When Acid Fights Back: 10 Things You Should Know About GERD
Gastroesophageal reflux disease (GERD) is a common infection in the U.S; affecting approximately one in every five adult men and women; however, many medical professionals don’t recognize this disease. Also, doctors often misunderstand the symptoms. Unfortunately, serious health complications arise if you don’t seek medical attention in due time.
Heartburn is GERD’s most common symptom; however, the disease may be present without exhibiting any apparent symptoms. Heartburn is not specific to GERD since it can occur due to other disorders outside and inside the esophagus. GERD is too often mistreated or self-treated.
GERD is classified as a chronic disease; thus, you must maintain treatment on a regular basis, even after your symptoms disappear. You need to address your issues with lifestyle choices in the quest to render the long-term medication effective. You can only achieve this through continued education and follow-ups with your doctor.
GERD is usually characterized by severe pain that undermines your overall quality of life. Surgical procedures, proper medication and a healthy lifestyle are the most effective methods to treat GERD.
If you experience recurrent, chronic GERD symptoms, you should seek a proper and accurate diagnosis. You should also co-operate with your physician to obtain the most effective medication. Here are some common questions people ask about GERD, along with some helpful answers for you.
1. What is GERD?
Gastro esophageal reflux disease (GERD) is a common disorder. Gastro esophageal affects your stomach and esophagus. Reflux is the back-flow of non-acidic or acidic stomach substances into the esophagus.
GERD is commonly associated with symptoms, irrespective of tissue damage. It results from the continued and prolonged stomach acidic or non-acidic contact with the esophagus lining. Where tissue damage has occurred, an individual is considered to be experiencing erosive or esophagitis GERD. The presence of symptoms lacking tissue damage is referred to as non-erosive GERD.
GERD is accompanied by acid regurgitation and heartburn symptoms. However, your symptoms may never show any presence of GERD. It may only be evident after complications arise.
2. What Causes Acid Reflux?
As food travels down your esophagus, the stomach cells are stimulated, producing pepsin and acid that aid digestion. The lower esophagus band of muscles acts as barrier to prevent your stomach contents from flowing back. Then it relaxes to enable the smooth passage of swallowed foods into your stomach.
Reflux occurs on irregular relaxation of the lower esophagus band of muscles, when it’s weak or when fatally compromised. Delayed stomach pre-emption, stomach distention, hiatal hernia or production of excess stomach acid can trigger reflux occurrence.
3. What Causes GERD?
There exists no single gastro esophageal reflux disease (GERD) known cause. It actually occurs when the esophageal defenses are overcome by the concentrated gastric juices that reflux, causing tissue injury. Nevertheless, most GERD patients testify of minimal to no esophageal damage.
Gastro esophageal reflux is triggered when the esophagus muscle barrier is compromised. Reflux occasionally occurs without the heartburn consequence in individuals without GERD while individuals with GERD experience esophageal tissue damage issues.
Some people suffering from hiatal hernia also have GERD and vice versa. Hiatal hernia results from part of the stomach moving past the diaphragm to the chest area. The diaphragm is the muscle separating your chest from your abdomen. Diaphragm complications prevent the esophagus muscles from effectively managing acid reflux. Hiatal hernia decreases sphincter pressure needed to support the anti-reflux barrier.
Reflux can however occur even when your diaphragm and anti-reflux barrier are functioning normally and intact. The esophagus muscles may relax on the intake of heavy meals, causing distension of your upper stomach; reducing the adequate pressure to prevent reflux. Some patients, anti-reflux tissue may be too weak to inhibit reflux when exposed to increased abdominal pressure.
The severity of GERD depends on the reflux frequency, refluxed material exposure to the esophagus and amount of acid reaching the esophagus.
4. What Are the Common Symptoms of GERD?
Gastroesophageal reflux disease (GERD) symptoms vary between different individuals. Most GERD patients exhibit mild symptoms; with no esophagus tissue damage and minimal complications risk.
Chronic heartburn and acid regurgitation are the most common GERD symptoms. Acid regurgitation is associated with bitter and sour taste.
5. What Are GERD’s Symptoms Besides Heartburn?
There are numerous symptoms associated with GERD, other than heartburn. For instance: pain or difficulty when swallowing, belching and excess saliva. Dysphagia, or the sensation of food in the esophagus, is also a symptom that demands timely medical attention.
Other GERD symptoms include: laryngitis, chronic sore throat, throat clearing, gum inflammation, chronic cough, and teeth enamel erosion. Small acid deposits can reflux into the esophagus or lungs, causing discomfort and irritation.
