What is GERD?

Sometimes on burping we feel an acidic taste in our mouth. What is it? It is a digestive disorder that occurs when acidic juices from the stomach, food and fluids flows back into the tube connecting our mouth and stomach. It can affect people of all ages whether infants or adults. GERD occurs when the sphincter at the bottom of the oesophagus becomes weak, or opens when it should not.  People with asthma are at higher risk of developing GERD. Asthma flare-ups can make the lower oesophageal sphincter relax, allowing stomach contents to flow back, or reflux, into the oesophagus. Acid reflux irritate the airways and lungs worsening asthma. This, in turn, can lead to progressively more serious asthma. GERD can be managed with lifestyle changes and medications. But many a time people with GERD may require stronger medications or surgery to ease the symptoms.

GERD occurs more commonly in people who are:

• overweight or obese because of the increased pressure on the abdomen
• pregnant
• taking certain medications, including some asthma medications, calcium channel blockers, antihistamines, sedatives, and antidepressants
• Smoking, and being exposed to second-hand smoke
• Drinking Alcohol or coffee
• Eating certain kinds of foods like fatty or fried foods may trigger it
• Suffering from Hiatal hernia. It is a condition where an opening in the diaphragm lets the top of the stomach move up into the chest. This lowers the pressure in the oesophageal sphincter and raises the risk of GERD

Symptoms

Common signs and symptoms of GERD include:

• A burning sensation in the chest/heartburn, which might be worse at night
• Chest pain
• Difficulty swallowing
• Regurgitation of food or sour liquid
• Sensation of a lump in your throat
• Chronic sore throat
• Laryngitis or hoarseness
• Inflammation of the gums
• Cavities
• Bad breath

GERD if not treated on time and worsen. It can lead to complications like:

• Oesophagitis:Inflammation of the esophagus.
• Oesophageal stricture: The oesophagus becomes narrow, making it difficult to swallow
• Barrett’s oesophagus: The cells lining the oesophagus can change into cells similar to the lining of the intestine and can develop into cancer.
• Respiratory problems: Sometimes stomach acid can be breathed into the lungs, which can lead to chest congestion, hoarseness, asthma, laryngitis, and pneumonia.

Diagnosis

To diagnose GERD several tests may be used including:

• X-ray of the upper digestive system
• Endoscopy (examines the inside of the esophagus)
• Ambulatory acid (pH) test (monitors the amount of acid in the oesophagus)
• Oesophageal impedance test (measures the movement of substances in the oesophagus)

Treatment & Management

If you have both GERD and asthma, managing your GERD will help control your asthma symptoms.

Lifestyle changes to treat GERD include:

• Elevate the head of the bed 6-8 inches
• Lose weight
• Stop smoking
• Decrease alcohol intake
• Limit meal size, avoid heavy meals and eat slowly
• Do not lie down immediately after eating
• Avoid foods and drinks that trigger reflux like fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine.
• Avoid tight-fitting clothing

Your physician may also recommend medications to treat reflux or relieve symptoms. Over-the-counter antacids and H2 blockers may help decrease the effects of stomach acid. Proton pump inhibitors may be effective in blocking acid production.

In severe and medication intolerant cases, surgery may be recommended. Surgical treatments for the prevention of GERD may include:

• Fundoplication: Here the surgeon sews the top of the stomach around the oesophagus which adds pressure to the lower end of the oesophagus to reduce reflux.
• Endoscopic procedures: To tighten the sphincter muscle stitches are used, and radiofrequency, which uses heat to produce small burns that help tighten the sphincter muscle.