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Acid Reflux (GERD)
- Healthpind Staff
- Reviewed by Dr Singh, J.P. MBBS, MD, DNB
GERD stands for Gastroesophageal reflux disease and is commonly known as acid reflux. In Britain, it is called GORD. When we take food, it goes from the mouth through the esophagus (food pipe) to the stomach. The stomach is a bag-like structure connected to the food pipe on one end and the intestine on the other end. For a short period, the stomach stores food, where it is mixed with acid and enzymes. There is a sphincter at the lower end of the esophagus. Sometimes, the sphincter action is compromised, resulting in acid and food going back into the esophagus. The acid irritates the esophagus, causing inflammation. If this happens repeatedly, it is Acid Reflux (GERD)
Do You Suffer From Acid Reflux?
If you have acid reflux, you will experience the following symptoms:
- Heart Burn: – This is the sensation of burning in the chest, usually at the middle portion behind the breastbone. It is most likely to occur after you eat and may worsen at night or lying down.
- Acid Regurgitation: – Usually, when you burp, you will have an acidic taste in the mouth. It will cause a sour taste in the mouth, which is quite unpleasant.
- Other symptoms you may experience are
•Bad breath.
• A chronic cough.
• Hoarseness of voice.
•Chronic sore throat.
•The difficulty to swallow.
• Chest pain – It is difficult to differentiate between chest pain due to GERD and heart attack. If you experience chest pain, immediately call for medical help.
Causes
Various factors may be responsible, which will cause your lower esophageal sphincter to behave abnormally.
•Obesity – Excess belly fat may increase your chances of having acid reflux. Excess fat puts pressure on the stomach, increasing the tendency to develop a hiatus hernia, which causes acid reflux.
• Hiatus Hernia – It is a condition where a part of the stomach bulges up in the chest cavity through the diaphragm.
• Certain Beverages and Food – Excessive intake of some foods and drinks such as coffee, alcohol, and fat-rich or spicy food increases the risk of developing chronic acid reflux. Other foods that may trigger acid reflux are -tomato sauce, garlic, onion, mint, and soda.
•Smoking – Nicotine present in the smoke irritates various tissues of the body. Smoking decreases the pressure of the lower esophageal sphincter and increases the tendency to strain-induced reflux.
• Pregnancy – A growing fetus will put pressure on your stomach and may cause acid reflux.
• Stress – A state of chronic stress and anxiety puts a strain on your body organs. Scientific studies have shown a positive relationship between acid reflux and psychological stress. Acid reflux increases with an increase in the degree of mental stress.
•Medications Such as NSAIDS – NSAIDS stands for “non-steroidal anti-inflammatory drugs.” They are used as common painkillers and include medicines like ibuprofen, naproxen, and diclofenac. They may weaken the stomach’s protective lining, increasing the risk of acid.
Diagnosis
If you feel you have GERD, you must consult your GP or family physician. He will diagnose the condition with the help of medical history and the detection of typical symptoms. He will prescribe some medication and recommend some lifestyle changes. If still, your health does not improve, he may refer you to a Gastroenterologist to perform specific investigations:
- Gastroesophageal Endoscopy – A gastroenterologist or surgeon will perform an endoscopy in a hospital. An endoscope is a tinny tube with a camera attached to one end. The camera sends a video of your stomach through the optic fiber to the screen, allowing your doctor to visualize the pathology of acid reflux directly. It may also be used to perform a biopsy of esophageal tissue.
- Acid and Impedance Testing – This technique measures the acid (PH) in your food pipe while you perform routine daily activities. It is the most accurate technique for diagnosing acid reflux. In this technique, a doctor inserts a thin tube inside your esophagus with a monitor attached to your body, which measures pH. The tube is removed after 24 hours.
- Bravo Wireless Esophageal PH Test – In this test, a small capsule is inserted during the endoscopy procedure. The capsule transmits data to a pager-sized receptor, which you may wear on your belt.
- Esophageal Manometry – It measures the muscle tone in the esophagus. The doctor will consider doing it if surgery is the treatment option.
- X-ray Imaging – X-ray imaging is done after having a barium meal. It can detect various abnormalities.
Lifestyle Changes and Home Remedies
These will help to control the acid reflux in most of the cases. You must follow these even if you are taking anti-acid reflux medicines.
