Gastroesophageal reflux is essentially the reflux or regurgitation of stomach contents back into the food pipe or esophagus. This is a normal process that occurs in otherwise healthy children, and adults. Most episodes are brief without causing any symptoms or problems. However, in some people, acid reflux can injure the esophagus and result in symptoms such as heartburn, vomiting, or pain when swallowing. This condition is called gastro esophageal reflux disease (GERD).
GERD occurs when the lower esophageal sphincter (LES) becomes weak or relaxes when it shouldn’t, thereby causing the stomach contents to rise up in the esophagus. Increased pressure on the abdomen due to excessive weight, obesity, pregnancy, and certain medicines such as those for asthma, calcium channel blockers, painkillers, sedatives, antidepressants and smoking, all contribute to the eventual weakening of the lower esophageal sphincter
The most common symptoms of GERD include heart burn, the regurgitation of food, chest fullness/ pain, feelings of excessive salivation and so on. Some patients also experience feelings of nausea, pain or the feeling of constantly having a lump in their throat, bad breath and the wearing down of their teeth. These symptoms are further exacerbated at night while lying down flat to sleep.
GERD can affect people of all ages, from infants to older adults. People with asthma are at a higher risk of developing GERD as asthma flare ups cause the stomach contents to flow back, or reflux into the esophagus. Conversely, acid reflux can make asthma symptoms worse by irritating the airways and the lungs. If one has both GERD and asthma, managing the GERD may help control the asthma symptoms.
Investigations may be necessary in some cases and may include Endoscopy (inserting a tube through the mouth to examine the inside of the esophagus), an X-ray of the upper digestive system, an ambulatory acid pH test (which monitors the amount of acid in the esophagus), and an esophageal impedance test (which measures the movement of the substances in the esophagus). If you have accompanying symptoms like persistent vomiting, loss of appetite, weight loss, difficulty in swallowing or vomiting blood etc. it is advisable to immediately see a doctor and get their advice.
Treatment for GERD starts with changes in lifestyle measures such as waiting for at least two hours after food before lying down, raising the head of the bed, avoiding tobacco, losing weight if overweight, decreasing alcohol intake, avoiding heavy meals, and decreasing caffeine intake.
However, the first step for treating GERD is to begin making the necessary dietary changes to help reduce the severity of your symptoms and give your body time to heal. It is important to consider which foods cause heartburn and discomfort and which foods don’t cause any painful symptoms at all. Few foods which are best avoided when on a GERD diet are spicy foods, trans fat and high-fat foods, very hot foods and liquid, mint and chocolate, alcohol and other foods which could be triggering an individual’s GERD. It should also be noted that each individual’s case is different and not everyone reacts the same way to particular foods. One needs to take the time to find out what ‘triggers’ theirs symptoms and make their own ‘safe to eat’ and ‘foods to avoid’ lists. It may take a little while before you fully understand your body’s reactions, but the most effective way to manage the condition is to “listen” to your body and work with it to devise a plan that will help in your specific situation. If these symptoms interfere with your daily life it is time to see your physician. Medications like proton pump inhibitors or histamine blockers may be necessary. Although sometimes in severe and intolerant cases, surgery may also be recommended.
Dr. Vijay Anand. V
Specialist Gastroentrologist
Aster Clinic, Al Qusais
