Gastroesophageal Reflux

Definition of Gastroesophageal Reflux

Gastroesophageal reflux disease is also known as GERD, acid reflux or in layman terms this condition is also known as heartburn. Whatever we eat goes from the mouth through esophagus into the stomach. The junction of esophagus and stomach is guarded by a sphincter known as lower esophageal sphincter (LES). This sphincter remains constricted most of the times and opens only when the food has to go from the esophagus into the stomach.

In GERD this sphincter loses its potency to close properly as the food goes down into the stomach. During digestion, stomach produces large amount of acid (HCL) and this acid moves back into the esophagus due to the building pressure inside the stomach. The lining of esophagus is sensitive to the action of acid and gets irritated easily. That’s how the symptoms of GERD appear.


Cause of Gastroesophageal Reflux

Following are the most important causes to how people might develop this condition.

  • Congenital anomalies like hiatal hernias.

  • Obesity.

  • Excessive use of alcohol.

  • Excessive cigarette smoking.

  • Excessive consumption of spicy foods.

  • Excessive consumption of fried foods.

  • Pregnancy.

  • Infection due to H.pylori.

  • Hypercalcemia.

  • Zollinger-Ellison syndrome.

  • Use of certain drugs like antidepressants, beta blockers etc.

  • Lying down immediately after meals.

  • Over eating.


Signs and symptoms of Gastroesophageal Reflux

This condition might manifest itself in the form of following signs and symptoms.

  • Intense pain in the epigastrium especially after consuming food.

  • The pain might radiate to the jaws or the back.

  • A feeling of fullness even after consuming small amount of food.

  • Hiccups.

  • Difficulty in swallowing.

  • Sore throat.

  • Hoarseness of voice.

  • Bad breath.

  • Coughing.

  • Weezing.

  • Worsening of symptoms at night, after meals and lying down.


Risk factors for Gastroesophageal Reflux

Following conditions are considered to be the risk factors for GERD.

  • Obesity.

  • Hiatal hernias.

  • Pregnancy.

  • Alcoholism.

  • Smoking.

  • Eating junk and unhealthy food.

  • Lack of physical activity.

  • People using aforementioned drugs.

Diagnosis of Gastroesophageal Reflux

The diagnosis of this condition is made on the basis of:

  • Complete history.

  • General physical examination.

  • Endoscopy.

Prevention from Gastroesophageal Reflux

  • Certain foods and lifestyle are considered to promote gastroesophageal reflux, however most dietary interventions have little supporting evidence. 
  • Weight loss and elevating the head of the bed are generally useful. 
  • Avoid moderate exercise because it improves symptoms however in those with GERD vigorous exercise may worsen them. 
  • Stopping smoking and not drinking alcohol do not appear to result in significant improvement in symptoms. 
  • Avoidance of specific foods and eating before lying down should only be recommended to those in which they are associated with the symptoms. Foods that have been implicated include: coffee, alcohol, chocolate, fatty foods, acidic foods, and spicy foods

Treatment of Gastroesophageal Reflux

The treatment options for GERD include:

  • Selection of a diet not rich in proteins and fats.

  • Avoiding spicy and fried foods.

  • Adopting healthy lifestyle behaviors like not lying down after eating and regular exercise.

  • Cutting short the use of sodas, colas and caffeinated drinks.

  • Simple home remedies like drinking a glass of water mixed baking soda, eating almonds, licorice etc can also help alleviate the symptoms.

  • A number of herbs have proven to be effective, such as:

    • Ginger.

    • Garlic.

    • St. John wort.

    • Fennel seeds.

  • Medicines include PPI, antacids, bismuth colloids, H2 receptor blockers.

  • Surgery might be needed in case of hernias.