HEARTBURN/GERD

GERD is a disorder of the digestive system in which the lower esophageal sphincter does not function properly. The sphincter lies between the lower end of the esophagus where it opens into the stomach. This causes the backflow of contents of the stomach into the esophagus which irritates the esophageal lining.

Most of the people try to manage the condition with over-the-counter medications. If left untreated, GERD can cause following complications:

• Barrett esophagus

• Esophageal structure

• Esophageal ulcer

A patient with GERD presents with certain characteristic symptoms:

• A burning sensation in chest after meals.

• The heartburn increases at night

• Chest pain

• Regurgitation of food

• Difficulty swallowing

• Chronic cough

• Laryngitis

• Feeling of a lump in throat

Lower esophageal sphincter only opens to allow the passage of food from esophagus into stomach. It remains closed rest of the time. When the sphincter becomes weak, it remains partially open all the time allowing the gastric contents to flow back into esophagus causing heartburn. There are certain risk factors which increase the risk for GERD development.

• Obesity

• Hiatal hernia

• Pregnancy

• Delayed stomach emptying

• Connective tissue disorders like scleroderma

Apart from risk factors, there are certain factors which aggravate the symptoms of GERD. These include:

• Smoking

• Eating large meals

• Excess coffee, spicy food

• eating late at night

• Eating too much fatty food

• Alcohol abuse

• certain medications like aspirin

A proposed diagnosis of GERD is made on the basis of complete medical history of the patient and his thorough physical examination.

• For a definitive diagnosis, following methods are used:

• Upper endoscopy.

• Ambulatory acid (pH) probe test

• Esophageal manometry

• X-ray of your upper digestive system

The first step in the treatment of GERD involves lifestyle and diet modification. Over-the-counter medications are also used. These medications include:

• Antacids that neutralize stomach acid

• known as H-2-receptor blockers to reduce acid production

• proton pump inhibitors which reduce acid production as well as heals esophageal lining

• the ENDOSOCPY may be needed

Other procedures including surgery are also used as follows:

• Fundoplication

• Stretta