Managing GERD: Understanding symptoms, causes and effective treatments

Besides acid reflux, GERD can also present itself as a chronic cough, recurrent sinusitis, hoarseness and difficulty swallowing.

Find relief from the discomfort of GERD by learning about its symptoms, common causes, and the range of available treatments to effectively manage this chronic digestive disorder.

GASTROESOPHAGEAL reflux disease, more commonly referred to as GERD, is one of the most prevalent gastrointestinal disorders in the world. It is a chronic digestive disorder that occurs when stomach acid flows back into the oesophagus, causing uncomfortable symptoms.

The prevalence of GERD and its complications have been reported to be lower in Asia than in the West, according to Dr Saravana Kumar, Gastroenterologist & Hepatologist at ParkCity Medical Centre. However, the incidence is increasing in Asia, as sedentary lifestyles and a rise in obesity is observed especially in those aged 30-50.

Nonetheless, understanding the symptoms, common causes and available treatments for GERD can help one manage this condition effectively.

Recognising the symptoms

“The most common symptom of GERD that patients come in with is acid reflux, a burning sensation in the chest,” says Dr Saravana. “There are also other ways that GERD can present, including a chronic cough, recurrent sinusitis, hoarseness and difficulty swallowing. These symptoms can significantly impact an individual’s quality of life and may lead to complications if left untreated.”

Dr Saravana: “There are also other ways that GERD can present, including a chronic cough, recurrent sinusitis, hoarseness and difficulty swallowing.Dr Saravana: “There are also other ways that GERD can present, including a chronic cough, recurrent sinusitis, hoarseness and difficulty swallowing.Dr Saravana says that occasionally people mistake gastritis for GERD: “Gastritis is inflammation of the tummy, while reflux is the backwash of acid and food from your tummy into your food pipe. Any discomfort you might feel below your ribcage is usually not reflux.”

Several factors can contribute to the development of GERD, including a weakened lower esophageal sphincter, that is the muscle that normally prevents the backflow of stomach acid. When the sphincter becomes weak, it allows stomach acid to flow back into the oesophagus, leading to GERD.

“One of the main culprits for this is, of course, obesity. When a person is obese, there is an increase in abdominal pressure pushing against one’s diaphragm and this weakens the lower esophageal sphincter,” explains the consultant physician.

Other factors include pregnancy, hiatus hernia (when part of the stomach squeezes up into the chest through an opening in the diaphragm), smoking, and certain medications, such as those used to treat asthma or high blood pressure, or even aspirin.

Dr Saravana adds that there is a chance that long-term diabetic patients may also suffer from GERD because their gastrointestinal system slows down, and it takes a longer time for them to digest food. “We call this gastroparesis. Diabetic patients with a poorly controlled diet can have gastroparesis and recurrent reflux,” he says, adding that rare disorders like scleroderma can also have the same effect.

“Shift workers also commonly fall victim to this condition. I see a lot of these cases in my line of work. They work throughout the night and then in the morning, have a heavy meal and go straight to bed. They tend to put on weight and reflux is common.”

Treating GERD

Fortunately, there are several treatments available to manage GERD effectively, including lifestyle modifications. Quitting smoking, managing stress, and engaging in regular exercise, for example, can help reduce symptoms and improve overall digestive health.

Dr Saravana says: “One should maintain a healthy weight, avoid trigger foods (anything too spicy, fatty or oily, or too much alcohol), eat a low-calorie, low-fat diet, and allow enough time for food to digest – that is, at least four hours – before going to bed. These are all simple, practical solutions that you can incorporate into your daily lives immediately. Elevating the head of your bed 30 degrees, or using two pillows, may also help reduce symptoms and hlep you sleep more comfortably.”

As for medication, over-the-counter antacids as well as acid reducers, such as proton pump inhibitors (PPIs), are commonly used to alleviate symptoms. Antacids work by neutralising stomach acid, while PPIs reduce the production of acid. However, it is essential to consult a healthcare professional before starting any medication, as long-term use could result in side effects.

“In more severe cases of GERD, and if PPIs have not alleviated your symptoms, your doctor may recommend an endoscopy or CT scan to rule out that it is not something more serious presenting as symptoms of reflux,” explains Dr Saravana, adding that in worst case scenarios, such as tumours, surgical interventions may be necessary.

“If your condition is not improving, and if there are warning signs such as weight loss, a low blood count or anaemia, and if you have a family history of GI cancer, then it’s best to get screened asap,” he says.

Recognising the symptoms, understanding the common causes, and exploring the available treatment options are crucial for managing GERD effectively.

With a combination of lifestyle modifications, over-the-counter medications, and, in some cases, prescription medications or surgery, individuals with GERD can find relief from their symptoms and improve their quality of life. If you suspect you have GERD, it is important to consult a healthcare professional for an accurate diagnosis and personalised treatment plan.

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