Acid Reflux and GERD: Everything You Need to Know

By Dr. Ajay Kumar in Institute For Digestive & Liver Diseases

Mar 02 , 2023 | 4 min read

Acid reflux is a condition where the acids from the stomach flow backwards into the throat. GERD, also called gastroesophageal reflux disease (GERD), is a chronic form of acid reflux.Heartburn is a common symptom of GERD.

Symptoms of GERD

Typical symptoms of GERD include heartburn and acid reflux. Reputation people experience hoarseness in the chest and trouble swallowing upon waking up in the morning and having acid reflux. Typical symptoms include:

Breathing difficulty
Chapped throat
Dry cough persistence
Difficulty in swallowing
Sensitive teeth

Treatment of GERD

Antacids help neutralise stomach acids. It is an instant form ofheartburn treatment. Overuse should be avoided.
Medications reduce acid production in the stomach, such asH2 blockers(cimetidine), famotidine (Pepcid AC), and nizatidine (Axid AR). Our long time body can develop substances to H2RA. They can decrease acid production for up to 12 hours.
Medications that reduce acid production and heal the food pipe are known asproton pump inhibitors (PPI).They block the acid for more time while allowing the food pipe to heal. PPI are the drug of choice for GERD.
Prokineticsare another group of drugs whose use is controversial due to serious side effects. They are indicated only in 1/3rd of the patients who have associated features to delayed gastric employing.
GERD in the large number of patients has long term symptoms and patients require maintenance treatment with PPI. while doing this, we would avoid/misuse/overuse/abuse of PPI.

Lifestyle changes for Acid Reflux

Consume meals 2-3 hours before bed. It gives the stomach enough time to burn the food and the acids to settle down.
Consuming small portions is more beneficial than overeating.
Avoid foods that trigger heartburn symptoms, like chocolate, heavy fat, peppermint, pickles, spices, citrus fruits and juices, tea, and coffee, cola drinks.
Quit smoking, as nicotine weakens the lower oesophageal sphincter. This muscle controls the tube opening between the stomach and the food pipe. When this tube is closed, the acids from the stomach cannot move backward.
Avoid alcohol. Alcohol is acidic and can disrupt the acid-base balance in the stomach and causeheartburn.
Keep a record of heartburn. Track how often it occurs and what food triggers it.
Drinking lots of wateris an effective, inexpensiveheartburn remedy.
Raise the bed such that the chest and feet are not in line.You can place 6-inch blocks at the head of the bed. However, avoid pillows as they can make theheartburn treatment worse.
Weight reduction.

Risk factors for acid reflux

Home remedies for acid refluxdo not work in various situations, such as:

Being overweight puts extra pressure on the stomach.
A hernia reduces LES pressure.
Smoking
Drinking alcohol
Pregnancy
Taking medicines that weaken the LES, such as antihistamines, calcium channel blockers, antidepressants, pain relief tablets, and sedatives.

Alcohol and GERD

Alcohol is known to cause GERD in more than one way. Firstly it damages the inner lining of the stomach and throat. Secondly, it is a diuretic, which makes the person want to pee more. This would lead to dehydration which makes the symptoms of acid reflux worse.

Dietary triggers for GERD

Foods that trigger heartburn cause food pipe to relax and delay digestion for longer. This allows food to sit in the stomach for a longer period. Food that is high in fat, salt, or spice is the worst culprit.

Fried food
Pizza
Highly processed food
Cheese
Chilly and pepper powder
Fatty meat

Diagnosing GERD

GERD can be diagnosed through several medical procedures, which have been listed below:

Endoscopy: A thin tube with a camera is passed down the throat to view the stomach and food pipe lining. It can show damage to the walls of the organs.
Ambulatory acid probe test: A monitor is placed to see the time until the acid is produced in the windpipe. This monitor is strapped around the stomach.
All patients of GERD do not require CGI Endoscopy but those with red flag patients undergo it.
Endoscopic treatment of GERD.

Surgery for GERD

This is done when no other form of management helps; when the food pipe is severely irritated, the food pipe becomes narrower, or a change occurs in the food pipe's cells because of the acid reflux. The surgery is called fundoplication. It can be done internally or externally. The surgeon cuts into the abdomen and wraps the top of your stomach around the lower part of your food pipe, sewing it in place. This tightens the food pipe and prevents acid reflux.

Children with GERD

It is observed that approximately one-fourth of children and teenagers have GERD. Some common signs are:

Irritable behaviour after feeding
Gagging
Acid reflux after burping
Fussy after a feeding
Not gaining any weight
Not wanting to eat
Vomiting
Wheezing
Breathing difficulties

GERD and other conditions

Anxiety: It increases the symptoms of GERD and abdominal pain.
Pregnancy:Pregnant women commonly experience GERD symptoms around the first trimester. It worsens in the last trimester. When the baby is born, the symptoms go away. The cause is due to hormonal fluctuation.
Asthma:GERD worsensasthma.The reason is unknown.
IBS: 2 out of 3 people with IBS also have symptoms of GERD. The exact reason is not known. However, both conditions impact segments of the digestive tract.

Complication of GERD

Stomach acid can damage the lining of the food pipe when left untreated. It can cause:

Bleeding
Ulcers
Scarring

The acid also causes changes in the food pipe over time. This is called Barrett’s oesophagus. It increases the risk of cancer, known as adenocarcinoma.

Takeaway

GERD symptoms can impact sleep quality. Long-term lifestyle changes help in reducing some symptoms. However, some people with GERD need medical aid. Doctors can create tailored treatment plans for individuals.