- Elevate the head end of your bed – raise it about 10 to 20 cm. Elevating your head during sleep will help your chest and head remain above your stomach, preventing acid reflux.
- Eat small meals frequently rather than having large meals at low frequency. This will help your stomach retain food.
- Try to shed some weight – If you are overweight, try to lose fat by regular exercise.
- Abstain from smoking and alcohol abuse.
- Avoid painkillers if taken frequently.
- Don’t eat fatty or spicy foods or foods that trigger acid reflux.
- Have meals about 3 hours before lying down to sleep.
Treatment
Medical Treatment
Over-the-counter drugs:
You can buy these medicines from pharmacies without a doctor’s prescription. These include:
- Antacids – These are medicines that can neutralize the acid. They include medications such as Maalox, Mylanta, and Rolaids. Antacids are the first choice in the case of acid reflux and provide quick relief. However, they may cause side effects, including diarrhea or constipation.
- H2 blockers – They decrease the production of acid in the stomach. Although it may take a longer time to act, the action stays long. They include medicines such as cimetidine ( Tagamet hb), famotidine ( pepad ac), ranitidine ( Zantac 75), and mizatidine (axid ar ).
- Proton Pump Inhibitor – These also lower acid production in the stomach but act in different ways than H2 blockers. It would be best to take them on an empty stomach. These include medicines such as lansoprazole and omeprazole.
Prescription medication:
These are medicines that you cannot buy without a prescription from the doctor. They are:
- Prescription Strength H2 Blockers: The doctor may prescribe Prescription-strength famotidine and ranitidine. Long-term administration may cause side effects like bone fracture and Vitamin b12 deficiency.
- Prescription Strength PPI : These include proton pump inhibitor like esomeprazole, pantoprazole rabeprazole.
- Prokinetics – These are medications that help to empty your stomach quickly. These include bethanechol and metoclopramide. These may cause various side effects, such as nausea, diarrhea, anxiety, and depression.
Surgery
The indication for a surgical procedure is that GERD does not improve with lifestyle changes and medical therapy. The surgery performed is called fundoplication.
Fundoplication – A surgeon performs this procedure under general anesthesia. In this procedure, the stomach’s upper end is stitched around the lower end of the esophagus. It strengthens the lower esophageal sphincter and prevents acid reflux.
Prevention of Gerd
- Relaxation – Try to do yoga or medication to keep away stress and anxiety.
- Avoid Spicy and Fatty Foods
- Exercise Daily – To prevent being overweight.
Q1: How can I stop my GERD?
- Dietary Changes: Avoid trigger foods like spicy, acidic, or fatty meals. Opt for smaller, more frequent meals and try not to eat at least 2-3 hours before bedtime.
- Elevate Your Head: When sleeping, elevate the head end of your bed by about 6 to 8 inches. This helps gravity keep stomach acid from flowing into the esophagus.
- Weight Management: If you’re overweight, losing excess pounds can reduce pressure on your stomach and lessen the severity of GERD.
- Avoid Smoking and Limit Alcohol: Both of them can contribute to GERD symptoms, so minimizing or quitting these habits may help.
- Medications: Over the counter antacids, H2 blockers, or proton pump inhibitors (PPIs) can be considered. However, it’s crucial to consult with a healthcare expert to determine the most appropriate medication for your specific case.
- Regular Exercise: Regular physical activity can aid digestion and contribute to maintaining a healthy weight.
Q2: Does GERD go away by itself?
GERD symptoms vary from person to person, and while some individuals may experience relief through lifestyle changes and medication, GERD itself may not completely “go away” for everyone.
For some people, making dietary and lifestyle modifications can effectively manage symptoms, and they may go long periods without experiencing significant issues. However, it’s important to note that GERD is a chronic condition, and the underlying causes—such as a weakened lower esophageal sphincter or hiatal hernia—may persist.
In some cases, people may find that their symptoms improve with consistent management, while others may require ongoing treatment to control symptoms and prevent complications. Regular follow-ups with a healthcare professional are crucial to monitor the condition and alter the treatment plan as needed.
If you’re experiencing GERD symptoms, it’s best to consult a medical expert for an accurate diagnosis and personalized treatment based on your specific situation.
- PubMed
Smoking and gastro-oesophageal reflux disease - American Academy of Allergy, Asthma & Immunology.
GERD - NHS
Heartburn and acid reflux - U.S. National Library of Medicine
Gastroesophageal reflux disease
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