It is a condition in which the contents of stomach reflux backward into the oesophagus. Since the stomach contents are acidic in nature this damages the inner lining of the food pipe.
At the junction of esophagus and stomach there is a muscular gateway (lower esophageal sphincter).Under normal circumstances ,this sphincter remains contracted so that no contents of the stomach can go back into the esophagus but when this sphincter becomes relaxed or weak,it may allow the contents of stomach to flow back into the esophagus causing inflammation of esophageal lining.
CAUSES OF GERD:-
- Functional abnormalities of lower esophageal sphincter-Abnormally weak contraction or relaxation of sphincter increase chances of backflow of stomach contents into the esophagus.
- Hiatus Hernia-A condition in which there is protrusion of the stomach up into the opening normally occupied by the esophagus in the diaphragm.
- Abnormal esophageal contractions-Coordinated esophageal contractions cause the forward movement of food from the esophagus to stomach.When the wave of contraction is defective the refluxed acid is not pushed back into the stomach and cause damage to lining of esophagus.
- Delayed emptying of the stomach-When food remains in the stomach for longer duration this increases the chances of reflux of the stomach contents.
- Dietary habits-fatty and fried food ,chocolates,garlic and onion,coffee,citrus fruits and tomatoes,spicy food,use of alcohol,cigarettes can cause GERD.
- Drugs-calcium channel blockers,antihistamines,nitrates etc. can cause GERD.
- Obesity,Pregnancy,Diabetes,Stress can cause GERD.
SYMPTOMS OF GERD:-
- Heartburn(burning sensation in chest),sometimes spreading to throat,along with a sour taste in mouth
- Chest pain
- Difficulty swallowing(Dysphagia)
- Dry cough
- Hoarseness or sore throat
- Regurgitation of food or sour liquid
- Sensation of lump in the throat
DIAGNOSIS OF GERD:-
- X-RAY of upper digestive system-To check the shape and condition of the stomach,esophagus and upper intestine.
- Passing a flexible tube down the throat(Endoscopy)
- Ambulatory acid probe test-use an acid measuring device to identify when and for how long stomach acid regurgitates into esophagus.
- Esophageal motility test-To measure movement and pressure in the esophagus.
TREATMENT OF GERD:-
- Antacids such as Maalox, Gelucil
- Medications to reduce acid production-H-2 Receptor blockers,these medicines include Cimetidine,Famotidine,Ranitidine etc.
2.Surgical and other procedures-
- Nissen fundoplication-To reinforce the lower esophageal sphincter
- Surgery to create a barrier preventing a backup of stomach acid.
- Stretta procedure-To form scar tissue in the stomach.
- Linx-to strengthen the lower esophageal sphincter.
The best result in GERD treatment can be achieved if the strategic treatment is targeted at the root of GERD as well as the symptoms.