Gastroesophageal Reflux Disease (GERD)

GERD stands for Gastroesophageal Reflux Disease.

It refers to the flow of the acidic juices of the stomach into the esophagus (the food passage that links the oral cavity to the stomach).

It happens because the junction between the gullet and the stomach does not function normally, resulting in reflux.

Symptoms of GERD are:

• Heartburn (burning sensation of the chest that usually rises from the stomach to the throat)
• Acid regurgitation (bitter or sour taste in the mouth)

Symptoms possibly associated with GERD:

• Burping or belching
• Chest pain or discomfort
• Bloated stomach
• Difficulty swallowing
• Hoarseness of voice
• Persistent sore thoat
• Persistent cough

Most people with GERD do not get severe problems other than the symptoms of GERD. Long standing reflux may potentially cause:

• Esophagitis, which is the inflammation of the lower gullet
• Stricture, or severe long standing inflammation can cause narrowing of the gullet lumen
• Barrett's esophagus, or changes to the cells of the lower esophagus, due to the damage done by the long standing acid reflux. Patients with Barrett's esophagus have higher risk of esophageal cancer compared to the general population.

GERD can be diagnosed by symptoms and the response to medication.

In some cases of GERD, inflammation of the gullet may be seen on endoscopy (a procedure when a flexible tube is placed via the mouth into the gullet and stomach).

Oesophagitis

GERD can also be diagnosed with the help of 24-hour pH monitoring - a tube is placed through the nose to the gullet and the acidity is measured.

When combined with Impedance testing (where a tube with multiple electrodes is inserted into the gullet), one can differentiate the contents of the reflux fluid, thus guiding the doctor in treatment.

Lifestyle changes can improve the symptoms, as described below:

You should try to avoid:

• Alcohol
• Chocolate
• Coffee
• Spicy food
• Tea
• Citrus fruits

You should also:

• Avoid overeating for each meal
• Avoid eating within 2-3 hours before bedtime
• Avoid lying down after meals
• Eat regular meals
• Raise the head of the bed if there is night-time symptoms
• Lose weight if you are obese

Please see a doctor if you have persistent symptoms despite appropriate lifestyle measures.