Gastroesophageal Reflux Disease Too Much Acidity

What is Gastroesophageal Reflux Disease?
Doctors call it Gastroesophageal Reflux Disease (GERD). Millions of people call it heartburn, and many others have coughing, hoarseness, wheezing problems without even realizing that GERD is to blame. By the name, GERD is familiar, bothersome and sometimes serious. A community based study in southern India stated that out of 6,147 people (3,157 urban, 2,599 male) , 8.2% had GERD. The prevalence was higher in urban areas (11.1%) as compared to rural areas (5.1%).

What is the main cause of gastroesophageal reflux disease?
A complex set of muscles in the mouth and tongue get the process started. These muscles close off the windpipe (trachea) in order to protect the lung, and then move food into the esophagus or food pipe, a tube that carries the food from the mouth to the stomach. The food does not just slide down the esophagus but also, the muscles that encircle the food pipe contract in an orderly, wave-like fashion to propel food into the stomach. Swallowing is normally a one-way event. In order to prevent the food from returning to the esophagus, the ring-like muscles of the lower esophagus closes the tube. These muscles are called as the Lower Esophageal Sphincter (LES) Gastroesophageal Reflux (GER) usually happens when LES does not close properly. This permits the stomach contents to reflux into the esophagus. Prolonged exposure of the esophageal lining to acid, damages it and results in GERD. This can lead to a burning sensation in the chest or throat, called Cardiac Risk Markers Test . Due to reflux into the esophagus, sometimes the stomach fluid can be tasted in the back of the mouth.

Who is most likely to suffer from gastroesophageal reflux disease?
Pregnant Women
GERD and Pregnancy go hand in hand. Most of the women experience heartburn or acid reflux during pregnancy. After a long tiring day or maybe feeling nauseous, they_ lie down and it hits them- a sour_ taste in their mouth and a strange burning sensation in their chest. A study conducted on 400 pregnant women revealed that the prevalence of GERD during 1st, 2nd, and 3rd trimester was 9.5%, 43.1% and 54.1% respectively. For pregnant women, it is usually not hard to figure out what is actually triggering the condition. The baby is growing and crowding the abdominal cavity, which eventually pushes stomach acid up into the esophagus. Once the birth is given, this gradually fades away

Babies
Sometimes, most babies spit up several times a day and that is normal. But when this causes other problems or comes with some symptoms, then it may be due to GERD. Most infants with GER are healthy, it is just that parts of their digestive systems are not yet fully mature. Babies usually grow out of GER by the time they are one year old. GERD may seem like an adult issue, but it can happen to infants and children too. Symptoms like vomiting, coughing, refusing to eat or trouble eating, crying during or after feeding, gas, belly pain etc, can be seen, which sometimes need medical attention in severe cases.

Insights to Genetics
Studies have shown that there is a genetic link to GERD. The association of GERD within families could be due to inherited genes or due to their shared environment that contains GERD promoting factors. Identical twins were approximately twice as likely to share symptoms of GERD than fraternal twins. This explains that inherited genes are the main culprit in the development of GERD.

What are the risk factors for GERD?
Obesity
Bulging at the top of the stomach up to the chest (hiatal hernia)
Pregnancy
Connective tissue disorders (scleroderma)
Delayed stomach emptying
Eating fried food, large meals or eating late at night
Drinking alcohol or excess coffee
Smoking

Common signs and symptoms of GERD include:
Heartburn
Chest pain
Difficulty in swallowing
Regurgitation (bringing back the swallowed food into the mouth) of food or sour liquid
Sensation of a lump in throat
Persistent coughing
Wheezing, asthma

What tests are done to diagnose GERD?
Esophageal Manometry Checks the function and movement of the esophagus and LES
pH Monitoring Checks for acid in esophagus.
Upper Endoscopy and Biopsy Checks for problems in esophagus or stomach. This test involves inserting a long, flexible, lighted tube with a camera down the throat. It also allows biopsies of suspicious lesions.
Esophagram Checks for ulcers or narrowing of esophagus.

What is the most effective treatment for GERD?
The mainstay of managing GERD is use of acid suppressors such as Proton-pump Inhibitors (PPIs), Antacids and H2 blockers.

Although GERD limits productivity and daily activities, it is rarely lifethreatening. With an understanding of causes, timely treatment, and lifestyle modifications, most people will definitely find relief.

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