Acid reflux can happen to anyone at any time. However, if it occurs again and again, then you may be suffering from a condition known as Gastroesophageal Reflux Disease (GERD). There are various ways to treat GERD (https://gastrohealth.com.sg/condition/gastroesophageal-reflex-diesease-gerd/). You may find the different treatment in this article along as other important information about this condition. Mainly, the following topics will be discussed:
- What is GERD?
- What are the symptoms of GERD?
iii. Who can get GERD?
- What are the treatments available for GERD?
- What can happen if GERD remains untreated?
What is GERD?
Gastroesophaegal reflux disease (GERD) happens when the stomach’s acid rolls back up to the ring of muscle, called the lower esophageal sphincter (LES), located in the middle of the esophagus and stomach. An acid reflux occurs when the lower esophageal sphincter is unable to close properly when food reaches the stomach. As a result, a backwash of stomach acid leaks back passing through the esophagus and into the throat and mouth. Having GERD is a sign that the lower esophageal sphincter is weak or unable to function correctly.
What are the symptoms of GERD?
The following symptoms can indicate the presence of GERD:
- A feeling like something is stuck at the back of your throat
- Asthma that worsens over time
- Dysphagia (problems with swallowing)
- Pain in the chest or upper abdominal area
- Persistent cough
- Regurgitation of food or stomach acid
Who can get GERD?
Anyone can get GERD, but some people have a higher risk of developing the condition due to these reasons:
- Disorders affecting the connective tissue
- Hiatal hernia
There are also certain factors can also worsen GERD in people that have been diagnosed with it:
- Consumption of specific food that can provoke the condition, especially food that are fried and contain a lot of fats
- Consumption of large amounts of food
- Consumption of food right before bedtime
- Some medications like aspirin
What are the treatments available for GERD?
Diagnosing GERD can be done by a gastroenterologist. To do this, you will be asked by your doctor about the symptoms you are experiencing and other information relating to your medical history. You will also be subjected to a physical examination.
If your doctor suspects that you have GERD, the following procedures may be recommended to give a more accurate diagnosis:
- Ambulatory acide (pH) probe test
- Esophageal manometry
- Transnasal esophagoscopy
- Upper digestive system X-ray
- Upper endoscopy
Treating GERD can be done in different ways. Before prescribing medications or a medical procedure, your doctor will most likely recommend changes to your lifestyle. This means quitting habits that cause or aggravate the condition. Your doctor may also suggest taking medications that do not need prescription. If there are no changes to your condition after a few weeks of tweaking your lifestyle, then you may be asked to take medications. Further testing may also be advised.
As mentioned, medications that are used to treat GERD are either:
- Nonprescription, or
- Prescription medications
Below are examples of nonprescription medications:
- Medicines that help lessen the production of acid
- Medicines that help stop the production of acid and promote esophagus healing
Antacids provide fast relief from GERD, although this medication will not heal an irritated esophagus. The key ingredient to antacid is calcium carbonate. Examples of this type of nonprescription medication are Tums, Rolaids, and Mylanta.
If you would like longer relief from GERD, then you may turn to medications that contain blockers known as histamine (H-2). These nonprescription medications are not as fast as antacids when giving relief, but they help reduce the production of stomach acid for a maximum of twelve hours. Examples of these are Axid AR (nizatidine), Pepcid AC (famotidine), and Tagamet HB (cimetidine).
Nonprescription proton pump inhibitors are medications that provide stronger acid blockers and also promote healing for a damaged esophagus. Nexium 24 HR (esomeprazole), Prevacid 24 HR (lansoprazole), and Prilosec OTC (omeprazole) are examples of these medicines.
Prescription medications that may be recommended for GERD are:
- Prescription-strength H-2 blockers
- Prescription-strength proton pump inhibitors
Examples of prescription-strength proton pump inhibitors and their generic names are:
- Aciphex (rabeprazole)
- Dexilant (dexlansoprazole)
- Nexium (esomeprazole)
- Prevacid (lansoprazole)
- Prilosec (omeprazole)
- Protonix (pantoprazole)
Side effects of these medications are usually tolerable, but note that you may experience the following:
- Low levels of B-12
- Low levels of Magnesium
Other procedures to treat GERD
Medications are usually effective enough to treat GERD. If these do not work for you or you do not want to take medicines for an extended period of time, then you can ask your doctor for alternative treatments, such as:
- LINX device
- Transoral inåisionless fundoplication (TIF)
- Weight-loss surgery
Fundoplication is a surgical procedure that is done by wrapping the top part of your stomach over the lower esophageal sphincter (LES). By doing this, the ring muscle becomes tight therefore preventing any back flow of the stomach acid. Fundoplication can be done partially (Toupet fundoplication) or completely (Nissen fundoplication).
LINX device is a minimally invasive surgery performed by attaching a ring of tiny beads that are magnetic around the intersection of the esophagus and stomach. The magnetic beads are able to let food pass through the esophagus to the stomach with ease and at the same time help keep the junction’s opening closed when the stomach acid attempts to flow into the esophagus.
Transoral incisionless fundoplication (TIF) is a non-surgical procedure that addresses GERD by partially wrapping polypropylene fasteners around the lower part of the esophagus. A medical tool called endoscope is used to carry out this procedure.
Weight-loss surgery, or Bariatric surgery, is another surgical procedure that can help reduce the symptoms of GERD. This is usually recommended for people who are obese and are suffering from GERD. While this treatment can help ease the symptoms of GERD, it can also cause GERD to occur or worsen the condition.
What can happen if GERD remains untreated?
Complications can arise if GERD remains untreated, such as:
- Barrett esophagus – the lower esophagus’ tissue lining becomes damage and increases the risk for the development of esophageal cancer.
- Esophagitis – causes difficulty swallowing and pain due to the damage done by the stomach acid to the esophagus, resulting to bleeding, inflammation, and ulcer.
- Esophageal stricture – also causes difficulty swallowing due to the stomach acid’s damage to the lower esophagus resulting to the formation of scar tissue.
Gastrohealth Clinic – Dr Bhavesh Doshi | Gastroenterologist | Colonoscopy Singapore
6A Napier Rd, #03-370 Gleneagles Hospital Annexe Block, Singapore 258500
+65 6355 5773