Gerd Be Gone

Gastroesophageal Reflux Disease, or GERD, is the medical term for what most people refer to as acid reflux disease.

Gastroesophageal is a relatively new term for acid reflux disease. It has been used for approximately the past 20 years. Before that it was just referred to as heartburn. But heartburn is just one of the symptoms of GERD. Some of the other symptoms of GERD are regurgitation, hoarseness or laryngitis, the feeling of a lump in the throat, coughing, bad breath, asthma, difficulty swallowing, and water brash. Some people with GERD do not have any symptoms at all.

What happens to cause GERD? It starts with acid in the stomach washing back up into the esophagus repeatedly, which happens if the lower esophageal sphincter becomes relaxed.

Some foods and beverages can cause the lower esophageal sphincter to relax. This is not an all-inclusive list but some of the most common are: chocolate, licorice, peppermint, fatty foods, caffeinated beverages, and alcohol. Barbiturates, calcium-channel blockers, Diazepam and Sumitriptan are some of the medications that cause the lower esophageal sphincter to relax and allow acid back in to the esophagus.

Lifestyle changes can be very effective in helping to control GERD although over- the-counter medications, prescription medications, and possibly surgery, may also be necessary. Some of the lifestyle changes that may help control GERD include: losing weight if you are overweight, avoiding high-fat foods, not lying down right after eating, not eating large heavy meals (i.e. don’t overstuff yourselfespecially on fatty foods), and stopping smoking if you are a smoker.

GERD can be a difficult disease to diagnosis. That is because of the wide range of symptoms people can experience and the complication of some people not experiencing any symptoms at all. It is easier to diagnosis if a person is experiencing the classic symptoms of GERD which are heartburn and regurgitation. In some cases a physician will not do tests right away but will first prescribe over-the-counter or prescription medications to see if they clear up the symptoms.

If the medications do not take care of the symptoms then a physician will likely do one or more of the following diagnostic tests: x-rays with a barium swallow, an upper gastrointestinal x-ray series, an upper endoscopy, an esophageal manometry, or a 24-hour pH probe. The reason physicians may try over-the-counter or prescription medications before running tests is because some of the tests, such as the upper endoscopy and pH probe are invasive, and because of the costs of some of the tests.

After diagnosing GERD, a physician will recommend lifestyle changes such as the ones mentioned earlier in this article to help control the GERD, and depending on the severity will recommend over-the-counter medications or will prescribe a stronger medication by prescription. The medications may need to be continued indefinitely because over half of all people who stop taking their medications after getting their symptoms under control have a recurrence within a year.

If the medications do not alleviate the symptoms, surgery may be needed. Surgery is also an alternative to having to take medications indefinitely. A procedure called a ‘Nissen fundoplication’ is the type of surgery typically done to relieve GERD. In the surgery the upper part of the stomach located near the esophagus, called the ‘fundus,’ is wrapped around the lower esophagus. Doing this strengthens the barrier function of the lower esophagus, thus preventing gastreosophageal reflux and repairing the main irregularity that occurs in people suffering from GERD. The surgery is usually done laparoscopically. It is considered a safe surgery (but remember any surgery carries risks) that typically gives good results.

By: D Ruplinger

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D Ruplinger is a featured writer for www.acidrefluxhq.com. For more information about acid reflux and GERD (Gastroesophageal Reflux Disease) visit www.acidrefluxhq.com

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Gastroesophageal reflux disease (GERD) is a more serious form of gastroesophageal reflux (GER), which is common. GER occurs when the lower esophageal sphincter (LES) opens spontaneously, for varying periods of time, or does not close properly and stomach contents rise up into the esophagus. GER is also called acid reflux or acid regurgitation, because digestive juicescalled acidsrise up with the food.

The esophagus is the tube that carries food from the mouth to the stomach. The LES is a ring of muscle at the bottom of the esophagus that acts like a valve between the esophagus and stomach.

Gastroesophageal reflux disease, or GERD, affects at least an estimated 5% to 7% of the global population – men, women, and children. (Prevalence based on once per day heartburn.) heartburn and/or acid regurgitation experienced weekly has been found to occur in 19.8% of individuals.[1]

Anyone, including infants and children, can have GERD. If not treated, it can lead to more serious health problems. In some cases, you might need medicines or surgery. However, many people can improve their symptoms by
Avoiding alcohol and spicy, fatty or acidic foods that trigger heartburn
Eating smaller meals
Not eating close to bedtime
losing weight if needed
Wearing loose-fitting clothes

What are the symptoms of uncomplicated GERD?
The symptoms of uncomplicated GERD are primarily heartburn, regurgitation, and nausea. Other symptoms occur when there are complications of GERD and will be discussed with the complications.

What causes heartburn and GERD?
To understand gastroesophageal reflux disease or GERD, it is first necessary to understand what causes heartburn. Most people will experience heartburn if the lining of the esophagus comes in contact with too much stomach juice for too long a period of time. This stomach juice consists of acid, digestive enzymes, and other injurious materials. The prolonged contact of acidic stomach juice with the esophageal lining injures the esophagus and produces a burning discomfort.

Pathophysiology
The physiological and anatomical factors that prevent the reflux of gastric juice from the stomach into the esophagus include the following:
The lower esophageal sphincter (LES) must have a normal length and pressure and a normal number of episodes of transient relaxation (relaxation in the absence of swallowing).
The gastroesophageal junction must be located in the abdomen so that the diaphragmatic crura can assist the action of the LES, thus functioning as an extrinsic sphincter. The presence of a hiatal hernia disrupts this synergistic action and can promote reflux.

Complications of Long-Term GERD

If gastroesophageal reflux disease (GERD – also referred to as acid reflux disease) is not treated effectively, the constant acid reflux can irritate the lining of the esophagus, and serious complication can occur.
The more serious complications of GERD that may occur are Barrett’s esophagus, esophageal cancer, laryngeal cancer, erosive esophagitis, and esophageal strictures.

Management of GERD with chest pain
Coronary artery disease should be given ample consideration early in the diagnostic protocol in patients presenting with chest pain because the implications of this diagnosis are more profound than are those of GERD. Patients with unexplained chest pain should be considered to have a cardiac cause for their pain until proven otherwise, and should be evaluated by an ECG and Exercise stress test before a GI evaluation.

By: James Sameul

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Technorati Tags: Acid Reflux, Gastroesophageal Reflux, GERD