Gastro Esophageal Reflux Disease (GERD)

What is gastro esophageal reflux disease (GERD)?

GERD is a condition whereby pure acid reflux flows back into the esophagus from the stomach when patients are asleep. This occurs due to a weak muscle at the lower end of the esophagus that is normally tight enough to prevent stomach acid from flowing back into the lower esophagus. This causes an irritation of the lining of the lower esophagus.

This can turn into a condition called chronic esophagitis which usually develops in the lower area of the esophagus, where the concentration of acid is the highest. A break down of tissue in one spot in the lower esophagus can lead to an esophageal ulcer, which causes similar pain as stomach or duodenal ulcers.

Over several years, chronic esophagitis leads to scarring of the underlying connective tissue of the esophagus until an esophageal stricture (narrowing of the opening of the esophagus) develops. This makes the esophagus even more vulnerable to chronic irritation as on top of the acid irritation the body forces food through with higher pressures and friction irritating the lining of the lower esophagus even more. After decades of that abuse the esophagus develops highly abnormal cells in its lining right there where the highest irritation has been. This precancerous condition is called Barrett’s esophagus (also Barrett’s syndrome, Barrett’s dysplasia or metaplasia). If this is missed, and further chronic irritation occurs, a high percentage of cases will develop cancer of the esophagus.

What are the signs and symptoms of GERD?

The key symptom of acid reflux or GERD is heart burn. There may be regurgitation of acid content into the mouth, but the acid may never reach that high and only reach up to the lower third of the esophagus. With an acute esophagitis a burst blood vessel can cause profuse bleeding, which may be vomited up or swallowed. The vomited material is mostly blood while swallowed blood is being digested and leads to melena (black stools).

Most of the time the disease is not that dramatic. Apart from heart burn there might be a pain with swallowing solid foods, but not so much with swallowing drinks. When stricture develops, there might ray ban sunglasses be a stinging pain right after a swallow, then there is relief as the food passes through. With an esophageal ulcer there is a sharp stinging pain in the lower part of the chest bone or higher right behind the center of the chest bone.

How is GERD diagnosed?

The patient’s history often suggests the diagnosis. Endoscopic procedures are the most often used techniques to make a diagnosis.

How is GERD treated?

GERD is treated with a combination of the following steps:

• Avoid acid producing drinks like coffee, alcohol, cola drinks etc.
• Avoid certain foods such as chocolates and fast.
• Smoking has to be stopped,
• Avoid certain anticholinergic drugs.
• Elevate the head of your bed about 6 inches.
• Use a cheap MLB Jerseys liquid antacid: 1-2 tablespoons 1 hour after each meal and at bedtime in order to neutralize the acidity of the stomach juice. Common brand names of liquid antacids are: Diovol, Maalox and Mylanta.
• The doctor will order an H2- blocker to suppress acid production of the stomach lining. Commonly prescribed H2-blockers are: Ranitidine (Zantac, Nu-Ranit, Gen-Ranitidine, Alti-Ranitidine, Novo-Ranidine, Apo-Ranitidine).
• The doctor may decide to also prescribe medication with the intent to improve the lower esophageal sphincter.

Apart from regular drugs as explained, there is an FDA-approved non-drug method available, IceWave patches from Lifewave, which can be used to control pain.

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