GERD is a digestive disorder that affects the lower esophageal sphincter, which is the ring of muscle between the esophagus and stomach. Gastroesophageal reflux is the backward flow of acids from the stomach into the esophagus. Doctors believe that some people usually suffer due to a condition called hiatal hernia. Pregnant women usually suffer from heartburn or acid indigestion caused by Gastroesophageal Reflux Disease.

The primary goals in the treatment of this disease are relief from symptoms, healing of erosive esophagitis and prevention of complications of esophagitis. The symptoms include heartburn and regurgitation. The setting includes a proton pump inhibitor (PPI). Patients suspected due to GERD with non-cardiac chest pain are recommended to have diagnostic evaluation before institution of therapy. For diagnosing GERD, barium radiographs should not be used.

The other points that must be remembered to diagnose GERD are
1. Endoscopy is recommended only in case of alarming symptoms. Even in typical symptoms, the upper endoscopy is not recommended.
2. For preoperative evaluation, esophageal manometry is recommended, but it has no role in diagnosing GERD.
3. Ambulatory reflux monitoring is a test that can assess association of reflux symptoms.

Management:
The suggested lifestyle modifications for the patients with GERD are

    Weight loss is recommended for patients who are overweight. So, avoid large meals and decrease dietary fat intake.
    Avoid alcohol, chocolate, onions, garlic, acidic foods and peppermint.
    Do not lie down within 3 to 4 hours after meal (recommended for nocturnal GERD patients).
    For symptom relief and to heal erosive esophagitis, a 8-week course of PPIs is the therapy of choice.
    Medications that help in potentiating GERD symptoms, including alpha-adrenergic agonists, nitrates, calcium channel blockers and theophylline should be avoided.
    For patients without diagnostic evaluation, therapy for GERD other than acid suppression, including prokinetic therapy should not be used.
    For patients with partial response to PPI therapy, additional symptom relief can be achieved by increasing the dose twice daily or switching to a different PPI.
    It is recommended to elevate the head of the bed 10 to 20 cm.
    Avoid wearing clothes which are tight around the waist.
    If patients experience heartburn relief, Histamine-receptor antagonists (H2RA) therapy can be used as a maintenance option in patients without erosive disease.

Some surgical options
1. For long-term therapy for patients suffering with GERD, surgical therapy is the best treatment option.
2. In patients who have no evidence of erosive esophagitis, preoperative ambulatory pH monitoring in mandatory.
3. Gastric bypass is the preferred operation for patients who are suffering with obesity and are contemplating surgical therapy for GERD.

Apart from these, there are potential risks that are associated with PPIs such as switching them can be considered in setting of side effects and the therapy can be a risk factor for Clostridium difficile infection.

Management of Gastroesphageal Reflux Disease (GERD)

Gastroesophageal Reflux Disease (GERD) is a form of digestive disorder, which affects the lower oesophageal sphincters or the muscle ring present between the stomach and the food pipe. GERD incorporates the return of the contents of the stomach back to the oesophagus or food pipe. The functioning of the lower oesophageal sphincter is disrupted.

Causes

Hiatal hernia is a common cause of GERD. An unhealthy lifestyle and diet may also lead to GERD. Intake of an excess amount of chocolates, fried food, coffee or alcohol triggers the chance of a reflux. GERD also occurs in obese people and pregnant women.

Symptoms

Heartburn, also known as acid indigestion, is the primary symptom of GERD. The affected person may feel a burning chest pain which starts from behind the breastbone and reaches up to the throat. The feeling can be defined as food coming back to the throat with a bitter, acidic taste. The burning sensation may last as long as two hours.

Other symptoms include:

    Excess saliva secretion
    Chronic conditions of sore throat
    Laryngitis
    Gum inflammation
    Tooth cavities
    Unpleasant breath

In order to diagnose GERD, several tests may be conducted . They are:

    An X-Ray of the upper part of the digestive system.
    Endoscopy to examine the inner part of the oesophagus.
    Ambulatory acid test for monitoring the amount of acid within the oesophagus.
    An oesophageal impedance test to measure substance movement inside the oesophagus.

