The prevalence of gastroesophageal reflux disease (GERD) is increasing due to lifestyle habits such as eating, sleeping patterns, and other behaviors. GERD symptoms tend to fluctuate based on these habits, potentially leading to esophageal stricture and, in severe cases, esophageal cancer.
What is GERD?
GERD occurs when stomach acid flows back into the esophagus. Chronic acid reflux can damage the esophagus, causing inflammation, bleeding, and narrowing. Prolonged irritation can lead to changes in the esophageal lining, increasing the risk of esophageal cancer.
Causes of GERD
GERD can result from various factors, including:
- Malfunction of the lower esophageal sphincter, leading to decreased esophageal pressure.
- Alcohol consumption and smoking.
- Certain foods and medications.
- Overweight.
- Stress.
- Abnormal esophageal or gastric motility, increasing acid reflux risk.
Symptoms Indicating GERD
Esophageal and Throat Symptoms:
- Difficulty swallowing or pain during swallowing.
- Sore throat, phlegm in the throat, especially in the morning, or constant throat irritation.
- Chest and epigastric burning pain, sometimes radiating to the neck.
- Frequent burping, nausea, feeling of food or acid backing up into the chest or throat.
- Bitter or sour taste in the mouth or throat.
Non-Esophageal Symptoms:
- Bad breath, tooth sensitivity, or tooth decay.
- Chronic cold, persistent hoarseness or hoarseness in the morning, voice changes.
- Chronic cough, choking on saliva, or nighttime breathing difficulties.
- Worsening or persistent asthma despite medication, chest pain, recurring pneumonia.
Confirming GERD Diagnosis
Gastrointestinal symptoms can be similar across various conditions. For accurate diagnosis, additional tests may be required:
- Esophageal Manometry: Measures esophageal muscle function.
- Esophageal pH Monitoring: Measures acid reflux in the esophagus.
- Gastroscopy: Endoscopic examination of the esophagus and stomach.
Lifestyle Adjustments for Managing GERD
1. Behavioral and Lifestyle Changes:
- Avoid stress.
- Quit smoking.
- Avoid tight clothing, especially around the waist.
- Lose weight if overweight.
- Treat constipation and avoid straining.
- Avoid lying down, exercising, lifting heavy objects, or bending immediately after meals; wait at least 3 hours.
2. Dietary Changes:
- Eat low-fat foods; avoid fried, fatty, and hard-to-digest foods.
- Avoid onions, garlic, tomatoes, fast food, chocolate, nuts, candy, peppermints, butter, eggs, and spicy, sour, salty, or very sweet foods.
- Avoid coffee, tea, soda, energy drinks, and alcoholic beverages.
- Eat moderate portions without overeating.
3. Sleeping Habits:
- Elevate the head of the bed by about 6-10 inches.
Medication for GERD
Approximately 90% of GERD patients can manage their symptoms with medication. It is important to:
- Take medication as prescribed without adjusting the dose or stopping without consulting a doctor.
- Regularly attend follow-up appointments to adjust medication as needed.
- Avoid self-medicating, as some drugs can increase stomach acid production or relax the lower esophageal sphincter.
Surgical Treatment for GERD
Surgery is an option for patients who do not respond to medication or prefer not to take medication long-term. Fundoplication surgery, which corrects the lower esophageal sphincter, addresses the root cause of GERD. Pre-surgical assessments are necessary to determine patient eligibility for the procedure.
