Gastroesophageal Reflux Disease (GERD)

What is GERD?

Gastro Esophageal Reflux, GERD is that burning sensation that occurs after a meal as a result of acidic stomach contents that moves upwards into the esophagus. GERD is a condition in which the stomach contents leak backwards from the stomach into the esophagus. This can irritate the esophagus and cause heartburn and other symptoms.

SIGNS AND SYMPTOMS

 Heartburn
 Bringing back up food
 Burning on swallowing
 Tasting acid/burning in throat
 Belching
 Nausea

HOW DOES IT OCCUR?

Acid reflux occurs when the normal defense mechanisms such as the Lower Esophageal Sphincter (LES) and Esophageal Motility are defective or become overwhelmed so that the esophagus is bathed in acid or bile and acid containing fluid for prolonged periods.

Delayed gastric emptying can also increase stomach volume and pressure until the LES fails and the valve mechanism is defeated, leading to acid reflux.

COMMON CAUSES

1. Drugs - Certain drugs you may be taking, can cause acid reflux. These include:

• Aspirin 
• Ibuprofen
• Diclofenac
• Naproxen
• Iron Supplements
• Narcotics
• Anti-Depressants
• Nitrates

2. Diet- foods high in fat, spicy foods, caffeine, citrus juices, soft drinks, alcohol

3.Lifestyle-cigarette smoking, obesity, tight-fitting clothes, heavy exercise, laying too flat while sleeping, stress

4. Medical or surgical– Your doctor may advise you accordingly, in the event you may have some underlying condition

LIFESTYLE CHANGES

• Avoid stressful situations 
• Maintain an adequate weight and quit smoking 
• Eat meals more frequently but in small quantities 
• Raise the head of the bed at a 20 degree angle 
• Have dinner at least 2 hours before bedtime 

DIETARY RECOMMENDATION FOR PATIENTS WITH GERD
Dairy Products

• Skim milk
• Milk (1% fat)
• Low fat soy milk

Vegetables

Celery, Eggplant, Broccoli, Cauliflower, Spinach, Cucumber, Sweet peppers, Lettuce, Carrots


 

Drinks

• Mix of drinks (without sugar)
• Fruit teas (except mint tea) 

PHARMACOLOGIC TREATMENT

There are many treatments for GERD which include:
Antacids: these are in the form of chewable tablets, dissolvable powders, or liquids which neutralize the stomach acid and help to reduce the burning and discomfort associated with GERD. Eg: Calcium carbonate, magnesium hydroxide.

Histamine Receptor Antagonists: they are Cimetidine, Nizatidine, Famotidine and the most commonly used one Ranitidine, it comes in tablet form as well as dissolvable tablets, they help in GERD by reducing the formation of acid in the stomach and provide relief by reducing the associated discomfort.

Proton Pump Inhibitors: these are Pantoprazole, Rabeprazole, Esomeprazole and the most common is Omeprazole, they work by reducing the production of acid in the stomach, they are the most effective at reducing the amount of acid present in the stomach, they take a short while to work but are very effective in reducing the discomfort associated with GERD.