What is gastroesophageal reflux disease?
Gastroesophageal reflux disease (GERD) is a digestive disorder where acid from the stomach leaks back into the oesophagus and causes irritation and discomfort. It usually occurs because of weakness in the lower oesophageal sphincter, the ring of muscle between the oesophagus and stomach. If left untreated it can lead to symptoms such as chest pain and trouble with swallowing.
Many people, including pregnant women, suffer from acid reflux that is caused by GERD. The severity of GERD depends on the dysfunction of the sphincter and the type and amount of fluid brought up from the stomach. GERD can be relieved through diet and lifestyle changes but in more severe, persistent cases may require surgery.
What are the symptoms of gastroesophageal reflux?
The symptoms of gastroesophageal reflux may include:
What are the causes?
Gastroesophageal reflux is caused when there is a repeat occurrence of acid reflux. A circular band of muscle (sphincter) around the bottom of the oesophagus usually relaxes to allow food to pass into the stomach. If it becomes weak, the stomach acid can flow back up into the oesophagus. The backwash of acid irritates the lining of the oesophagus, which causes it to become inflamed.
Risk factors that may increase the risk of GERD include obesity, pregnancy and connective tissue disorders, whereas factors such as smoking, eating late at night, or indulging in foods that are fatty and fried can also aggravate acid reflux.
How can it be prevented?
Lifestyle and dietary changes should be implemented. The condition is prevalent in those who are overweight or obese as excess weight puts more pressure on the stomach. It is recommended to steadily lose weight.
You should also recognise which foods and drink trigger flare-ups of GERD. It’s recommended to avoid greasy foods, citrus fruit juices, fizzy drinks, caffeine, onions and alcohol. You can try eating smaller meals and avoid lying down after you have eaten.
Smokers should also consider quitting as it damages the lower oesophageal sphincter, and when these muscles weaken it can lead to more frequent heartburn episodes.
How is gastroesophageal reflux treated?
It may be recommended to first treat symptoms of GERD with over-the-counter medications such as antacids that neutralise the stomach acid. Medications such as H2 receptor blockers reduce acid production. Proton pump inhibitors can block acid production and give the oesophageal time to heal.
If medications do not work in the long term, your specialist may recommend surgery with either of the procedures, fundoplication or LINX device.