GERD (Gastroesophageal Reflux Disease)
GERD is a chronic digestive disorder that occurs when stomach acid or bile flows back into the esophagus, irritating the lining and causing symptoms like heartburn and regurgitation. If left untreated, it can lead to serious complications like esophagitis, Barrett's esophagus, or even esophageal cancer. At Blume Health, our gastroenterology team offers comprehensive diagnosis and treatment options for GERD.
Causes
- Weakened lower esophageal sphincter (LES), which normally prevents stomach contents from flowing back
- Hiatal hernia, where the upper part of the stomach bulges through the diaphragm
- Obesity or being overweight, which increases pressure on the abdomen
- Pregnancy, which temporarily increases pressure on the abdomen
- Smoking, which can impair LES function and increase acid production
- Regular use of certain medications, including aspirin, ibuprofen, and some muscle relaxants
- Consuming large meals or lying down right after eating
- Dietary triggers such as spicy foods, fatty foods, citrus, chocolate, mint, and carbonated beverages
- Alcohol consumption
- Delayed stomach emptying (gastroparesis)
Signs and Symptoms
- Heartburn - a burning sensation in the chest, typically after eating
- Regurgitation of food or sour liquid into the throat or mouth
- Chest pain, particularly when lying down
- Difficulty swallowing (dysphagia)
- Sensation of a lump in the throat
- Chronic cough, particularly at night
- Laryngitis or hoarseness, especially in the morning
- Disrupted sleep due to discomfort
- Worsening of asthma symptoms
- Dental erosion from stomach acid exposure
- Bad breath
Diagnosis
Upper Endoscopy (EGD)
A procedure where a thin, flexible tube equipped with a light and camera (endoscope) is passed down the throat to examine the esophagus, stomach, and upper part of the small intestine. This allows direct visualization of inflammation, ulcers, or other abnormalities.
Ambulatory pH Monitoring
A test that measures the amount of acid in the esophagus over a 24-48 hour period using a small probe. This helps determine the frequency and duration of acid reflux episodes and their correlation with symptoms.
Esophageal Manometry
A test that measures the strength and coordination of the esophageal muscles during swallowing. This helps evaluate the function of the lower esophageal sphincter and detect any abnormalities in esophageal motility.
Barium Swallow
An X-ray examination that uses a contrast solution (barium) to highlight the upper digestive tract, allowing visualization of structural abnormalities, hiatal hernias, or narrowing of the esophagus.
Treatment Options
Lifestyle and Dietary Modifications
Often the first line of treatment, including weight management, avoiding trigger foods, eating smaller meals, not lying down after eating, elevating the head of the bed, and quitting smoking.
Medications
Various medications can help reduce or block acid production, heal the esophagus, or strengthen the lower esophageal sphincter, including antacids, H2 blockers, proton pump inhibitors (PPIs), and prokinetics.
Endoscopic Treatments
Minimally invasive procedures performed through an endoscope, including radiofrequency ablation for Barrett's esophagus, endoscopic suturing to tighten the LES, or LINX device placement.
Home Remedies
Elevate the Head of Your Bed
Raising the head of your bed by 6-8 inches using blocks or a wedge pillow can help prevent acid reflux while sleeping by using gravity to keep stomach contents down.
Maintain a Healthy Weight
Excess weight puts pressure on your abdomen, pushing up your stomach and causing acid to back up into your esophagus. Maintaining a healthy weight can help reduce this pressure.
Avoid Trigger Foods
Identify and avoid foods that trigger your symptoms. Common triggers include spicy foods, fatty foods, citrus fruits, tomatoes, chocolate, mint, garlic, onions, and carbonated beverages.
Eat Smaller Meals
Large meals increase pressure on the lower esophageal sphincter and fill the stomach, increasing the risk of reflux. Eating smaller, more frequent meals can help.
Wait Before Lying Down
Wait at least 3 hours after eating before lying down or going to bed to allow your stomach to empty partially and reduce the risk of reflux.
Preventive Care
- Maintain a healthy weight through regular exercise and balanced diet
- Quit smoking and avoid secondhand smoke
- Limit alcohol consumption
- Eat smaller meals and avoid eating late at night
- Avoid tight-fitting clothing around the waist
- Identify and avoid personal trigger foods and beverages
- Stay upright for at least 3 hours after meals
- Sleep with the head of your bed elevated
- Manage stress through relaxation techniques
- Have regular check-ups with your gastroenterologist, especially if you experience frequent symptoms
Surgical Options
Fundoplication
A surgical procedure where the upper part of the stomach (fundus) is wrapped around the lower end of the esophagus and stitched in place. This strengthens the lower esophageal sphincter and prevents acid reflux. It can be performed as an open surgery or laparoscopically, with the latter offering faster recovery and less pain.
LINX Procedure
A less invasive surgical option that involves implanting a small flexible ring of magnetic beads around the junction between the stomach and esophagus. The magnetic attraction between the beads helps keep the sphincter closed when not swallowing, preventing reflux, while allowing food to pass normally.
Hiatal Hernia Repair
If GERD is caused or worsened by a hiatal hernia, surgical repair may be recommended. This procedure involves pulling the stomach back down into the abdomen and repairing the diaphragm opening. It is often combined with fundoplication for optimal results.
Schedule a Consultation
If you're experiencing symptoms of gerd (gastroesophageal reflux disease), our expert team is here to help you find the right treatment approach for your specific needs.