What Causes GERD?

• Weak Lower Esophageal Sphincter (LES): The LES is a ring of muscle at the junction between the esophagus and stomach. If it weakens or relaxes abnormally, acid can escape into the esophagus.
• Hiatal Hernia: A condition where part of the stomach pushes up through the diaphragm into the chest cavity, which can impair the function of the LES and lead to reflux.
• Obesity: Increased pressure on the abdomen can weaken the LES and contribute to acid reflux.
• Pregnancy: Hormonal changes and increased abdominal pressure during pregnancy can lead to GERD.
• Delayed Stomach Emptying: Conditions that slow the emptying of the stomach can increase the risk of GERD by allowing food and acid to linger.
• Dietary Factors: Certain foods and beverages like fatty or fried foods, chocolate, caffeine, alcohol, citrus fruits, spicy foods, and tomato-based products can relax the LES or increase stomach acid.
• Lifestyle Factors: Smoking, eating large meals, eating late at night, and lying down immediately after eating can also trigger GERD.

What Are the Symptoms of GERD?

• Heartburn: A burning sensation in the chest, especially after eating or at night.
• Regurgitation: A sour or bitter taste in the mouth due to acid or food coming back up.
• Dysphagia: Difficulty swallowing.
• Chest Pain: Sometimes confused with heart-related pain.
• Chronic Cough, Sore Throat, or Hoarseness: Often due to irritation from acid.
• Laryngitis and Wheezing: Due to irritation of the airways and throat.

How is GERD Diagnosed?

• Clinical Evaluation: Based on symptoms like heartburn and regurgitation.
• Endoscopy: Allows visualization of the esophagus and stomach lining.
• Esophageal pH Monitoring: Measures acid levels in the esophagus.
• Manometry: Measures the pressure and function of the esophagus.
• Barium Swallow X-ray: Identifies structural abnormalities like hiatal hernias.

Treatment of GERD

1. Lifestyle and Dietary Modifications

• Weight loss: Reduces pressure on the abdomen and LES.
• Diet changes: Avoid spicy, fatty, caffeinated, and acidic foods.
• Eat smaller meals: Large meals can cause excess stomach acid production.
• Avoid lying down after eating: Wait at least 2–3 hours before lying down or going to bed.
• Elevate the head of the bed: Helps prevent nighttime reflux.
• Quit smoking and reduce alcohol consumption: Both can worsen symptoms.

2. Medications

• Antacids: Neutralize stomach acid (e.g., Tums, Maalox).
• H2 Blockers: Reduce acid production (e.g., ranitidine, famotidine).
• Proton Pump Inhibitors (PPIs): Stronger acid reducers that heal the esophagus (e.g., omeprazole, esomeprazole).
• Prokinetics: Improve stomach emptying (e.g., metoclopramide).

3. Surgery and Other Procedures

• Fundoplication: A surgical procedure where the top of the stomach is wrapped around the LES to strengthen it.
• LINX Device: A ring of magnetic beads placed around the LES to prevent reflux.
• Endoscopic Treatments: Techniques like the Stretta procedure to tighten the LES without surgery.

Complications of Untreated GERD

• Esophagitis: Inflammation and damage to the esophagus.
• Esophageal Strictures: Narrowing of the esophagus due to scar tissue.
• Barrett’s Esophagus: Pre-cancerous changes in the esophageal lining.
• Esophageal Cancer: Long-term GERD increases the risk of esophageal adenocarcinoma.

Note: Early treatment can help manage GERD effectively and prevent permanent complications. If you experience persistent symptoms, consult a specialist for proper diagnosis and care.