchable tube is passed via the nose into the esophagus to measure the strength of esophageal muscles.
Esophageal pH Monitoring: A pH monitor is passed into the esophagus to measure the way acid is regulated by the system over a period.
After confirming the diagnosis, the doctor will decide what best treatment plan will work for the patient and may also evaluate if surgery is an option.
Treatment
To effectively control and ease symptoms of GERD, the healthcare provider may ask the patients to make certain lifestyle modifications such as:
Maintain weight
Quit smoking
Refrain from having heavy meals in the evening
Wait for at least a few hours before going to bed after having food
Elevate head while sleeping
Medication
The doctor may also recommend the patient to take over-the-counter medications like antacids, H2 receptor blockers, proton pump inhibitors to get respite from symptoms and improve health.
