What Is Gastroesophageal Reflux Disease or GERD?

Gastroesophageal Reflux Disease (GERD) is a medical condition where the oesophagal sphincter which functions to prevent the backflow of stomach acid unable to constrict fully hence causing the rise of stomach acid into the oesophagus (the food tube). It is one of the common presentations in the clinic affecting mostly adults of working age and older population. What are the symptoms of GERD? The most presented symptoms of GERD is heartburn especially during the night time or related to meals. GERD patients also often complaining night cough and sleep disturbance as a result of the backflow of stomach acid that got into the trachea (air tube). This causes the irritation of the cell linings of the trachea which induce cough reflex. In the severe form, it can cause aspiration pneumonia which is a lung infection due to stomach acid. GERD patients also will have to prolong sore throat and discomfort due to the chronic effect of the acid towards the oesophagus wall. Are they any risk factors predisposing to have GERD? There are some risk factors which can contribute to the development of GERD. Some can be controlled with changes in lifestyle while others may need intervention in terms of medical or surgical. Common risk factors are pregnancy, obesity/overweight, smoking, drinking alcohol, use of certain medications and hiatus hernia. By knowing the risk factors, the symptoms of GERD can be significantly reduced by tackling the contributing factors while taking medications as well. What if GERD is not treated or controlled? GERD can cause many medical complications if not treated or controlled sufficiently. One of the complications that are often felt by the patients is the inflammation of the oesophagus or oesophagitis. This will further cause stress to the oesophageal wall which in turn lead to other complications such as ulceration of the oesophageal wall, oesophageal stricture, Barret’s oesophagus and oesophageal cancer. Oesophagitis can also cause bleeding of the oesophageal wall which can cause vomiting blood. How is the doctor going to diagnose it? In most cases, GERD can be diagnosed without having to go extensive investigations in the clinic setting. However, depending on the history and the presentation of the patient’s story, the doctor may request several investigations like blood investigations and even scope investigation in a high-risk patient who they deem to have complications of GERD or just to confirm the cause of it.  What are the treatment options for treating GERD? Treating GERD involves patients cooperation in terms of changing their lifestyle and adhering to the medications given. The treatment principles of GERD can be divided into three steps which are conservative, medical and surgical treatments. For conservative management, the patient will be advised to change their lifestyle like stop smoking and drinking, avoid caffeinated drinks, avoid hot and acidic foods, stop eating three hours before sleep, lose weight and sleep with more pillows. Medical treatment means giving the patients the medication to control the symptoms like antacids such as Gaviscon, proton-pump inhibitors (PPI) such as omeprazole and H2-Receptor Antagonist like ranitidine. Surgery is the last option if all efforts failed. The surgery includes bariatric surgery and a procedure called Nissen fundoplication. Medical and surgical intervention have their pros and cons thus the patients are advised to discuss further with their doctors for whichever methods suit them. In summary, GERD is not something that people should look easy at as it can give birth to even serious problem if not treated correctly. Therefore, if you have inquiries regarding this matter, ask questions to doctor near you.

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