GERD (Acid Reflux): Symptoms, Causes, Treatment | Dr. G. Parthasarathy | KIMS Hospitals

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Lets talk about a very common problem of the GI tract, which we see in our practice everyday, the problem is called GERD , or gastro esophagul reflux disease, or called reflex problem.
What are the common symptoms ?
The contents of the gastric(stomach) region, usually contains the acid or bile, they abnormally rise up into the food pipe or the esophagus, these acid and bile should not be entering into the food pipe or the chest.
Severe burning sensation behind the chest bone, that usually goes away by drinking water, or taking an antacid, but when this problem progresses repeatedly, gets more severe, it becomes reflux disease.
What are the common symptoms of this reflux disease or GERD?
1) Heart burn : by which we mean an intense burning pain behind the chest bone, which the patient experiences while lying down or at some point in the day.
2) Regurgitation : While burping the food rises up into the chest and comes into the throat or in severe cases come out of the nose when the patient bends.
3) Reflux : where the patient feels like fluid is raising up into their chest.
4) Excessive belching : because of acid they start burping a lot.
5) Water brash : when the acid rises into the throat or the chest, body secretes a lot of saliva, when the patients start producing a lot of saliva and swallowing it to dilute the acid.
6) Very rarely Reflux can present in form of asthma, wherein the acid comes to the throat and again gets sucked into the wind pipe the patient can develop wheezing or breathing difficulty.
7)Sometimes a long standing reflux causes the acids to keep coming into the mouth & the teeth get eroded , so when we see a patient with reflux they might have yellow teeth.
What are the risk factors?
1) Obesity : One of the most important risk factor which causes the acid reflux is obesity, because there is an excess amount of fat that is stored in the abdominal cavity, the pressure on the stomach and intestines is more, so the pressure on the abdominal cavity is high, so when the pressure below is very high, whatever is there in the stomach tries to escape back in the chest.
2) Smoking : The problem wherein the nicotine directly goes and loosens the valve,which controls or prevents the reflex from happening, that valve is under the control of many chemicals, it becomes weaker and causes GERD.
3) Excessive fatty and junk food intake: IT can also increase the incidents of acid reflux
4) Pregnancy : During pregnancy due to the hormonal changes the sphincter becomes loose and during pregnancy, we can see many women experience an increased amount of acid reflux into the chest.
5) Excessive alcohol intake : This is also one of the risk factors for acid reflux, So, among all these conditions, the most important one that increases risk of acid reflux is obesity and improper dietary habits.
How is it diagnosed?
GERD usually does not require any major testing for diagnosis, the symptoms are clear, they have a burning sensation, feel something rising up from my tummy into the chest, I can feel some sour or bitter fluid coming into my throat, I also have food coming into my throat. To diagnose reflux is not very difficult, but still when we want to evaluate a person with reflux disease there are some tests which are useful,
1) Endoscopy: One of the most important tests we use to diagnose or evaluate a patient with GERD is an upper J endoscopy or an endoscopy test wherein, a tube is passed through the food pipe into the stomach, it will evaluate the nature of the valve.
2) Manometry :Used in patients who have severe GERD problems, where some sort of a surgery or an endoscopic treatment is being contemplated, to judge if these patients will benefit from using a laparoscopic procedure to treat the problem.
What are the treatment options?
GERD is a problem majorly linked to obesity and bad diet, so, by making modifications to lifestyle one can have a great amount of symptom relief,
Avoid high fatty foods, smoking & alcohol, since these act directly on the valve and loosen it,
Apart from this weight reduction is very important,
It is also advised to use elevation in their bed, keeping extra pillows .
What are the surgical options?
IF the patient has been treated with medications and lifestyle changes for a long time , yet the patient has not responded , or if the patient is getting dependant on medications, in such patients we offer a laparoscopic fundoplication wherein, through some small key holes, the stomach is wound around the food pipe and an artificial valve is created and this valve will function to prevent acid from reflexing back into the chest. This operation is to be used in only the patients which deserve this.
Dr. G. Parthasarathy
Sr. Consultant, Surgical Gastroenterology, Laparoscopic &
Hepato-Pancreaticobiliary Surgery
KIMS Hospitals Secunderabad