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Gastroesophageal reflux disease (GERD)

Overview

Gastroesophageal reflux disease (GERD) is a condition where stomach acid or occasionally stomach contents flows back upwards into the food pipe or oesophagus. This can irritate the lining of the oesophagus and lead to various symptoms and complications.

  • Lower oesophageal sphincter (LES) dysfunction: The LES acts as a one-way valve allowing ingested food to go down into the stomach but prevents stomach acid from coming up. A weakened LES can allow stomach contents to reflux upwards.
  • Hiatus hernia: This occurs when the LES is loose and part of the stomach moves up into the chest.
  • Obesity
  • Pregnancy
  • Improper diet and lifestyle: Irregular food timing, fast pace of eating, sleeping immediately after a heavy meal, certain foods such as spicy and fatty food, caffeine, alcohol, and smoking or tobacco chewing can trigger symptoms of GERD.

  • Heartburn (burning sensation in the chest)
  • Regurgitation of food or sour liquid
  • Difficulty swallowing (dysphagia)
  • Chronic dry cough
  • Asthma or worsening of asthma symptoms
  • Recurrent hoarseness or soreness of throat
  • Sensation of a lump in the throat

  • Review of symptoms and medical history: Taken by your gastroenterologist.
  • Physical examination: Examination of your throat and abdomen for any signs of GERD by the doctor.
  • Endoscopy: Upper GI endoscopy is used to make a proper diagnosis of GERD and its complications. In this procedure the gastroenterologist looks inside your food pipe and stomach using a thin, flexible telescope called an endoscope.
  • Oesophageal pH monitoring: This test enables exact diagnosis of GERD.
  • Oesophageal manometry: This test assesses the muscular contractions of the oesophagus.

  • Lifestyle changes: weight loss, eating smaller meals, conducting a lifestyle assessment, avoiding trigger foods, and not lying down after meals.
  • Medications:
    • Antacids: Antacids can be used to neutralise the stomach acid.
    • H2-receptor antagonists: Help reduce acid production.
    • Proton pump inhibitors: These also reduce acid production and are stronger than the H2- receptor antagonists in their action.
  • Advanced endoscopic procedure: Procedures such as endoscopic anti-reflux procedure can be performed by your gastroenterologist. This procedure remodels the disturbed lower oesophageal sphincter making it tight without any surgery or external incision.
  • Surgery: In severe cases, surgical options like fundoplication may be considered for acid reflux treatment.

  • Maintain a healthy weight.
  • Follow a balanced diet and avoid trigger foods.
  • Avoid having heavy and late dinner.
  • Take a walk after dinner.
  • Avoid smoking/chewing tobacco and limit alcohol intake.
  • Elevate the head of the bed if symptoms occur at night.

If you suspect you have GERD or are experiencing persistent symptoms, it is important to consult a healthcare professional for proper diagnosis and treatment.

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