he esophagus is a tube that carries food from your mouth to your stomach. There
is a sphincter, or a band of muscles, at the end of the esophagus that acts as a
valve that prevents the back flow of food and stomach acid.
This muscle may open spontaneously or may not close properly, allowing stomach contents to regurgitate back up the esophagus.
This is known as “reflux.”
When the stomach contents travel back up the esophagus, a burning sensation is produced in the chest - commonly known as “heartburn” or acid indigestion.
Other symptoms include a dry cough and difficulty swallowing. Occasional heartburn is common and does not mean you have Gastroesophageal Reflux Disease or GERD.
Persistent heartburn, more than twice a week, is considered GERD. GERD can lead to more serious health problems and effects people of all ages; it’s linked to hiatal hernias, asthma and scleroderma.
Many factors may contribute to or exacerbate GERD including:
•Obesity - increases intra-abdominal pressure
•Pregnancy - hormones/increases intra-abdominal
pressure
•Smoking - relaxes the lower esophageal sphincter
•Eating large meals - small meals reduce reflux; eat
several small meals
throughout the day
•Positioning of the body after eating- maintain an
upright position after
eating, raise the head of your bed 6-8 inches by
securing blocks under the bedpost
•The nature of the foods you eat - common foods that
worsen reflux include: citrus fruits or beverages,
caffeine and alcohol, carbonated beverages, garlic and
onions, fatty and fried foods, spicy foods, chocolate,
mint flavoring and tomato-based foods
Diagnosis of GERD can be made by either a barium
swallow or an upper endoscopy. During a barium
swallow, you will be asked to drink a solution, and
X-rays are taken to visualize the anatomy of the upper
GI system.
An upper endoscopy is more accurate. It consists of numbing
the throat, and passing a thin flexible tube with a light and
lens down the throat. This allows for direct visualization of the lining of the esophagus and stomach.
A biopsy of the esophagus also ca be done during the endoscopy. This can detect damage to esophageal cells, abnormal growths or infection.
GERD affects people in different ways, from mild unnoticeable symptoms to excruciating pain. Long-term complications of GERD include chronic inflammation of the esophagus that can lead to damage of the lining and result in bleeding and ulcers.
Scarring from the inflammation can lead to strictures or narrowing of the esophagus or “Barrett’s esophagus,” in which the cells of the esophageal lining take on an abnormal shape and color and may, over time, lead to esophageal cancer. GERD also interferes with daily activities.
Many people who suffer from untreated GERD experience sleep deprivation due to unrelieved heartburn and pain. If you are diagnosed with GERD, your doctor will usually recommend lifestyle changes, dietary modifications and medication.
If GERD persists despite these changes, surgery may be an option. Fundoplication is the standard surgical treatment.
The NISSEN Fundoplication technique is the most common and involves wrapping the upper part of the stomach around the lower esophageal sphincter to tighten the muscle.
This is usually done laparoscopically in which small tiny incisions are made in the abdomen; small instruments and a camera are passed through these incisions. The procedure is generally safe and effective.
If you experience persistent heartburn that does not respond to over-the-counter antacids and dietary changes, see your doctor for testing and treatment.
Keep a log of foods you eat that trigger pain and other symptoms, as well as what gives you relief.