Morning hoarseness, bad breath, or a sour taste can be symptoms of GERD. Chronic asthma, wheezing, non-cardiac chest pain and coughing may be caused by GERD. People with such symptoms have minimal or no GERD related heartburn issues.
Chest pressure and chest pain may also indicate acid reflux; this discomfort demands urgent medical diagnostics. Possibility of heart conditions needs to be excluded first.
While consulting a medical practitioner, improvement after the immediate proton pump inhibitor trial therapy can be the green light to a GERD infection. This can be further verified by use of pH monitoring, measuring esophagus acid refluxing levels and observing a high larynx.
6. What Is Heartburn?
Most people recognize heartburn as the sensational burn, mid-chest, just behind the breastbone. It often radiates to your throat, causing esophagus acid reflux discomforts. The esophageal lining has much more acid sensitivity as opposed to the stomach. This is the core reason for the burning sensation. People with GERD suffer painful, persistent heartburn that disrupt productivity and can even awake the individuals at night.
7. Is Heartburn Dangerous?
Heartburn is considered a common GERD symptom. Survey shows that 44 percent of all American adults experience heartburn at least once per month. If heartburn persists, an individual’s esophagus lining can suffer significant injuries. This causes ulceration and eventually discomfort or internal bleeding
Stricture, thinning of esophagus by reflux acid resulting to formation of scars, is a consequence of frequent and chronic acid reflux. Individuals with stricture face major difficulties in swallowing food.
Severity, intensity or frequency is not the distinguishing factor between people without or with erosive GERD. However, individuals should consult a physician for advice when signs of a severe condition show up. Such conditions include:
- Frequency of incidences, amounting to more than once per week.
- Increased severity of symptoms over time.
- Night occurrences, waking up you up, causing sleep disturbances.
Typical symptoms such as wheezing, hoarseness, chronic cough or non-cardiac chest pains require prompt evaluation by a medical practitioner for GERD diagnosis. Occasional heartburn that has occurred for several years, or linked dysphagia signals the presence of a severe condition.
Individuals suffering continued chronic heartburn risk serious complications such as a pre-cancerous disease or stricture that entails an esophagus cellular change known as Barrett’s Esophagus.
There are over-the-counter preparations appropriate for treating heartburn. Numerous preparations are readily available with no prescription to diagnose occasional heartburn. They include:
- Antacids: These are taken orally in chewable tablets, liquids and pills form and include sodium bicarbonate, aluminum hydroxide, calcium carbonate and magnesium hydroxide.
- Alginic Acid: Products like Gaviscon, produce a foam barrier to block your reflux.
- Low Dose H2 Blockers: Medications like Pepcid, Zantac, Tagamet and Axid help reduce your acid production. You can buy them over the counter, but higher doses are usually available via a prescription for GERD treatment.
These medications can immediately relieve you of the discomfort you experience from intermittent heartburn, especially if it’s occasionally caused by various activities or foods.
Antacids and alginic acids give you the most rapid relief. The H2 blockers give more sustained relief and are most useful if taken prior to an activity known to bring on heartburn, like eating spicy foods.
Zegerid OTC, Prilosec OTC, and Prevacid twenty-four hour are common proton pump inhibitors (PPIs) currently accessible over-the-counter. These techniques are by far more effective and powerful than the medications listed above. As per recommendation, they should be administered daily for a fortnight; should not be taken without prescription. If symptoms persist or recur after the PPI, please consult a physician.
Over-the-counter solutions however, only offer temporary relief. They are not capable of preventing symptoms recurrence or in any way heal an injured esophagus. Therefore, you should not utilize them regularly to substitute prescribed medicines. They could even be concealing a catastrophic condition. For regular usage, consult your doctor for a diagnosis and the necessary treatment plan to follow.
8. What Are Some Diagnostic Tests for GERD?
The Diagnosis of GERD requires a combination of studying your medical history, as well as through the keen analysis of your complaints to your physician, especially with the typical symptoms. However, if your symptoms are uncommon or your diagnosis requires a confirmation, your doctor will recommend several tests, such as:
- Esophagram – The esophagram is a radiographic technique for studying the esophagus. You will swallow some barium, which is the contrast agent, while the radiologist systematically visualizes and analyzes the stomach and esophagus under fluoroscopy. This test helps detect issues such as esophagus stricture or presence of hiatal hernia. It also gives the esophageal muscle contraction extent.
It can also help determine whether the person has Barrett’s esophagus or esophageal mild inflammation. Moreover, discovery of a normal esophagus doesn’t rule out the possibility of GERD.
