Gastroesophageal Reflux Disease - Symptoms, Causes, Diagnosis, and Treatment

Comprehensive Guide to GERD: Signs, Solutions, and Care

Gastroesophageal reflux disease (GERD) affects around 7.6% to 30% of the Indian population. It is a digestive disorder that occurs when stomach contents and acid flow back into the esophagus. Although people with GERD can live long, untreated cases may lead to esophageal inflammation, ulcers, and a higher risk of esophageal cancer.  

Recognizing the symptoms of gastroesophageal reflux disease, both with or without esophagitis, helps anticipate the need for early intervention and treatment. This guide outlines the symptoms and causes of GERD, its risk factors, diagnostic measures, and various treatment options. 

Table of Contents 

What is Gastroesophageal Reflux Disease? 

Symptoms of Gastroesophageal Reflux Disease 

Causes of Gastroesophageal Reflux Disease 

Diagnosis of Gastroesophageal Reflux Disease 

Treatment of Gastroesophageal Reflux Disease 

Frequently Asked Questions 

What is Gastroesophageal Reflux Disease? 

Gastroesophageal reflux disease (GERD) is a common condition involving the reverse flow of stomach contents into the esophagus, the tube connecting the stomach to the mouth. This gastrointestinal disorder affects the lower esophageal sphincter (LES), a muscular ring that separates the esophagus from the stomach.  

Patients with GERD tend to experience heartburn or acid indigestion. Physicians feel that a hiatal hernia could be a cause of GERD in some patients. Although most are able to control their GERD symptoms by changing their diet and lifestyle, others might need medication or surgery. 

Symptoms of Gastroesophageal Reflux Disease 

The common symptoms of gastroesophageal reflux disease (GERD) are as follows: 

• Severe heartburn 
• Burning sensation in the stomach that may radiate to the chest, neck, and throat 
• A sour or bitter taste that remains in the mouth 
• Regurgitation of liquid or food from the stomach into the mouth 
• The feeling of fullness or lump in the throat (Globus sensation) 
• Coughing 
• Bad breath 
• Hoarseness 
• Trouble swallowing (dysphagia) 
• Pain while swallowing (odynophagia) 
• Occasional bleeding 
• Unintended weight loss 
• Nausea or occasional vomiting 
• Anemia 

Causes of Gastroesophageal Reflux Disease 

The following are the main causes that are responsible for triggering gastroesophageal reflux disease (GERD): 

• Lower Esophageal Sphincter (LES) Dysfunction 

The lower esophageal sphincter (LES) usually keeps stomach contents from flowing back into the esophagus. When this muscle relaxes or becomes weak, acid reflux happens, resulting in GERD. 

• Obesity 

Excess weight, particularly around the abdominal area, puts extra pressure on the stomach, pushing acid into the esophagus. 

• Pregnancy 

Hormonal fluctuations during pregnancy may relax the lower esophageal sphincter (LES), and pressure from the enlarging fetus on the stomach contributes to reflux. 

• Hiatal Hernia 

A situation where a part of the stomach bulges up through the diaphragm and disrupts the usual functioning of the lower esophageal sphincter. This leads to increased stomach acid reflux, which can eventually turn into GERD.  

• Smoking and Alcohol 

Smoking weakens the lower esophageal sphincter (LES), decreases saliva flow (which neutralizes stomach acid), and reduces the clearing of the esophagus while increasing the chances of GERD. Alcohol also hinders the LES and inflames the esophageal mucosa, thus triggering acid reflux. 

• Dietary Habits 

Spicy foods, citrus fruits, chocolates, caffeine, and fatty or fried foods can stimulate GERD. These can cause a temporary loosening of the LES or stimulate the production of acid. 

• Medications 

Certain medications, such as anti-inflammatory agents to treat blood pressure and sedatives, weaken the LES or inflame the esophagus, which can exacerbate the symptoms of GERD. Some medications, such as drugs to treat asthma, sedatives, calcium channel blockers, antihistamines, and antidepressants, also contribute to GERD. 

• Poor Swallowing Function 

As you swallow, the LES should relax to enable food and liquid to enter the stomach and then close tightly. If this does not function properly, stomach acid can flow in the opposite direction, leading to GERD. 
 

