Gastroesophageal Reflux Disease(GERD) Definition, Reason, Symptoms, Treatment & Prevention
Understanding
What is GERD? Gastroesophageal reflux disease or GERD is a chronic disease of the digestive system.
This condition occurs when stomach acid returns to the esophagus (gullet). This occurs due to the weakening of the sphincter (valve). This can cause irritation of the esophagus.
Under normal circumstances, food should enter the mouth through the lower esophageal sphincter.
The valve will close tightly when food has entered the stomach to prevent stomach contents from returning to the esophagus.
That’s where food generally lasts 3-4 hours to digest.
However, in cases of GERD disease, there are abnormalities in the form of relaxation (relaxation) or weakness of the lower esophageal sphincter.
As a result, food that has been accommodated in the stomach rises back into the esophagus or it could just be stomach acid.
When stomach acid or food rises back up into the esophagus, sufferers generally experience a burning or burning sensation in the chest.
A person can experience mild gastric GERD at least twice a week.
Meanwhile, GERD conditions are moderate to severe at least 1 time a week.
Disturbances that are quite severe and interfere with activities and sleep can also be an indication of GERD
If GERD is not handled properly, complications can arise that can harm you.
For example, inflammation of the esophagus (esophagitis) which can cause bleeding, sores, ulcers, and scarring of the esophagus.
This scar tissue can make the esophagus narrower which will further interfere with swallowing.
Between 10-15 percent of sufferers of prolonged GERD can trigger more serious health problems.
One of them is Barrett’s esophagus which can become esophageal cancer later in life.
Symptom
GERD usually has symptoms similar to ulcer disease. However, here are some GERD symptoms that you need to be aware of.
- A burning sensation in the chest sometimes radiates to the esophagus. This burning sensation can last up to 2 hours
- Generally, the burning sensation worsens after eating. Lying down can also exacerbate these symptoms
- This sensation can also be accompanied by a sour or bitter taste in the mouth
- Chest pain
- Difficult to swallow
- Sore throat and hoarseness
- Nausea or vomiting
- Bad breath
- Difficulty breathing
- Sensation of a lump in the throat
- Prolonged dry cough
Reason
The cause of GERD is failure to relax the ring (sphincter) whose job it is to regulate the process of opening and closing the door/valve that connects the lower esophagus to the stomach.
The sphincter itself is a ring of muscle fibers located around the inner surface of the body.
Its function is to regulate the passage of substances needed by the body.
Sphincter weakness can occur on its own in pregnant women or people who are obese.
In addition, people with asthma, diabetes, scleroderma, and hiatal hernia are also susceptible to GERD.
There are several foods that can be factors that trigger GERD, including coffee, alcohol, chocolate, fried foods, tomato sauce, and garlic and red onions.
Other things that can also increase the risk of gastroesophageal reflux disease are bad habits that are done consciously or not, such as:
- smoke
- the habit of consuming food within three hours before going to bed
- reduce the portion of food consumed
In addition, taking certain drugs, such as aspirin, can also increase the risk of GERD.
Diagnosis
To diagnose GERD, the doctor will collect information from you as well as several supporting examinations.
1. Checking the Amount of Stomach Acid (Ambulatory Acid (pH) Test)
This examination assesses the amount of stomach acid for 24 hours.
In this way, it will be known how often and how long the process of rising stomach acid is.
2. Barium Meal Radiology
This examination can see the condition of the mucous membranes of the esophagus and stomach.
Before carrying out the radiology process, you will be asked to drink barium liquid. After that then do the photo with X-rays.
3. Endoscopy
Endoscopy uses a camera device that can monitor the situation directly from your esophagus and stomach.
If there are wounds or ulcers, they will be clearly seen through this examination.
4. Esophageal Manometry
Esophageal Manometry is an examination to see how the rhythm of the muscles of the esophagus contract when swallowing.
This examination is carried out to see the continuity of the contractions of your esophageal muscles.
Treatment
Doctors will usually recommend lifestyle modification therapy and the use of over-the-counter drugs.
If within 2 weeks other complaints appear, the doctor may recommend patent drug treatment and surgery.
GERD therapy can be done by taking stomach acid-suppressing drugs, such as omeprazole, lansoprazole, and pantoprazole. This drug is consumed before meals.
In addition, baclofen, a drug to strengthen the sphincter, can also be given. However, these drugs have side effects, such as headaches and nausea.
In addition, drugs can also be given to facilitate the movement of the digestive tract, such as domperidone.
All of these medicines must be consumed under the instructions and prescription of a doctor.
If needed, the doctor will recommend drugs to reduce stomach acid production, known as proton pump inhibitors, and help restore damaged esophageal tissue.
This is done so that GERD does not recur.
If you suspect a GERD disorder, there are several actions you can take, namely:
- Placing the head pillow slightly higher will minimize your symptoms
- Taking over-the-counter stomach medications (antacids). If it doesn’t work, consult a doctor immediately
If GERD still cannot be treated with conventional treatment, then surgery is needed.
The surgical method used aims to strengthen the esophageal sphincter to make it stronger.
There are several methods recommended by doctors.
1. Fundoplication
The surgeon will twist and tighten the lower esophageal sphincter area to prevent reflux from occurring.
This is done with a minimally invasive procedure (laparoscopic).
2. LINX Devices
The doctor will place a small magnetic bracelet around the lower esophageal sphincter and esophagus.
The effect of the magnet is to make the gap between the esophageal sphincter and stomach closed to reflux acid but allows food to pass through the gap.
3. Transoral Incisionless Fundoplication (TIF)
This procedure is performed by tightening the lower esophageal sphincter by creating a pocket around the lower esophagus with polypropylene fasteners.
If you have a large hiatal hernia, TIF alone is not an option. However, it is possible if TIF is combined with laparoscopic hiatal hernia repair.
Prevention
Below are some tips for preventing GERD.
- Avoid eating before bed. It’s best to have your last dinner 3 hours before going to bed
- Also, avoid consuming food and drinks that can trigger GERD. For example spicy, sour, oily foods and soft drinks
- Eat food in small portions
- Stop smoking
- Keep your body weight ideal. If you have a problem with being overweight, follow a healthy diet so you can avoid GERD. If necessary, consult a nutritionist
- Avoid wearing clothes that are too tight. These clothes can put pressure on the stomach and esophageal sphincter, making it easier for GERD to occur