Understanding and Managing Gastroesophageal Reflux Disease (GERD): From Lifestyle Changes to Advanced Therapies
Gastroesophageal reflux disease (GERD) is a common ailment with pervasiveness of around 10%-20% in Western countries. This disease can be apparent in diverse symptoms that can be classified into typical, atypical, and extra-esophageal symptoms. The GERD condition in most patients can be successfully managed using medical therapy. However, few patients may require anti-reflux surgery after undergoing an effective pre-operative evaluation.
What is GERD?
Gastroesophageal reflux disease (GERD) refers to symptoms or mucosal damage resultant due to the gastric contents or the abnormal reflux into the esophagus or parts beyond it, the lung, or into the oral cavity. The disease occurs when the stomach acid repeatedly flows back into the tube joining your stomach (esophagus) and mouth. This acid reflux (also called backwash) can inflame your esophagus’ lining.
It is one of the most ordinarily encountered conditions by both gastroenterologists and primary care physicians. Many people may occasionally encounter acid reflux. However, the condition is termed GERD if the acid reflux occurs frequently. Most people can deal with the discomfort due to GERD by incorporating lifestyle changes and effective medications. However, some patients may need to undergo surgery to alleviate their symptoms.
The common GERD risk factors entail excessive body weight (especially obesity), smoking, modest/high alcohol consumption, emotional stress, postprandial and strenuous physical activity, and a dearth of routine physical activity.
Typical gastroesophageal reflux disease symptoms involve heartburn and acid ejection that have low sensitivity for GERD. Atypical symptoms like dyspepsia, epigastric pain, bloating, nausea, and belching may be indicative of GERD. However, they may overlay with other ailments in the differential diagnosis including peptic ulcer, gastritis, achalasia, gastroparesis, and dyspepsia. Other extraesophageal symptoms include asthma, chronic cough, dental erosions, and laryngitis.
Here are a few other gastroesophageal reflux disease symptoms:
- A burning agitation in the chest (heartburn), commonly faced after eating (it may prove to be worse during the night or when lying down)
- Backwash (regurgitation) of sour liquid or food
- Pain in the chest or upper abdominal part
- Swallowing difficulties (dysphagia)
- Agitation of a lump in the throat
Who is prone to GERD disease?
People who are overweight and/or struggling with obesity are more prone to encounter GERD symptoms than those who have a healthy weight. Smokers or people who are intensely exposed to secondhand smoke are also more prone to GERD development. Moreover, it is common for pregnant females to diagnose with GERD symptoms. The team at apollo hospital in Patna can quickly diagnose your GERD symptoms and recommend an effective treatment plan shortly.
Incorporating dietary and lifestyle changes are the foremost step in managing GERD. Traditionally, lifestyle and diet changes encompass head-of-bed elevation, weight loss, prevention of nighttime meals, and exclusion of trigger foods like alcohol, chocolate, and caffeine.
If patients experience nighttime reflux, they must elevate the head of their bed and abstain from recumbency 3 hours postprandially. Despite strictly following lifestyle changes, they are inadequate at alleviating symptoms. Hence, medical therapy becomes inevitable in most cases.
How to alleviate GERD symptoms?
Here are a few suggestions to alleviate GERD symptoms.
- Overweight patients should lose weight
- Stay away from foods that raise the amount of acid in your stomach (for example caffeinated drinks)
- Don’t eat foods that reduce the pressure in your lower esophagus (for example alcohol, fatty foods, and peppermint)
- Don’t eat foods that decelerate gastric emptying (for example fatty foods)
- Don’t eat foods that impact peristalsis (the movement of muscle in your digestive tract) (examples of these foods: alcohol, coffee, and acidic liquids)
- Avoid large meals
- Quit smoking
- Don’t lie down just after a meal
The team of doctors in the best hospital in Patna includes gastroenterologists, thoracic surgeons, nurses, and advanced practitioners who work effectively to relieve your GERD symptoms.
The pillar of gastroesophageal reflux disease treatment is acid suppression. It can be attained with various classes of medications including histamine-receptor antagonists (H2RAs), antacids, or proton-pump inhibitors (PPIs). Studies discovered more comprehensive curing of erosive esophagitis and heartburn with PPIs compared to H2RA.
The PPI therapy is one of the advanced therapies to manage GERD. It is recommended for the diagnosis of GERD with the help of maintenance PPI therapy. However, the patients must make sure to take the lowest effective dose because the more proportion of the dose will worsen the patient’s condition once the therapy discontinues. When undergoing PPI therapy, the patient should take medications 30 – 60 minutes before meals.
If you encounter chronic or daily reflux then surgery may be inevitable. Despite incorporating lifestyle modifications and using powerful anti-reflux medications, certain patients may still experience GERD symptoms. They would need to undergo endoscopy therapy or surgery. Surgical therapy is an effective gastroesophageal reflux disease treatment option for availing of long-term therapy. It has become more prevalent since the inception of laparoscopic anti-reflux surgery. Moreover, the corresponding surgery aims to reinforce the anti-reflux barrier.
Transoral incisionless fundoplication (TIF) is another effective option to treat GERD. It benefits patients with less pain, faster recovery, and shorter treatment duration compared to laparoscopic surgery.
The TIF procedure uses a special TIF device to generate a passageway for a flexible, cylindrical imaging instrument known as an endoscope. This procedure lets the physician use preloaded fasteners and tweezers to repair or replenish the valve that works as a natural barrier to reflux. If there is a need for a procedure to treat GERD, the thoracic surgeons working with the best gastroenterologist in Patna are experienced with minimally invasive anti-reflux surgery.
Determination of symptoms and risk factors is essential for effective treatment of GERD. Incorporating the suggested lifestyle changes can significantly assist in curtailing the adverse effects of this disease. If the lifestyle or dietary changes doesn’t show desired results then the patients can undergo advanced therapies like PPI or endoscopy surgery or TIF procedure as discussed above.