- Upper Endoscopy – This test enables real-time visualization of the esophageal and intestine lining by use of the endoscope inserted via the mouth, through the esophagus and stomach, to the small intestine. The direct esophageal lining visualization allows the physician to probe for damages such as esophagitis and ulcers. It also will enable the physician to handle examination of biopsies to determine whether the patient suffers Barrett’s esophagus. Approximately 40 to 60 percent of GERD patients exhibit normal endoscopic examination.
- Esophageal Manometry – The test entails small diameter tubing passed via nose to the esophagus-nose and throat numbed before procedure. Upon tube positioning, the patient is advised to swallow. Esophageal function measurement is achieved by observation of esophagus muscle contraction pressure readings. The pressure of the lower esophageal sphincter can also be quantified.
Esophageal manometry aids physicians in interpreting esophagus motility and probe the lower esophageal sphincter. The test doesn’t confirm presence of GERD, but aids physicians in deriving esophageal motility shortcomings that could be contributing to GERD symptoms.
- Ambulatory 24 Hour pH Probe – The test consists: small tubing inserted via your nose to your esophagus at the anti-reflux level. A pH sensor at the tube’s tip, allowing esophagus acid exposure measurement that is recorded on a portable PC. The pH remains intact for 24 hours; the tube is thereafter removed and the computer results interpreted.
The results are comparative to the normal esophagus acid exposure. This is the standard measurement of the reflux disease. A pH probe is typically ordered in situations whereby the physician is not sure about a patient’s GERD symptoms or if the GERD patient is immune to medical therapy.
Most recently, an esophagus-lining clip has been developed and acts as a special measuring device. With the attached sensor, no nose tubing is needed. The sensor transmits a message to the PC that stores the data on the 24-hour esophageal acid exposure. This data can be printed and further compared with the ideal. The probe slowly detaches from the esophagus, passed via stool and finally discarded.
- Impedance – The impedance test is administered at selected medical facilities. It involves the same pH test procedure; tubing passed via nostril into the esophagus anti-reflux lower muscle. It effectively measures liquid movement originating from the stomach to the esophagus.
The test can be of importance to individuals experiencing reflux symptoms, bile reflux, and no acid reflux and hence have similar results to the pH probe. Twenty-hour impedance test measurement is obtained in same time with the twenty-hour pH probe. Unfortunately, the impedance test is not feasible with the pH device clipped to the esophageal lining.
9. What Can I Do to Treat or Prevent My GERD?
Gastroesophageal reflux disease (GERD) treatment goals include:
- Quelling the symptoms so that you will experience an improved quality of life upon recovery.
- Healing your esophageal inflammation or injuries.
- Preventing or managing complications, such as stricture or Barrett’s esophagus.
- Maintaining GERD symptoms, keeping them in remission so that you can regain a normal life.
Some ways to treat your GERD are as follows:
- Modification of Personal Habits: This amounts to lifestyle changes. Modification involves avoiding the known factors that can trigger your symptoms or even worsen them, such as your daily routine or dietary changes. Though diet doesn’t cause gastroesophageal reflux disease (GERD), reflux heartburn can be catalyzed by foods. Certain treatments can aggravate related symptoms. All medication should be further disclosed to the physician for accurate GERD diagnosis.
Heartburn, the burning chest sensation behind your breastbone, is triggered by the stomach acid that refluxes into your esophagus. Upon noticing this symptom, you and your doctor should probe the habitual causes and work towards its prevention.
- Position: Gravity is the core of reflux control. When people with a weakened lower esophageal sphincter (LES) lie after a heavy meal, the food often returns to the esophagus, causing heartburn discomforts. Individuals should therefor determine when the heartburn occurs: after having a heavy meal, while lying in bed during the night or while taking a nap after a normal meal. An upright posture maintained till the meal digestion completes may significantly reduce heartburn.
When heartburn occurs often at night, you should consider raising the bed’s head or insert a triangular wedge to elevate the esophagus slightly above the stomach. After meal exertion should be avoided at all cost; it exerts pressure on the abdominal muscles, contracts them and thus forces food up the compromised sphincter. This is usually true for activities involving bending such as cleaning the floor or lifting.
Tip: Never lie down within three hours after eating. This’s when your digestive system is at peak acid production; plan early suppers and avoid late night bedtime snacks.
- How You Eat: What is perhaps of more importance than what one ingests? A heavy meal empties the stomach slowly and further exerts pressure on the lower esophageal sphincter. A bedtime snack is sufficient to reflux when the individual lies down. It is ideal to eat dinner early in the evening to ensure that digestion occurs at bedtime. Try eating the main meal in the afternoon and consider having a light supper.
