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Reflux/ Heartburn/ GERD
Summary: 30 Seconds Read
Overview of GERD:
- GERD is frequent acid reflux irritating the esophagus.
- Occasional reflux vs. weekly GERD.
- Managed with lifestyle changes, OTC meds, or stronger treatments.
- GERD results from frequent acid reflux.
- Lower esophageal sphincter dysfunction allows acid to flow back up.
- Conditions increasing GERD risk include obesity, hiatal hernia, pregnancy, and more.
- Smoking, large meals, trigger foods, alcohol, and certain medications worsen reflux.
- Common symptoms include heartburn, chest pain, swallowing issues, regurgitation, and throat lump.
- Nighttime reflux may lead to cough, laryngitis, asthma, and sleep disruption.
When to See a Doctor:
- Immediate care for chest pain with shortness of breath or jaw/arm pain.
- Consult if severe/frequent GERD or using OTC meds > twice a week.
- Chronic GERD can cause esophageal narrowing, ulcers, and precancerous changes.
- Tests like endoscopy, pH probe, manometry, and X-rays confirm GERD and complications.
- Options include lifestyle changes, OTC antacids, H2 blockers, and PPIs.
- Surgery considered for severe cases or complications.
- Lifestyle changes like weight management, stress reduction, and avoiding trigger foods.
- Hydration, meal timing, and elevating the head during sleep help.
- No smoking or alcohol; chew gum; wear loose clothing.
Home Care for Acidity:
- Dietary changes: avoid trigger foods, eat smaller meals, high-fiber diet, ginger/peppermint.
- Hydration, meal timing, elevate head.
- Lifestyle: manage weight, stress, avoid tight clothes, and chewing gum.
- No smoking/alcohol; OTC antacids for temporary relief.
When to Take Medical Advice:
- Consult a doctor for frequent/severe acidity, unresponsive symptoms, complications, unexplained weight loss, worsening symptoms, or if over 50, pregnant, on other medications, or quality of life is affected.
Gastroesophageal reflux disease (GERD)/ Reflux/ Heartburn occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus.
Many people experience acid reflux from time to time. GERD is mild acid reflux that occurs at least twice a week, or moderate to severe acid reflux that occurs at least once a week.
Most people can manage the discomfort of GERD with lifestyle changes and over-the-counter medications. But some people with GERD may need stronger medications or surgery to ease symptoms.
GERD is caused by frequent acid reflux.
When you swallow, a circular band of muscle around the bottom of your esophagus (lower esophageal sphincter) relaxes to allow food and liquid to flow into your stomach. Then the sphincter closes again.
If the sphincter relaxes abnormally or weakens, stomach acid can flow back up into your esophagus. This constant backwash of acid irritates the lining of your esophagus, often causing it to become inflamed.
Conditions that can increase your risk of GERD include:
- Bulging of the top of the stomach up into the diaphragm (hiatal hernia)
- Connective tissue disorders, such as scleroderma
- Delayed stomach emptying
Factors that can aggravate acid reflux include:
- Eating large meals or eating late at night
- Eating certain foods (triggers) such as fatty or fried foods
- Drinking certain beverages, such as alcohol or coffee
- Taking certain medications, such as aspirin
Common signs and symptoms of GERD include:
- A burning sensation in your chest (heartburn), usually after eating, which might be worse at night
- Chest pain
- Difficulty swallowing
- Regurgitation of food or sour liquid
- Sensation of a lump in your throat
If you have nighttime acid reflux, you might also experience:
- Chronic cough
- New or worsening asthma
- Disrupted sleep
WHEN TO SEE A DOCTOR
Seek immediate medical care if you have chest pain, especially if you also have shortness of breath, or jaw or arm pain. These may be signs and symptoms of a heart attack.
Make an appointment with your doctor if you:
- Experience severe or frequent GERD symptoms
- Take over-the-counter medications for heartburn more than twice a week
Over time, chronic inflammation in your esophagus can cause:
- Narrowing of the esophagus (esophageal stricture). Damage to the lower esophagus from stomach acid causes scar tissue to form. The scar tissue narrows the food pathway, leading to problems with swallowing.
- An open sore in the esophagus (esophageal ulcer). Stomach acid can wear away tissue in the esophagus, causing an open sore to form. An esophageal ulcer can bleed, cause pain and make swallowing difficult.
- Precancerous changes to the esophagus (Barrett’s esophagus). Damage from acid can cause changes in the tissue lining the lower esophagus. These changes are associated with an increased risk of esophageal cancer.
Your doctor might be able to diagnose GERD based on a physical examination and history of your signs and symptoms.
To confirm a diagnosis of GERD, or to check for complications, your doctor might recommend:
- Upper endoscopy. Your doctor inserts a thin, flexible tube equipped with a light and camera (endoscope) down your throat, to examine the inside of your esophagus and stomach. Test results can often be normal when reflux is present, but an endoscopy may detect inflammation of the esophagus (esophagitis) or other complications. An endoscopy can also be used to collect a sample of tissue (biopsy) to be tested for complications such as Barrett’s esophagus.
