GERD Essentials

by Michael Sanford

GERD stands for gastroesophageal reflux disease, a clinical condition that occurs when reflux of stomach acid into the esophagus is severe enough to impact the patient's life and/or damage the esophagus. Gastroesophageal refers to the stomach and esophagus while reflux means to flow back or return. You see, when chewed-up food slides down the esophagus or swallowing tube, and into the stomach, there digestive juices begin to break down the food. A special type of muscle called a sphincter connects the esophagus and the stomach. The sphincter works like a gate. It opens up so food can get into the stomach, and then it closes again. This keeps the food and acidic stomach juices from flowing back into the esophagus. However, if the sphincter is weak or opens at the wrong time, there's a problem. Whatever's in the stomach goes the wrong way, which is back up into the esophagus. And because what's in the stomach is high in acid, this can irritate the esophagus. This condition is then called reflux.

GERD affects at least an estimated 5% to 7% of the global population. GERD is most common in adults over age 40 but virtually anyone can get GERD, even infants. Persistent heartburn is the most frequent symptom of GERD. It is an uncomfortable burning sensation behind the breastbone, most commonly occurring after a meal. This condition has nothing to do with the heart, but everything to do with the stomach and the esophagus. Eating too much and going to bed in a very full stomach can cause heartburn in a lot of people. The difference between GERD and heartburn is that GERD is a disease and heartburn is its most common symptom. Almost everyone has experienced heartburn. About 25 million American adults suffer daily from heartburn. Someone who experiences recurring, significant heartburn two or more times a week may have GERD. Frequent heartburn that disrupts one's lifestyle suggests the diagnosis of GERD. Another symptom of GERD is regurgitation. It is a sensation of acid backed up in the esophagus. Early diagnosis of GERD is important to avoid complications in the future. A physician can usually make an easy diagnosis of GERD if the patient finds relief from persistent heartburn and acid regurgitation after taking antacids for short periods. Laboratory or more invasive tests, including endoscopy, barium-swallow radiograph, PH monitor examination, and manometry may be required if the diagnosis is still uncertain. If patients develop persistent GERD with frequent relapses, however, and it remains untreated, serious complications can develop over time. Such complications can include the following: ulcers, severe narrowing of the esophagus, erosion of the lining of the esophagus, precancerous changes in the cells of the esophagus, and problems in other areas, including the teeth, throat, and airways leading to the lungs

There are various methods to effectively treat GERD starting from lifestyle measures to the use of medication or surgical procedures. But initial treatment of GERD is with lifestyle changes. Eating anything within three hours before bedtime should be avoided, stop smoking, avoid fatty foods, decrease portions of food at mealtime, elevating the head of the bed or mattress 6 to 8 inches, and losing weight if overweight. It is essential for individuals who suffer GERD to change their lifestyle, and seek an accurate diagnosis with their physician to receive the most effective treatment available.

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