Be sure to eat all of your meals in a stress-free, relaxed environment. Postpone kitchen trips for food fetching or the performance of other activities while eating and for some time after dining. A relaxed, upright posture and lighter meals can together minimize reflux related complications.
Tip: Avoid heavy meals during the day. When possible try taking your main meal during the midday hours instead.
- What You Eat: Certain types of foods restrain your sphincter’s anti-reflux ability and should be avoided before exertion or lying down. However, this differs across individuals. Most people find onions, chocolate and fats particularly risky. Alcohol also causes heartburn by compromising your esophageal anti-reflux muscles, leading to irritation and simulation of stomach acid production.
Common beverages including: caffeinated coffee, decaffeinated coffee, tea, tomato juice, citrus juice and cola aggravate reflux symptoms by esophageal lining irritation or stomach acid simulated production. Other foods bother individuals-scheduling an avoidance period or consequent intake reduction may be beneficial.
Oral medications such as antibiotic tetracycline or potassium supplements can cause irritation if deposited along the esophagus lining. To be assured of safety, medication should be swallowed while in an upright position and washed down with adequate water.
Tip: Individuals should experiment to find out what works best with their respective condition. Consider reducing onions, chocolate and fatty foods.
- Other Factors: Reflux can also be catalyzed by obesity. Excessive abdominal fats pile lots of pressure on the stomach and losing even moderate amounts of weight can make an individual feel more comfortable. Pregnancy, especially in the first three months, is also troubled by heartburn.
Certain hormones are known to weaken your lower esophageal sphincter, resulting to an increasingly packed abdomen that encourages reflux. Typically, if a woman only gains minimal weight, the heartburn is bound to improve immediately after delivery.
Antacids can temporarily reduce heartburn due to the related reactions that neutralize the stomach acid. Numerous over-the-counter medications for reducing acid production can be prescribed for occasional and short-term heartburn relief.
In case heartburn occurs for more than twice a week irrespective of the measures outlined above, one should consider seeking medical attention.
10. What Medications Can I Take to Ease My GERD Symptoms?
Gastro esophageal reflux disease (GERD) medicine classifications include: H2 blockers, proton pump inhibitors and pro-motility agents. Depending on the severity and the symptoms, these medications can be effective in helping you feel more comfortable. They include:
- Promotility Drugs: Promotility drugs are useful to people with mild esophagitis or non-erosive GERD. However, Propulsid has reportedly adverse effects on persons with pre-existing conditions and other known drugs that are cardiac arrhythmias related.
If you are prescribed the drug, Cisapride, you are encouraged to consult your physician to best evaluate use and possible alternatives. You should be sure to promptly reach your healthcare provider for advice.
- H2 Blockers: H2 blockers limit your stomach’s acidity levels. When prescribed, they eliminate reflux symptoms and enable esophageal healing in approximately 50 percentages of victims. Nevertheless, remission is usually maintained on roughly 25 percent of H2 blockers users.
Proton Pump Inhibitors (PPIs): Proton pump inhibitors (PPIs) limit stomach acid secretion. They typically enable quick symptom resolution and esophagus healing in about eighty to ninety percentage of patients. This drug is useful in stricture, a major GERD complication, and diagnosis management.
Upon successful symptoms control, the underlying GERD may still persist later. It is feasible that an individual may need GERD medication for the rest of their life to effectively manage the condition. However, long-term medication should always be under close supervision and directed by a knowledgeable physician. Though side effects are quite rare, any drug can trigger adverse effects.
- Surgery: Surgery is the ideal alternative when long-term medication is undesirable or ineffective, or due to GERD persistent, adverse complications. When weighing on the surgery option, one needs to conduct a thorough review of the related procedures with a gastroenterologist and advise the surgeon accordingly.
- Approximately five to 20 percentages of GERD patients who undergo surgery have side effects, such as belching or vomiting impairment, and swallowing difficulties. Most side-effects are temporary, but some may persist.
Things to Remember
Reflux symptoms can become prolonged, even after surgery, demanding regular anti-reflux medications. Moreover, surgery should not be advised as a cancer-preventing procedure in most cases, but your doctor is the best one to decide. If your GERD and Barrett’s esophagus cancer risk is low, you still should work to prevent acid reflux.
If you are comfortable with PPI therapy, your doctor must monitor and advise you as you progress with your medication. PPIs are not for long term usage, because the longer you use them, the more your body will depend on them. Surgery should only be reserved to unresponsive or intolerant to PPIs or related medications.