GERD

GERD Overview:

GERD, also known as acid reflux, is an acronym that stands for Gastroesophageal reflux disease.

It is a chronic illness that affects 5-7% of the world population and is associated with serious medical complications if untreated.

It is a condition in which the liquid content of the stomach regurgitates (backs up, or refluxes) into the esophagus. The liquid can inflame and damage the lining of the esophagus although this occurs in a minority of patients.

The regurgitated liquid usually contains acid and pepsin that are produced by the stomach. (Pepsin is an enzyme that begins the digestion of proteins in the stomach.) The refluxed liquid also may contain bile that has backed-up into the stomach from the duodenum.

(The duodenum is the first part of the small intestine that attaches to the stomach.) Acid is believed to be the most injurious component of the refluxed liquid.

Pepsin and bile also may injure the esophagus, but their role in the production of esophageal inflammation and damage (esophagitis) is not as clear as the role of acid.

GERD Symptoms:

Persistent heartburn is the most frequent, but not the only GERD symptom. (The disease may be present even without apparent GERD symptoms.)

Heartburn is so common that it often is not associated with a serious disease, like GERD.

Sometimes GERD can cause serious complications including inflammation of the esophagus from stomach acid that causes bleeding or ulcers. In a relatively small number of patients, GERD has been reported to result in a condition called Barrett's esophagus, which over time can lead to cancer.

GERD describes a backflow of acid from the stomach into the esophagus. Most patients with GERD experience an increase in the severity of GERD symptoms (usually heartburn or coughing and choking) while sleeping or attempting to sleep.

If the acid backs up as far as the throat and larynx, the sleeper will wake up coughing and choking. If the acid only backs up as far as the esophagus the GERD symptom is usually experienced as heartburn.

Other GERD symptoms may include nausea, burping, coughing, a sour taste in the mouth, and respiratory conditions such as asthma, pneumonia and chronic bronchitis.

Causes Of GERD:

Causes of GERD include age, diet, alcohol use, smoking, pregnancy and obesity. Also, certain foods associated with reflux events include spicy foods, garlic and onions, citrus fruits, drinks with caffeine, chocolate, fatty and fried foods, mint flavorings and tomato-based foods, like spaghetti sauce, chili, and pizza.

GERD - Risk factors

Conditions that cause difficulty with digestion can increase the risk of heartburn or GERD. These include:

• Obesity. Excess weight puts extra pressure on your stomach and diaphragm, forcing open the lower esophageal sphincter and allowing stomach acids to back up into your esophagus. Eating very large meals or meals high in fat may cause similar effects.
• Pregnancy. Pregnancy results in greater pressure on the stomach and a higher production of the hormone progesterone. This hormone relaxes many of your muscles, including the lower esophageal sphincter.
• Peptic ulcer. An open sore or scar near the valve in the stomach that controls the flow of food into the small intestine can keep this valve from working properly or can obstruct the release of food from the stomach. Food doesn't empty from your stomach as fast as it should, causing stomach acid to build up and back up into your esophagus.
• Delayed stomach emptying. In addition to diabetes or an ulcer, abnormal nerve or muscle functions can delay emptying of your stomach, causing acid backup into the esophagus.
• Asthma. Some asthma medications that widen (dilate) airways may also relax the lower esophageal sphincter and allow reflux. The acid reflux that causes heartburn may worsen asthma symptoms. For example, you may inhale small amounts of the digestive juices from your esophagus and pharynx, damaging lung airways.
• Diabetes. One of the many complications of diabetes is gastroparesis, a disorder in which your stomach takes too long to empty.

When To Seek Medical Care:

Most problems with heartburn are fleeting and mild. But if you have severe or frequent discomfort, you may be developing complications that need more intensive medical treatment and prescription medications. Talk to your doctor if you have:

• Heartburn that returns soon after your antacid wears off
• Heartburn that wakes you up at night
• Heartburn several times a week