Acid Reflux Disease (GERD)
Countless people in the world are suffering from acid reflux disease but still people are not known about the exact symptoms, causes and treatment of this disease. Acid reflux action is a never ending disease. Once it is started it never ends for rest of the life but do not worry one can reduce the harmful effects of this disease if you about it so let’s start the journey of knowing about acid reflux disease from here.
Acid reflux disease
Acid reflux disease is also known as Gastroesophageal reflux disease (GERD). It is a condition in which the liquid substance of stomach flows back in to the esophagus. This liquid can damage the lining of esophagus but the signs of inflammation occur in a small number of patients. The liquid which flows back consists of acid and pepsin that are produced in the stomach. Pepsin is an enzyme that helps in the digestion of proteins in the stomach. The reflux liquid may also contain bile in it. Acid is the most injurious substance of reflux liquid as compare to bile and pepsin. If there is an injury in the lining of oesophagus it is also a dangerous situation. After the oesophagus is healed the injury returns in the patients with in few months.The reflux of the stomach liquid occurs in the normal people too but it occurs more frequently in the patients with this disease. The only difference is that the reflux liquid of patients is more acidic in nature than the normal patients.
Human body has many ways to protect itself from harmful effects of reflux and acid as well. Most of time the reflux occurs during day time and people are upright at day time so the reflux flows back to the stomach. When the humans are awake they intentionally or unintentionally swallow back the reflux when it comes to their esophagus. The saliva of our mouth contains bicarbonate in it. When people swallow the saliva the bicarbonates from the saliva also helps in neutralizing the acidity of the reflux.
Gravity, swallowing and saliva are most effective ways to protect the working of esophagus but they are effective only when the person is in upright position. When a person is sleeping the gravity does not work at that time, the swallowing process becomes difficult and the secretions of the saliva are reduced. So the remains of the acid stay for longer time in the esophagus and it causes damage to the esophagus.
Causes of GERD
There are different causes of GERD which includes lower esophageal sphincter, hiatal hernias and esophageal contractions.
1. Lower esophageal sphincter
Lower esophageal sphincter is an important factor that prevents the reflux. Esophagus is the muscular tube that goes from lower throat to the stomach. The patients of GERD have different abnormalities of the LES like weak contraction of LES and abnormal relaxation of LES. Weak contraction of LES reduces the ability to block the reflux. The abnormal relaxation allows reflux to happen more easily.
2. Hiatal hernia
Hiatal hernias also add to reflux. This is not necessary that every patient has GERD due to the hiatal hernia but most of them have GERD due to hiatal hernia.
3. Esophageal contractions
Swallows are important part in reducing the acidity in the esophagus swallowing cause contractions in the muscle of esophagus. This contraction starts in the upper esophagus and ends in the lower esophagus. It pushes food particles, saliva in to the stomach that comes to the esophagus.
When the wave of contractions is damaged the reflux is not pushed back in to the stomach which results in causing GERD.
Symptoms of GERD
The symptoms of GERD are heartburn, nausea and regurgitation.
1. Heartburn
When acid refluxes back in to the esophagus in patients with GERD heart burn is most common symptom. Heart burn is the pain in the middle of the chest. This pain may extend up to the stomach, neck or back. Heart pain can be dull or sharp.
Heartburn, acid reflux is more common after meals. Heart pain is also felt when the people lie down as the effect of gravity reduces, action of saliva also reduces when a person is lying.
2. Nausea
Nausea is also a symptom of GERD. Nausea can be severe or it can also result in vomiting. When a person feels nausea constantly, He must go for a GERD test.
3. Regurgitation
Regurgitation is the emergence of refluxed liquid in the mouth. In some patients of GERD, they get a little amount of reflux liquid in their lower esophagus and in some patients refluxed liquid reaches to their upper esophagus. The upper end of esophagus is known as upper esophageal sphincter. The lower end of the esophagus is known as lower esophageal sphincter. The functions of upper esophageal sphincter are very similar to lower esophageal sphincter. The upper esophageal sphincter helps to block the esophageal content to flow back in to the throat. Recurrent and extended regurgitation can cause acid induced erosion of the teeth.
Complications of GERD
The complications that can occur due to GERD can be
- Ulcers
- Cough and asthma
- Inflammation of throat
- Inflammation of larynx
- Inflammation and infection of lungs
Diagnosis of GERD
GERD can be diagnosed in the following ways:
1. Endoscopy
2. Biopsy
3. X-ray
4. Examination of throat and larynx
5. Esophagul acid testing
1. Endoscopy
In endoscopy a tube like structure is swallowed and it examines the lining of esophagus, stomach as the tube passes down inside the body.
2. Biopsy
Biopsy is done for the patients of GERD whose disease is not diagnosed by an endoscopy.
3. X-rays
Before the beginning of endoscopy, an x-ray was used to diagnose GERD. The xray of esophagus is known as esophgram.
4. Examination of throat and larynx
In a patient of GERD the larynx and throat causes symptoms like cough, sore throat. When the patient visits ENT specialist the doctor refers for the tests of GERD TO CONFIRM GERD.
5. Esophageal acid testing
This is the main test for GERD. The doctor asks about the time of reflux a person has during a day. Ph testing of the acid is also done to diagnose the GERD.
Treatment of GERD
Treatment of GERD can be done as follows:
1. Change in lifestyle
The first and foremost treatment of GERD is considered as a change in the life style of patients. It can be combination of different habits.
The reflux occurs mostly at the night time when a person is lying while sleeping. So a person sleep with upper body in a wedge shape or by putting blocks under the bed at the head side. So the esophagus does not store the reflux.
2. GERD diet
Changes in eating habits are good for treating the acid reflux. Following things should be avoided as they cause acidity in the stomach including:
- Chocolate
- Alcohol
- Pepper mint
- Caffeine
- Coffee
- Smoking
3. Use of drugs
The disease of reflux acid is largely reduced with the help of medicines like medicines that contain aluminum, magnesium and calcium in it as it absorbs the releases of gastrin from the stomach that prevent the reflux acid.
Another drug that neutralizes the acid from the stomach is Histamine antagonists. Its action is for a short time. The patient is required to take the medicine after an every hour.
Proton pump inhibitors and pro- motility drugs are another type of drug developed for acid related diseases.
4. Foam barriers
Foam barriers are unique type of medicines that are made up of foam and acid neutralizing agents. This medicine is taken after meal. This medicine converts in to foam when it goes inside the stomach. The foam floats on the top of liquid preventing reflux to go back meanwhile the neutralizing agent acts to reduce the acidity from the liquid.
5. Surgery
Sometimes when the drugs are not effective then surgery called reflux surgery or anti reflux surgery is done for the treatment of GERD.
6. Endoscopy
Recently a new treatment is introduced which is done by endoscopy in which the lower esophagus is stitched that tightens the esophagus. It prevents the backflow of reflux.
If patients take this disease non-seriously. It will make your life dull and problematic. This disease can also lead to the cancer of esophagus, stomach etc. so if you feel any of symptoms of GERD. Do not wait to consult a doctor.