- Ambulatory acid (pH) probe test. A monitor is placed in your esophagus to identify when, and for how long, stomach acid regurgitates there. The monitor connects to a small computer that you wear around your waist or with a strap over your shoulder. The monitor might be a thin, flexible tube (catheter) that’s threaded through your nose into your esophagus, or a clip that’s placed in your esophagus during an endoscopy and that gets passed into your stool after about two days.
- Esophageal manometry. This test measures the rhythmic muscle contractions in your esophagus when you swallow. Esophageal manometry also measures the coordination and force exerted by the muscles of your esophagus.
- X-ray of your upper digestive system. X-rays are taken after you drink a chalky liquid that coats and fills the inside lining of your digestive tract. The coating allows your doctor to see a silhouette of your esophagus, stomach and upper intestine. You may also be asked to swallow a barium pill that can help diagnose a narrowing of the esophagus that may interfere with swallowing.
To prevent and relieve symptoms of GERD, your doctor might encourage you to make changes to your eating habits or other behaviors.
They might also suggest taking over-the-counter medications, like:
- H2 receptor blockers
- Proton pump inhibitors (PPIs)
In some cases, they might prescribe stronger H2 receptor blockers or PPIs. If GERD is severe and not responding to other treatments, surgery might be recommended.
Some over-the-counter and prescription medications can cause side effects.
SURGERY FOR GERD
In most cases, lifestyle changes and medications are enough to prevent and relieve symptoms of GERD. But sometimes, surgery is needed.
For example, your doctor might recommend surgery if lifestyle changes and medications alone haven’t stopped your symptoms. They might also suggest surgery if you’ve developed complications of GERD.
There are multiple types of surgery available to treat GERD.
Lifestyle changes can help ease heartburn:
- Maintain a healthy weight. Excess pounds put pressure on your abdomen, pushing up your stomach and causing acid to back up into your esophagus.
- Avoid tightfitting clothing, which puts pressure on your abdomen and the lower esophageal sphincter.
- Avoid foods that trigger your heartburn.
- Avoid lying down after a meal. Wait at least three hours.
- Avoid late meals.
- Elevate the head of your bed if you regularly experience heartburn at night or while trying to sleep. If that’s not possible, insert a wedge between your mattress and box spring to elevate your body from the waist up. Raising your head with additional pillows usually isn’t effective.
- Avoid smoking and alcohol. Both smoking and drinking alcohol decrease the lower esophageal sphincter’s ability to function properly.
- Avoid large meals. Instead eat many small meals throughout the day.
HOME CARE FOR ACIDITY:
WHEN TO TAKE MEDICAL ADVICE:
It’s essential to seek medical advice for acidity under certain circumstances. While occasional acidity or heartburn can often be managed with lifestyle and dietary changes or over-the-counter antacids, you should consult a healthcare professional when:
- Frequent Occurrence: If you experience acidity or heartburn regularly (more than twice a week), it could be a sign of a more severe condition like gastroesophageal reflux disease (GERD).
- Severe Symptoms: If your symptoms are severe and not responding to over-the-counter antacids or home remedies, it’s crucial to consult a doctor. Severe symptoms might include intense chest pain, difficulty swallowing, or vomiting blood.
- Persistent Symptoms: If your symptoms persist for an extended period, despite making dietary and lifestyle changes, you should seek medical advice. Persistent symptoms could indicate an underlying issue that needs to be addressed.
- Unintended Weight Loss: If you’re experiencing unexplained weight loss along with acidity or digestive issues, it may be a sign of a more serious problem that requires medical evaluation.
- Worsening Symptoms: If your symptoms worsen over time or if you start to experience new symptoms that are concerning, such as black or bloody stools, consult a healthcare professional immediately.
- Age and Risk Factors: If you are over 50 years old or have risk factors for digestive disorders (such as a family history of gastrointestinal cancers), it’s advisable to discuss your symptoms with a healthcare provider.
- Pregnancy: Pregnant individuals should consult a healthcare professional before taking any medication or making significant dietary changes to manage acidity.
- Medication Interactions: If you are taking other medications, especially on a long-term basis, it’s a good idea to consult a doctor before self-medicating with antacids or acid-reducing medications, as they can interact with other drugs.
- Quality of Life: If your symptoms significantly impact your quality of life, interfere with your daily activities, or disrupt your sleep regularly, it’s essential to seek medical advice to improve your overall well-being.
Remember that while occasional acidity is common and can often be managed with lifestyle modifications and over-the-counter remedies, chronic or severe acidity may indicate an underlying medical condition that requires professional evaluation and treatment. It’s always better to consult a healthcare provider if you have any doubts or concerns about your digestive health.