Diagnosis of Gastroesophageal Reflux Disease 

Following are the key diagnosis techniques used in Gastroesophageal Reflux Disease (GERD) diagnosis: 

• Medical History and Physical Examination: The physician will discuss your symptoms and lifestyle. A physical test will be conducted to eliminate other conditions that lead to identical symptoms. 
• Esophageal pH and Impedance Monitoring: This test measures the volume of acid in the esophagus and how it changes with different activities, such as sleeping or eating. It assists in determining the severity of acid reflux. 
• Ambulatory 24-Hour pH Probe: A thin tube with a pH sensor at the end is passed through the nose into the esophagus to monitor acid exposure for 24 hours. The information is transmitted to a portable monitor for analysis. 
• Upper GI Endoscopy: A thin, flexible tube with a small camera (endoscope) is placed inside the esophagus to examine the lining for inflammation, ulcers, or other abnormalities. A biopsy can be obtained to eliminate other possibilities. 
• Esophageal Manometry: A thin, flexible tube is inserted through the nose into the esophagus to assess muscle contractions during swallowing and the pressure of the LES. This test evaluates how effectively the esophagus propels food and liquid. 
• Esophageal pH Monitoring: This consists of passing a monitor into the esophagus to measure acid levels over several days, offering precise data about acid reflux patterns. 
• Esophagram: In this test, the patient needs to intake a barium solution. Subsequently, the doctor will perform X-ray images to analyze the shape of the esophagus and check for physical defects such as strictures or hiatal hernias. 
• Bravo Wireless Esophageal pH Monitoring: A small, soft capsule is placed against the lining of the esophagus to monitor acid levels continuously for about 48 hours without wires outside the body. This offers detailed information about reflux patterns. 

Treatment of Gastroesophageal Reflux Disease 

Effective treatment of GERD is a combination of lifestyle changes, medicines, and surgery. Treatment aims to control symptoms, avoid complications, and enhance quality of life. The following is an overview of the main treatment methods: 

Lifestyle Changes 

Establishing healthy lifestyle habits can easily ease GERD symptoms and minimize the recurrence of acid reflux. These simple lifestyle changes encompass the following: 

• Dietary Modifications: Avoid irritant foods, including hot foods, citrus fruits and juices, chocolate, caffeine, and fatty and fried foods. Have smaller but more frequent meals instead of three large ones. 
• Weight Reduction: Maintaining normal weight decreases strain on the stomach, reducing the chances of acid reflux. 
• Quitting Smoking: Smoking deteriorates the function of the lower esophageal sphincter (LES) and distorts acid clearing, exacerbating symptoms of GERD. 
• Lift the Head When Sleeping: Lifting the head of your bed by 6–8 inches may prevent nocturnal reflux, which can trigger GERD. 
• Stress Reduction: Stress tends to aggravate GERD symptoms, so relaxation measures such as deep breathing exercises, yoga, or meditation may be helpful. 

Medications 

When lifestyle modifications fail, medications may be used to control symptoms of GERD by lowering the production of acid in the stomach or enhancing the function of the esophagus. The most common medications are: 

• Proton Pump Inhibitors (PPIs): These are the most potent medications that decrease acid production and allow the esophagus to recover. Omeprazole and esomeprazole are examples of such medications. 
• H2 Receptor Blockers: Drugs such as ranitidine or famotidine decrease the production of acid and relieve heartburn. 
• Antacids: Tums or Maalox, available over-the-counter, neutralize stomach acid to treat symptoms immediately. 
• Prokinetics: These medications enhance the passage of food through the digestive tract and make the LES stronger, although they are less often prescribed. 

Surgery 

Surgery is often considered a last option when other treatments for GERD are unsuccessful. It is usually recommended if GERD leads to complications such as esophageal strictures, ulcers, or Barrett's esophagus. Some of the common surgeries are: 

• Fundoplication: Fundoplication is a surgery that aims to normalize pressure within the lower esophageal sphincter by wrapping the fundus of the stomach around the oesophagus. This is the most frequently performed surgery for GERD. 
• LINX Reflux Management System: A thin, adjustable ring of magnets is wrapped around the LES to help it remain closed while still allowing food to move.  
• Bariatric Surgery: Bariatric surgery is done in order to aid in weight loss and reduce the risk of severe health complications from being overweight. 

GERD is a tenacious ailment that can affect the quality of life if not treated. Early recognition of the symptoms of gastroesophageal reflux disease and proper treatment can control the disease and avert complications.  

Having access to complete healthcare coverage will help you easily meet treatment expenses. Star Health Insurance offers comprehensive health insurance plans that provide peace of mind and protection against financial setbacks while taking care of your well-being.