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Gastroesophageal Reflux Disease

Gastroesophageal Reflux Disease (GERD) is a condition in which gastric contents, mainly acid, flows back up into the esophagus. GERD occurs, when this backflow is frequent and excessive, causing symptoms and damage to the esophageal lining. GERD causes an array of symptoms including heartburn, chest pain, regurgitation, lump in throat, nausea, vomiting, hiccups, burping and troubled or painful swallowing.

Causes

Interestingly, GERD can also result in a range of complications affecting the respiratory tract, throat, and sinuses. If you have chronic issues with halitosis (bad breath), hoarseness, laryngitis, hypersalivation, dental enamel erosions, gingivitis, frequent throat clearing, sore throat, chronic cough, wheezing, difficult to control asthma, sinus infections, aspiration pneumonia or sleep apnea, you may have significant GERD.

Who is at risk?

GERD occurs equally among both genders and all ethnicities, however, complications tend to occur more commonly in Caucasian males. Family history and the presence of a hiatal hernia appear to increase one’s risk. GERD is more common in middle age people, people who have gained weight, or women who are pregnant. There are certain rare medical conditions which also increase your risk of GERD (e.g., scleroderma).

How is GERD diagnosed?

GERD is diagnosed based on history and physical examination. If there are complicating, alarming or atypical features, then you should visit your Gastroenterologist for evaluation. Sometimes additional testing is needed including, endoscopy, pH/impedance monitoring, manometry and radiographic upper GI series.

Minimizing Symptoms

There are many measures one can take to minimize the Gastroesophageal Reflux Disease related symptoms. These include certain lifestyle changes (e.g., weight loss, smoking cessation), dietary modifications (e.g., minimizing alcohol, and coffee, chocolate) and medication avoidance.

What are the possible complications?

Aside from the discomfort of heartburn, GERD can over time, if left untreated, result in multiple complications. When irritation becomes severe the esophagus can become inflamed (“esophagitis”) and ulcerate, and if left untreated these ulcers can cause significant pain and even bleed. When irritation becomes chronic, the esophagus can scar and narrow and may even cause strictures, rings or webs which can cause difficulty when swallowing food. In some patients, this irritation can induce changes to the lining of the esophagus, termed Barrett’s Esophagus – a precursor to esophageal cancer.
Factors that increase one’s risk of developing complications include; Caucasian ethnicity, male gender, obesity, smoking, age and concurrent hiatal hernia.

Treatment

The foundation for treatment includes lifestyle changes and medications but in some instances patients continue to have symptoms. Digestive Health Associates of Texas, P. A. gastroenterologists are expertly trained in treating these challenging cases, with more advanced medical therapy and can offer guidance for those considering various anti-reflux operations.
Medications used for management of the Gastroesophageal Reflux Disease include those that decrease gastric acid specifically antacids, H2 blockers and PPIs (proton pump inhibitors). Other medications with different mechanisms exist which can be used for a treatment of refractory cases of GERD.

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