What is GERD (Gastroesophageal Reflux Disease)?

GERD is the reflux of stomach contents back into the esophagus (food pipe). This means food, mixed with acid and bile, enters the food pipe, causing irritation of its lining, which gives rise to a variety of symptoms and problems.

What is the difference between Acid Reflux and GERD?

When you have acid reflux once in a while, it’s typically considered a temporary condition. However, when you experience heartburn more than twice a week for several consecutive weeks, it is classified as Gastroesophageal Reflux Disease (GERD). GERD is the chronic, more severe form of acid reflux.

What does Acid Reflux Feel Like?

Common symptoms include:
• A burning sensation in the chest, often called heartburn. This typically occurs after eating and may worsen at night or while lying down.
• Regurgitation: The sensation of acid or sour liquid backing up into your throat or mouth, sometimes producing “wet burps.”
• Upper belly or chest pain.
• Dyspepsia (Indigestion): Can include burping, nausea after eating, or a sensation of stomach fullness/bloating.
• Globus sensation: Feeling like you have a lump in your throat or a feeling of fullness there, often leading to repeated throat clearing.
• Acid reflux chest pain: Pain in the esophagus can be felt in the chest and may not feel like burning. Because the heart and esophagus share nerves, this pain can sometimes mimic a heart attack (a heart attack must always be ruled out first).

Night time/Chronic symptoms may include:
• An ongoing or chronic dry cough.
• Hoarseness (laryngitis) due to inflammation of the vocal cords.
• New or worsening asthma.
• Bad breath when stomach contents wash back up.
• Teeth erosions due to repeated acid exposure.

Why does Acid Reflux/GERD happen?

The problem stems from the Lower Esophageal Sphincter (LES), a muscular valve connecting your esophagus to your stomach. The LES’s job is to keep stomach acid contained. If this valve relaxes or doesn’t close properly, acid can flow backward (reflux) into the esophagus.

What factors contribute to GERD/Acid Reflux?

• Eating very late at night.
• Living a sedentary lifestyle or going to sleep immediately after eating.
• Consuming trigger foods such as spicy foods, excessive ginger/garlic, chocolates, caffeine, tea, coffee, and carbonated/fizzy drinks.
• Smoking and alcohol consumption.
• Being overweight or obese.
• Pregnancy, due to increased abdominal pressure and hormonal changes.
• Delayed stomach emptying (gastroparesis).
• Connective tissue disorders such as rheumatoid arthritis, scleroderma, or lupus.

GERD

How is GERD diagnosed?

A thorough history taken by a doctor is often enough to diagnose GERD. Endoscopy is typically not required for a standard diagnosis but is necessary in cases of atypical presentations (such as chronic cough or sudden-onset asthma) or complications (such as difficulty swallowing). In such complex cases, additional tests like 24-hour pH monitoring and manometry may be performed.

What are the treatment options for GERD?

Lifestyle changes (most effective)

No medicine is as effective as changing your lifestyle. Key changes include:

  • Losing excessive weight and engaging in regular exercise.
  • Eating healthy, steamed, non-fatty food and avoiding non-vegetarian diets.
  • Eating a bland diet and avoiding restaurant/street food as much as possible.
  • Avoiding smoking and alcohol.

Medical treatment

Medical drugs (e.g., those reducing acid secretion or increasing stomach emptying) are useful initially, particularly when symptoms are severe, but are typically prescribed only for a few weeks.

Frequently asked Questions (FAQs)

What is the difference between Acid Reflux and Heartburn?

Acid reflux is when stomach acid flows back into the food pipe (esophagus). Heartburn is the burning feeling in the chest that happens because of acid reflux

Acid reflux vs. Indigestion (Dyspepsia)?

Indigestion (dyspepsia) is a broad term describing general discomfort or pain in the upper belly after eating. Reflux is just one of the many possible causes of indigestion.

Is breathing difficulty a sign of acid reflux?

Yes. If stomach acid travels high enough to reach your airways, it can cause them to contract or narrow. This can lead to shortness of breath or wheezing, which may be mistaken for asthma.

Can GERD present as a heart attack-like scenario?

Yes. It may present with severe chest pain that closely mimics a heart attack. Due to this potential confusion, a heart attack must always be ruled out first by relevant investigations in the hospital. Please visit a doctor immediately if you experience severe chest pain.

When do Acid Reflux Symptoms most often occur?

Symptoms most often happen:

  • After you eat a heavy meal.
  • When you bend over or lift an object.
  • When you’re lying down, especially on your back.
  • In the middle of the night and early morning, especially after a heavy dinner.
What foods can make acid reflux symptoms worse?

To lessen your symptoms, try avoiding:

  • Citrus fruits
  • Chocolate
  • Caffeinated drinks or alcohol
  • Spicy, fatty, or fried foods
  • Garlic and onions
  • Peppermint
  • Tomatoes
What lifestyle habits worsen acid reflux symptoms?

Habits that can make reflux worse include:

  • Eating big meals or lots of fatty foods.
  • Eating late at night.
  • Drinking coffee or alcohol.
  • Smoking.
  • Taking medications that may irritate the stomach, such as aspirin.
  • Wearing tight-fitting clothes.
What health conditions can worsen acid reflux symptoms?
  • Obesity: Extra weight in your belly area puts more pressure on your LES.
  • Hiatal herni: When the top of your stomach bulges up above your diaphragm, squeezing the stomach and causing acid backup.
  • Pregnancy: Increased hormones and pressure from a growing fetus.
  • Connective tissue disorders: Conditions such as scleroderma can damage your esophagus.
What medications can aggravate acid reflux symptoms?

Some medicines can make symptoms worse, often because they relax your LES. They include:

  • Pain killers like aspirin, ibuprofen, and naproxen.
  • Medicines used for high blood pressure.
  • Antidepressants.
  • Benzodiazepines (used to treat anxiety and seizures).
  • Hormone replacement therapy for menopause symptoms.
  • Theophylline, which treats asthma.

Always consult your doctor before stopping or changing any prescribed medication.

What happens if GERD/reflux is left untreated?

Untreated GERD could potentially lead to:

  • Worn tooth enamel: Stomach acid can erode the hard outer layer of your teeth over time.
  • Esophagitis: Irritation and inflammation of the lining of the esophagus.
  • Trouble swallowing: Caused by scarring that narrows your esophagus.
  • Barrett’s esophagus: When normal cells in the esophageal lining are replaced by a different, potentially precancerous type of cell.
  • Esophageal cancer: Years of exposure to stomach acid may cause cancer of the esophagus.
When should I see a doctor for acid reflux symptoms?

Call your doctor right away if you have any “alarming” symptoms:

  • Unexpected weight loss.
  • Blood in your vomit.
  • Black, tarry, or maroon-colored poop.
  • Difficulty or pain with swallowing.

Other symptoms that should prompt a call if they persist or don’t let up include:

  • Asthma-like symptoms, such as wheezing or dry cough.
  • Hoarseness, especially in the morning.
  • Chronic sore throat.
  • Hiccups that don’t let up.
  • Nausea that lasts for more than a day or two.
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