Gastroesophageal Reflux Disease “GERD” is a condition where stomach acid flows back into the esophagus, causing key symptoms such as a burning sensation in the chest and sour or bitter liquid refluxing into the mouth. Chronic acid reflux can lead to pathological changes in the esophagus, including esophagitis, bleeding from the esophagus, and possible narrowing of the lower esophagus. It can also cause changes in the esophageal lining cells, which in severe cases may develop into esophageal cancer.
What are the main causes of acid reflux disease?
This disease can arise from various causes, such as abnormalities of the lower esophageal sphincter, resulting in decreased sphincter pressure or more frequent opening than normal. This can be caused by alcohol consumption, smoking, certain foods and medications, fluid overload, stress, or abnormalities in the motility of the esophagus or stomach, increasing the chance of acid reflux from the stomach into the esophagus.
Symptoms depend on the organs irritated by the acid
1. Throat and esophageal symptoms
- Difficulty swallowing, feeling stuck or like there is a lump in the throat, or painful swallowing
- Sore throat, phlegm in the throat especially in the morning, or constant irritation
- Burning pain in the chest and epigastric area (heartburn), sometimes radiating to the neck
- Frequent burping, nausea, feeling like food or stomach acid is refluxing into the chest or throat
- Feeling a bitter taste of bile or sour acid in the throat or mouth (bile or acid regurgitation)
2. Extra-esophageal symptoms
- Bad breath, tooth sensitivity, or tooth decay
- Chronic rhinitis
- Chronic hoarseness or hoarseness mainly in the morning, or abnormal voice changes
- Chronic cough, feeling of choking on saliva, or nighttime shortness of breath that may cause awakening at night
- Worsening or no improvement of existing asthma symptoms (if any) despite medication, non-cardiac chest pain
- Recurrent pneumonia
Acid reflux… can be treated with these methods
1. Lifestyle modification
- Avoid stress and quit smoking
- Avoid wearing tight or restrictive clothing, especially around the waist
- Try to reduce excess weight
- If constipated, treat it and avoid straining
- Do not lie down, exercise, lift heavy objects, twist, or bend immediately after eating
- Eat low-fat foods, avoid fried foods, fatty foods, hard-to-digest foods, and certain vegetables such as onions, garlic, tomatoes, and fast food
- Avoid foods like chocolate, nuts, candies, peppermint, butter, eggs, milk, or strongly flavored foods such as very spicy, sour, salty, or sweet foods, including certain drinks like coffee, tea, soda, energy drinks, and alcoholic beverages
- Eat moderate portions at each meal; do not overeat
- When sleeping, elevate the head of the bed about 6-10 inches from the flat surface
2. Medication About 90% of GERD patients can control their symptoms with medication
- Take medication regularly as prescribed by the doctor; do not reduce the dose or stop medication on your own. Attend follow-up appointments regularly and continuously for dose adjustment
- Do not self-medicate when ill, as some medications can increase stomach acid secretion or relax the lower esophageal sphincter muscle more
3. Surgical treatment
Currently, medication treatment usually yields good results but requires long-term use, and most patients experience symptom recurrence after stopping medication. Surgery is recommended for patients who have been on medication for a long time but cannot control symptoms or stop medication, patients who cannot tolerate long-term medication due to side effects, young patients who need long-term medication, and patients with severe complications from the disease, especially pediatric patients.