Treatment

    A person must make several changes to his daily lifestyle and diet plan for treatment of GERD.
    Food and beverages like chocolates, fatty food, coffee, alcohol and peppermint should be avoided in order to reduce the weakening of the lower oesophageal sphincter. Several food items irritate the damaged oesophageal lining and should also be avoided. They include citrus fruits, tomato and pepper.
    Smoking cigarettes results in weakening of the lower oesophageal sphincter and should be stopped to reduce GERD.
    One should elevate the head of the bed on which he or she sleeps on blocks measuring 6 inches. This reduces the heartburn as gravity minimizes stomach reflux to return to the oesophagus.
    Over the counter medicines can be used to cure GERD. Antacids are a good example and neutralize the acid in the oesophagus and stomach, reducing heartburn. Combining antacids with foaming agents is also effective. A foam barrier is formed over the stomach, preventing the occurrence of acid reflux.
    Medicines for reducing acid in the stomach are prescribed in cases of chronic GERD, which include H2 blockers by the likes of cimetidine, famotidine or nizatidine.

GERD is a digestive disorder, which causes disruption in digestion, as reflux from the stomach is returned to the oesophagus. Proper treatment measures should be taken.


Gastroesophageal Reflux Disease (GERD)

Gastroesophageal reflux disease (GERD) is also called as acid reflux. It is a long-term digestive disorder that affects the lower esophageal sphincter, the ring of muscle between the esophagus and stomach which causes the stomach contents to come back up into the esophagus resulting in either symptoms or complications. Gastroesophageal reflux disease is mild acid reflux that occurs at least twice a week or moderate-to-severe acid reflux which occurs at least once a week.

Epidemiology

In western populations, GERD affects approximately 10% to 20% of the population and 0.4% newly develop the condition. In developed nations, the prevalence rate of GERD is associated with age; with adults aged 60 to 70 being the most commonly affected.

Signs and Symptoms

Esophageal symptoms include:

Heartburn
Regurgitation of food or sour liquid
Dysphagia
Sensation of a lump in the throat
Extraesophageal symptoms include:

Coughing and/or wheezing
Hoarseness, sore throat, or 
Otitis media
Noncardiac chest pain
Enamel erosion or other dental manifestations
New or worsening asthma
Disrupted sleep
Risk Factors

Obesity
Pregnancy
Hiatus hernia
Scleroderma and systemic sclerosis
The use of medicines such as prednisolone 
Delayed stomach emptying Zollinger-Ellison syndrome which can show an increase in gastric acidity because of gastrin production
A high blood calcium level which can increase gastrin production, leading to increased acidity
Visceroptosis or Gl nard syndrome, in which the stomach has sunk in the abdomen upsetting the motility and acid secretion of the stomach.
Factors that can increase acid reflux involve:

Smoking habit
Eating heavy meals or eating late at night
Eating fatty or fried foods
Drinking certain beverages, such as alcohol or coffee
Medications, such as aspirin
Tight clothes
Increased intra-abdominal pressure
Differential Diagnosis

Heart disease causing chest pain
Laryngopharyngeal reflux OR extraesophageal reflux disease
Infection
Peptic ulcer
Esophageal spasm
Complications

Narrowing of the esophagus (esophageal stricture): Stomach acid causes the formation of a scar tissue which narrows the food pathway.
An open sore in the esophagus (esophageal ulcer): Acid causes an open sore which bleeds, causes pain, and makes swallowing difficult.
Precancerous changes in the esophagus (Barrett's esophagus): Damage from acid can cause changes in the tissue lining the lower esophagus
Anemia
How to arrive at the diagnosis?

Upper gastrointestinal endoscopy/esophagogastroduodenoscopy
Esophageal manometry
Ambulatory 24-hour pH monitoring
Treatment

The goals of treatment are controlling symptoms, healing esophagitis, and prevention of recurrent esophagitis or other complications. Lifestyle modifications include the following:

Losing weight (if overweight)
Eating small and frequent meals instead of large meals
Waiting 3 hours after a meal to lie down
Elevating the head end of the bed by 8 inches
Avoiding bending or stooping positions
Medications

H2 receptor antagonists (ranitidine, cimetidine)
Proton pump inhibitors (omeprazole, pantoprazole)
Prokinetic agents (aluminum hydroxide)
Antacids (magnesium hydroxide)
Surgery

Transthoracic and transabdominal fundoplication
Placement of a device to augment the lower esophageal sphincter

Gastroesophageal Reflux Disease - What Causes It?

