Gastroesophageal Reflux Disease or GERD is one of the most common problems related to a digestive system which affects the lower esophageal sphincter (LES). It is the ring of muscle that exists between the stomach and esophagus. This is very common among people including pregnant women who suffer from acidity or heartburn caused by this digestive disorder. Some doctors say that this might be because of a hiatal hernia. Usually, GERD can be cured by diet and few lifestyle changes but severe conditions may need surgery or medication.
What Is Gastroesophageal Reflux?
The term, “Gastroesophageal” means stomach and esophagus together and “reflux” means to flow back. Thus, “gastroesophageal reflux” means the return of the contents in the stomach through the esophagus. Generally, the LES or (Lower Esophageal Sphincter) allows the food to pass through the esophagus into the stomach in normal digestion and the acidic juices present in the stomach prevents the food to flow back into the esophagus. But when this LES becomes weak or when it relaxes inappropriately, Gastroesophageal reflux takes place where the juices allow the food in the stomach to flow back into the esophagus.
The severity of GERD usually depends on the ability or strength of LES or LES dysfunction and depends on the type of and quantity of the stomach fluid. It also depends on the neutralizing effect of saliva.
The Role of Hiatal Hernia In GERD
As per some doctors, hiatal hernia weakens the lower esophageal sphincter and increases the risk of developing gastroesophageal reflux. When the upper part of the stomach moves upwards into the chest through the opening of the diaphragm which is called as diaphragmatic hiatus, a hiatal hernia occurs. The diaphragm is the muscle present in between the chest and abdomen. According to recent studies, the opening in the diaphragm supports the lower end of the esophagus. Those suffering from Hiatal Hernia don’t face heartburn or reflux. But suffering from hiatal hernia allows the stomach contents to reflux easily back into the esophagus.
Coughing, straining, sudden physical exertion, vomiting, etc. may increase the pressure on the abdomen as a result of which hiatal hernia occurs. If you are obese and pregnant then you are more prone to this condition. Healthy people who are above 50 years of age usually have a small hiatal hernia. Though this condition usually affects middle-aged people, it has an effect on all the age groups.
Hiatal hernia generally doesn’t need treatment but it may be necessary if it has chances of becoming strangulated; this means twisted in such a way that it cuts off the blood supply. It also needs treatment if it is complicated by severe GERD. You may need surgery to reduce the size of the hernia.
Other Factors Contributing GERD
The diet and lifestyle may contribute to GERD most of the time. Certain foods and beverages like peppermint, coffee, chocolate, fried or fatty foods can trigger heartburn or reflux. Studies also show that smoking can relax the LES. Pregnancy and obesity also play an important role in GERD.
Symptoms of Heartburn
Heartburn or indigestion is a very common symptom of GERD which feels like burning sensation in the chest along with pain that begins behind the breastbone and moves upwards till the neck and throat. According to many people, this means the food is coming back to the mouth and this leaves acid or bitter taste in the mouth.
The burning sensation or pain which is known as heartburn usually lasts for 2 hours and gets even worse after having food. Lying down on the bed and bending forward can worsen this condition. Many treat this condition by standing straight or by taking an antacid.
This is usually mistaken for heart attack or heart disease but there is a big difference between gerd and heart pain. Exercising usually aggravates the pain and results in heart disease and rest can relieve the pain the in chest. Heartburn is less likely associated with physical activity.
Treatment For GERD
Doctors recommend to make changes to lifestyle and opt for a suitable diet to treat GERD. Treatment is given to decrease the reflux amount and reduce the damage to the esophageal lining caused due to reflux materials.
Avoid all those foods that weaken the LES such as chocolate, fatty foods, alcoholic beverages, peppermint, coffee, etc. Foods and beverages like citrus fruits and their juices, tomato and tomato products, pepper, etc. damage the esophageal lining; thus, these should be avoided as they cause symptoms of GERD.
It is recommended to reduce the portion size and has more number of meals a day. It is recommended to eat your dinner 2 – 3 hours of sleeping as it can reduce the reflux in the stomach. In addition to this being overweight can worsen the condition.
Keeping the head at some height from the bed on a 6-inch blocks can reduce heartburn allowing the gravity to reduce the reflux of stomach content through the esophagus.
Along with these your doctor may also prescribe few medicines and few over-the-counter medicines. Antacids neutralize the acid in the esophagus and stomach reducing the heartburn. However, it is believed that antacids provide temporary relief and when combined with a foaming agent it helps some people. These agents form a foam a barrier on the top of the stomach to prevent this acid to form. However, long-term usage of these antacids can cause side effects like diarrhea, magnesium buildup in the body, altered calcium metabolism, etc. Too much magnesium can cause serious issues among kidney patients. If antacids are required for more than 2 weeks then it is recommended to visit a doctor.
Is Surgery Required To Treat GERD?
Some GERD patients may need a surgery to treat it due to severe reflux and poor response to medical treatment. However, surgery is not required until all the methods have been tried to treat GERD. Fundoplication is a type of surgery which increases the pressure on the lower esophagus. Endoscopic procedures involve improving the LES function and usage of electrodes promote the scarring of LES; these are few of the recommended treatments.