Table of Contents
What is GERD, and how to treat it?
Gastroesophageal reflux disease (GERD) occurs when stomach acid flows back into the tube that frequently connects your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the esophageal lining.
Many people suffer from acid reflux on occasion. Mild acid reflux occurring at least twice a week, or moderate to severe acid reflux occurring at least once a week, is classified as GERD.
The majority of people with GERD can manage their symptoms with lifestyle changes and over-the-counter medication. However, some people who suffer from GERD may require stronger medications or surgery to alleviate symptoms.
Symptoms of GERD can cause anxiety. This includes heartburn, chest pain, acid reflux, and coughing up blood. It’s important to understand how to treat this condition as it can lead to many anxiety symptoms if left untreated and an increase in anxiety levels.
Causes of GERD
Acid reflux is a common cause of GERD.
Your lower esophageal sphincter (i.e. the band of muscle that surrounds the bottom of your esophagus) opens when you swallow to allow food and liquid to pass into your stomach. Afterwards, the sphincter is again closed.
Sphincter relaxation or weakening can allow stomach acid to flow back up into the esophagus. As a result of this constant backwash of acid, the lining of your esophagus is often irritated, leading to inflammation.
Common risk factors for GERD
GERD risk factors include the following:
- Overweight and obesity
- Bulging of the stomach’s upper portion into the diaphragm (hiatal hernia)
- Pregnancy
- Scleroderma and other connective tissue disorders
- Constipation
How to treat GERD
Gastroesophageal reflux disease (GERD) can be treated in four ways, including medication and surgery. Patients frequently benefit from a combination of lifestyle changes and medication treatment.
Certain patients do not respond satisfactorily to these treatments and require surgery. Other patients choose surgery over a lifetime of medication.
Lifestyle approaches
The first step in treating GERD is making dietary and lifestyle changes to improve quality of life. Certain foods aggravate reflux. Tips for relieving symptoms include the following:
- If you are overweight, lose weight — this is the most effective lifestyle change you can make.
- Avoid foods and beverages that increase your stomach’s acidity, such as caffeinated beverages.
- Avoid foods that cause the lower esophagus’s pressure to drop, such as high-calorie foods, liquor, and mint.
- Avoid foods that impair peristalsis (muscle contractions in the digestive tract), such as caffeine, booze, and acidic fluids.
- Avoid foods that contribute to sluggish gastric emptying, such as fatty foods.
- Abstain from eating large meals.
- Say goodbye to your smoking.
- Avoid lying down immediately following a meal.
- Raise your head when lying in bed.
Medication for GERD
If lifestyle and dietary modifications are ineffective, your physician may recommend certain medications. There are two types of reflux medications. One lowers the acid level in your stomach, while the other increases the movement of the upper gastrointestinal tract.
Antacids
Antacids sold over the counter are most effective for symptoms of reflux that occur intermittently and infrequently. Antacids may exacerbate the problem if taken frequently. They pass quickly through the stomach, and as a result, your stomach produces more acid.
Histamine antagonists
Histamine 2 (H2) blockers are medications that aid in the reduction of acid secretion. In approximately 50% of patients, H2 blockers heal esophageal erosions.
Inhibitors of the proton pump
Proton pump inhibitors (PPIs) are drugs that inhibit the three main acid production pathways. PPIs are significantly more effective at suppressing acid production than H2 blockers. PPIs effectively treat erosive esophagitis in a large proportion of patients, including those with severe esophageal damage.
Agents prokinetic
Prokinetic agents are medications that stimulate the smooth muscle in the gastrointestinal tract. These medications are less effective than PPIs. They may be prescribed in conjunction with an acid-suppressing medication by your physician.
GERD surgery
If lifestyle changes or medication therapy do not improve your symptoms, you may require surgery. Certain patients prefer surgery over a lifetime of medication. The purpose of reflux surgery is to bolster the anti-reflux barrier.
Your surgeon will wrap the upper portion of your stomach around the lower oesophagus during a procedure called a Nissen fundoplication. The above procedure strengthens the anti-reflux barrier and may result in permanent reflux relief. Your surgeon may perform this procedure laparoscopically, a less invasive technique that requires less recovery time.