Favorite of most Indian households, ghee is indeed a superfood. Apart from being widely used in Indian cooking, it has also been used as a remedy for cough and cold. Sadly, due to the misconceptions that surround the use of ghee, it is often underutilized. While some are worried that it may make them put on weight, others feel that it is bad for their heart. Little do they know that these misconceptions are not true, and ghee actually has limitless health benefits.

Let us read on to know more about the benefits that ghee has to offer:

Packed with nutrients: Many-a-times, people love the taste of ghee but have strike it off from the diet owing to popular belief that ghee is unhealthy and fattening. However, the opposite of it is actually true and the short-chain fatty acids found in ghee offer several health benefits and keep your gut healthy. Ghee obtained from grass-fed butter consists of fat-soluble vitamins A, D, E, K. Fats present in ghee are free of oxidized cholesterol, trans-fats and hydrogenated oils, thus, the fat present in pure ghee is healthy.
Great for immunity and bone strengthening: Including ghee in your daily breakfast not only boosts your physical and mental strength, but also ensures that your body stays fit and gains the potential to fight against several illnesses. Being a rich source of fat soluble vitamins, ghee supports in the growth and development of bones. It is also known to strengthen your muscles and tendons.
Lowers cholesterol: It is considered as an excellent option for people with high cholesterol levels. Since ghee contains Vitamin K2, it prevents plaque formation in the arteries, which in turn prevents the blockag that may obstruct blood flow and lead to complication. It also increases the level of good cholesterol and lowers the level of bad cholesterol in the blood.
Promotes weight loss: An excellent source of medium chain triglycerides (MCTs), is known to boost the metabolism which in turn promotes weight loss. It also improves digestion, makes you feel full and increases the oxidation of fat; all of which help in reducing weight.
How to differentiate if the ghee is pure or not?

Ghee is stocked in every Indian household, but the thought of whether it is pure or not often crosses our minds. Adulterated ghee may contain vegetable oils and other greasy elements which are bad for your heart and health. So, here are some methods that can help you check the purity of your ghee at home.

Pure ghee normally melts at body temperature. You can check it by putting a spoon of ghee on your palm if it melts then it is pure, if not, it is best to get rid of it.
Pure ghee melts within seconds and turns brown when heated. If the ghee takes longer to melt and appears light yellow in color, it is impure.

It has been established that ghee is indeed good for your health, but only if it is pure. The simple tests mentioned above can help you determine whether the ghee is pure or not. So, eat safe and stay healthy!

Ghee In Your Daily Diet - Did You Know It Has More Benefits Than You Can Think Of?

Gastroesophageal reflux disease or GERD is a chronic condition that can cause discomfort and a burning sensation in the chest. This is caused by stomach acids or bile that flows backward into the food pipe. If this happens more than twice a week, the patient may be diagnosed with GERD. Mild cases of GERD may be treated with lifestyle changes, antacids, diet changes and proton pump inhibitors. In more serious cases, surgery may also be needed. This aims at repairing or replacing the lower esophageal sphincter (LES). This valve is responsible for the backward movement of acids from the stomach to the food pipe.

Types of Surgery for GERD
Surgery is usually the last option for doctors treating GERD. This relieves symptoms of GERD and eliminates the need for long-term medication. There are many different types of surgical treatments. Some of the factors that determine the best type of surgery suited to a patient include the patient s age, weight, overall health etc.

