What is the GERD?
GERD is a condition of gastric contents reflux which can irritate the lining of esophagus, causing frequent discomfort, acid indigestion and heartburn and may lead to tissue damage. Reflux does not always cause symptoms and may occur occasionally even in healthy people. GERD is a problem only if it creates severe symptoms or complications and requires lifestyle changes or medical treatment.
Causes of GERD
The role of the lower esophageal sphincter is to function as a barrier to gastric contents reflux. Conditions or substances that interfere with the sphincter’s ability to function properly can predispose a person to GERD. Pregnancy is the most common predisposing condition. The two-thirds of pregnant women are suffering of heartburn, which usually begins during the first trimester.
| Conditions that predispose to GERD | Substances that predispose to GERD |
| Ascites (accumulation of fluid in the abdomen) Delayed gastric emptying Eating large meals Lying down after eating Obesity Pregnancy Hiatal hernia Tight clothes |
Alcohol Caffeine Chocolate Garlic Onions High-fat foods Peppermint and spearmint Anticholinergic agents Antihistamines Calcium channel blockers Diazepam Progesterone Theophylline Tricyclic antidepressants |
Consequences of GERD
If gastric acid remains in the esophagus long enough, may lead to inflammation and lining damage. This condition is called esophagitis. Chronic inflammation will create ulcers and in severe causes even bleeding. Healing the ulcers the inner esophageal diameter may narrow and progressive dysphagia to solid food occurs. If small amounts of gastric content goes into respiratory path pulmonary disease may develop. Chronic unhealed GERD is associated with Barrett’s esophagus. In this condition the damaged esophageal cells are gradually replaced by cells similar to those in gastric or intestinal tissue, a degenerative condition that often leads to esophageal cancer.
Treatment of GERD
Treatment is focused initially to alleviate the symptoms, improving the quality of patient’s life and to heal the damaged tissue. Severe cases may require immediate medication treatment, whereas in mild cases lifestyle changes may be quite enough.
If medication and lifestyle modification are not enough to heal the esophagus, surgery may be required.
Lifestyle changes for GERD
- Avoid lying down after meals. The last meal should be consumed at least two or three hour before bedtime.
- Use an extra pillow in order to keep the head and the upper torso lifted up.
- Consume small and frequent meals (at least 6 per day). Drink liquids between the meals.
- Avoid foods that weaken lower esophageal sphincter pressure or increase gastric aid secretion. (Chocolate, fatty foods, spearmint and peppermint, coffee and tea.
- Avoid smoking and alcohol.
- Avoid tight clothes.
- If obesity is present, weight loss is necessary.
- If inflammation is present avoid foods that may irritate the esophagus lining, such as citrus fruits & juices, tomato and products, spicy foods, pepper, carbonated beverages and very cold or very hot foods.
- Avoid nonsteroidal anti-inflammatory drugs, which can damage the esophageal mucosa.