The number of patients with gastroesophageal reflux disease (GERD) is continuously increasing, often caused by daily lifestyle behaviors including eating habits, sleeping patterns, and various personal habits. This causes GERD symptoms to appear intermittently according to the patient’s lifestyle, which can lead to esophageal stricture fibrosis that may become severe enough to develop into “esophageal cancer”.
Deep insight! What is “Gastroesophageal Reflux Disease”?
Gastroesophageal reflux disease (GERD) is a condition where stomach acid flows back into the esophagus. If this acid reflux condition is left chronic, it can cause damage to the esophagus such as esophagitis, bleeding from the esophagus, and may result in esophageal stricture. Additionally, it increases the risk of cellular changes in the esophageal lining… which can be severe enough to develop into esophageal cancer.
What are the causes of gastroesophageal reflux disease?
This disease can arise from various causes such as abnormalities of the lower esophageal sphincter, causing decreased or more frequent esophageal pressure. This is often due to alcohol consumption, smoking, certain foods and medications, overweight conditions, stress, or abnormalities in the contractions of the esophagus or stomach, increasing the chance of acid reflux from the stomach into the esophagus.
Symptoms indicating… you might have “Gastroesophageal Reflux Disease”
- Throat and esophageal symptoms
- Difficulty swallowing, feeling stuck, like there is a lump in the throat, or painful swallowing
- Sore throat, phlegm in the throat especially in the morning, or constant throat irritation
- Burning pain in the chest and epigastric area, 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 taste in the throat or mouth
- Extra-esophageal symptoms
- Bad breath, tooth sensitivity, or tooth decay
- Chronic cold, chronic hoarseness, hoarseness especially in the morning, or abnormal voice changes
- Chronic cough, feeling of choking on saliva, or shortness of breath at night that may cause awakening in the middle of the night
- Worsening or no improvement of existing asthma symptoms (if any) despite medication, chest pain, recurrent pneumonia
Confirm your symptoms… whether it is “Gastroesophageal Reflux Disease” or not
Because gastrointestinal diseases often have similar symptoms, if you are unsure about your symptoms… you may undergo additional diagnostic tests using these methods!
- Esophageal manometry (measuring esophageal muscle function)
- Esophageal pH monitoring (measuring acid reflux in the esophagus)
- Gastroscopy (endoscopic examination of the esophagus and stomach)
Behavioral modification: the first step in treating “Gastroesophageal Reflux Disease”
- Changing habits and daily lifestyle
- Try to avoid stress
- Quit smoking
- Avoid wearing tight or restrictive clothing, especially around the waist
- Try to lose weight if overweight
- If constipated, treat it and avoid straining
- Avoid lying flat, exercising, lifting heavy objects, twisting or bending immediately after eating, or at least wait 3 hours after meals
- Changing eating habits
- Eat low-fat foods, avoid fried foods, fatty foods, hard-to-digest foods, certain vegetables such as onions, garlic, tomatoes, and fast food
- Avoid foods like chocolate, nuts, peppermints, butter, eggs, milk, or strongly flavored foods such as very spicy, very sour, very salty, very sweet foods, coffee, tea, soft drinks, energy drinks, and alcoholic beverages
- Eat moderate portions at each meal; do not eat until overly full
- Changing sleeping habits
- When sleeping, elevate the head of the bed about 6-10 inches from the flat surface
If treated with medication… follow these guidelines
Because about 90% of patients with GERD symptoms can control their symptoms with medication, correct medication use is important.
- Take medication regularly as prescribed by the doctor. Do not reduce the dose or stop medication on your own. Follow up with the doctor regularly and continuously to adjust the dosage.
- Do not self-medicate when ill, as some medications can increase stomach acid secretion or relax the lower esophageal sphincter muscle more.
Surgery… another option for treating acid reflux
At the beginning of treatment for “Gastroesophageal Reflux Disease”, patients usually choose antacid medication to reduce symptoms. If symptoms do not respond to treatment or if patients do not want to take medication to control symptoms long-term, “esophageal sphincter surgery” is another treatment option for acid reflux… that can address the root cause directly! However, a “test” must be done before the patient undergoes esophageal sphincter surgery.