Fundoplication: This surgery focuses on tightening the LES. Fundoplication may be performed as an open surgery or as a laparoscopic surgery. In both cases, the stomach is wrapped around the lower esophagus to reinforce and strengthen the LES. Fundoplication is the most common surgical procedure used to treat GERD and has a high success rate.
Stretta Procedure: This is an outpatient procedure that is performed using an endoscope. The doctor will pass a thin tube with an electrode at one end down the patient s esophagus. The electrode heats the tissue in the esophagus and makes tiny cuts. These cuts will then form scar tissue that strengthens the muscles surrounding the esophagus and blocks acid reflux. This is a fairly new procedure and hence the long-term results are still not clear.
Bard EndoCinch System: This procedure is not very common. It involves the use of an endoscope that is used to make stitches in the esophagus so as to create pleats in the LES. This helps strengthen the valve and prevent acid reflux.
Linx Surgery: This is a minimally invasive surgery where a special device called a linx is wrapped around the LES. A linx can be described as a small ring of magnetic titanium beads. This ring allows food to pass through but otherwise keeps the opening between the esophagus and stomach closed. Linx surgery is a relatively new procedure that has shown good results.
Recovering from Surgery for GERD
Recovering from surgery for GERD depends largely on the type of surgery undergone. Laparoscopic procedures have a short recovery time and are associated with less pain as compared to traditional open surgeries. Open surgery usually takes 2 weeks for full recovery while a patient may recover from laparoscopic surgery within a week.

Surgery For GERD - Types, Results and Recovery

The uneasy feeling in our abdomen, feeling inflated or growing in size is a common problem faced by people anywhere in the world. Medical professionals refer to this as  bloating,' i.e., a feeling of a full, tight, abdomen. The abdominal system includes organs such as the stomach, liver, pancreas, gallbladder, intestines, etc. It is when the gastrointestinal tract is filled with gas, pain due to bloating arises. Such bloating brings pain in different parts of the body (which would be continuously shifting) along with a feeling of a swollen tummy (though not physically swollen actually). 

This article shares the common causes of bloating and tries to help its readers find a solution.

Overeating: Many of us can recall exactly how many times we have ignored the level of consumption in a particular meal and then felt an irritable stomach pain. Overeating refers to the consumption of food more than the amount of energy an organism can produce in one process. Along with weight gain and obesity, bloating might also result from overeating. The fact is, overeating is completely voluntary, and hence, a person can choose to avoid over-consumption of food and thereby, the pain from bloating.
Lactose intolerance: The terminology might not be familiar, yet over 65% of the global population is lactose intolerant. It varies with age and gender, and anyone has either of the four different types of lactose intolerance   primary, secondary, developmental, and congenital. Though lactose intolerance does not cause damage to the gastrointestinal system, inability to digest thesugar in milk (lactose) can cause abdominal pain, bloating, diarrhea, etc.
Irritable bowel syndrome: People with irritable bowel syndrome (IBS) are yet to know what caused it in the first place. Though the exact causes of IBS are yet to be known, many doctors blame the miscommunication between the brain and the intestinal tract of a person which causes abnormal expansion and contraction of the intestinal walls. This results in irritable pain and abnormal bowel movement. 
Two cases might arise due to IBS

The abnormal movement of the intestinal walls might speed up the excretion process and hence, the passage of stool   diarrhea.
The spasms might slow down the excretion process resulting in constipation.
Irritable bowel syndrome (IBS) can occur over the years, and the absolute cure is yet to be found. Additional symptoms of IBS are   bloating and excess gas, pain in the lower belly, mucus in stools, etc.

Solutions to bloating
Bloating can be easily taken care of if the person is ready to implement certain dietary changes. For example, avoiding gassy foods such as cabbage, broccoli, lettuce, reduces the formation of gas in the stomach. Limiting the amount of fatty foods and foods with high fiber content, quitting milk products (if lactose intolerant), can help a lot. A diet plan, getting active and regularly exercising can help to eliminate the problem of gas and bloating.

Conclusion
Even though bloating can be uncomfortable and painful at times, it is not a cause for concern. Bloating can be remedied quite easily with a proper diet chart and routine exercise.

Bloating - Why It Happens?

Don't wait any longer, manage your Gerd Diet online with a Lybrate doctor today

Consult for Gerd Diet - Online and Easy!

FilterClear All

COMMON SPECIALITIES

COMMON ISSUES