Frequent heartburn? It could be gastroesophageal reflux disease (GERD)!

I had a friend at university named Chamari. He would often complain of stomach pain after eating, especially spicy Sri Lankan food, or after a late-night snack. Chamari thought it was just indigestion, but after a while, the heartburn started to come more often, to the point where it was disturbing his sleep. What he initially dismissed as "normal" turned out to be Gastroesophageal Reflux Disease ( GERD ) . This is when stomach acid comes up into the throat. That's what causes the burning and discomfort.

Finally, Chamari went to see a doctor. He learned that with a few lifestyle changes and some medication, he could control his condition. I thought I would share what he learned with you. Because GERD (Gastroesophageal Reflux Disease) is a more common condition than you might think, and there are ways to control it.

How to recognize GERD? Common symptoms

Chamari's main problem is frequent heartburn . It can sometimes be felt all the way down to the throat. But GERD (Gastroesophageal Reflux Disease) has other symptoms:

• I feel a sour, bitter taste in my mouth, especially when I lie down.
• Food or liquids come back up into the throat, which is very unpleasant.
• Feeling like something is stuck in the throat (this is called globus sensation ).
• Persistent cough , changes in voice.
• Sometimes, severe symptoms such as difficulty swallowing and weight loss can occur. In such cases, you should see a doctor immediately.

Why does GERD occur? The reasons are simple

Chamari learned that GERD (Gastroesophageal Reflux Disease) is often caused by a problem with the Lower Esophageal Sphincter (LES) . Simply put, the LES is like a valve at the lower end of our food pipe (esophagus) that only opens in one direction.After food enters our stomach (gastroesophageal reflux disease), this valve closes tightly, preventing food and acid from coming back up into the esophagus.

Think of it like a valve that opens only in one direction in a water pipe. After food passes from the food pipe into the stomach, this "valve" must close tightly. Then the food in the stomach and the acid in the esophagus will not come up.

But when this "valve," or lower esophageal sphincter (LES), becomes weak and doesn't close at the right time, stomach acid and food can come back up into the esophagus. That's when that unpleasant burning, heartburn feeling occurs.

There are several things that can cause this "valve" to not work properly:

• Hiatal Hernia : This occurs when the upper part of the stomach (stomach) protrudes through a hole in the diaphragm (the muscular membrane that separates the chest and abdominal cavities). It's as if part of the stomach has been pushed into the chest. When this happens, the "valve" doesn't work properly.
• Eating large meals, eating late at night: This puts a lot of pressure on that "valve" ( LES ).
• Obesity and pregnancy: This increases pressure in the stomach. Even then, that "valve" may not close properly.
• Lifestyle also has an impact. For example, if you smoke, it's very important to stop smoking, and if you regularly take medications like ibuprofen , these things can weaken the LES , that "valve," and increase the amount of acid coming up.

The impact of lifestyle and diet

Chamari began to recognize patterns in her problems. She realized that certain foods and habits were making her illness worse:

• Foods that contain a lot of oil (fried or greasy foods) make digestion difficult and increase the risk of reflux.
• Drinks that contain caffeine, such as coffee, tea, and soda .
• Spicy foods, citrus fruits, tomato- based sauces.
• Both alcohol and cigarettes can increase GERD symptoms.

These habits and foods can loosen the LES , our "valve," or increase the amount of acid in the stomach. This makes it easier for the acid to come up.

What tests are used to diagnose GERD?

When Chamari finally went to see a doctor, he was told to run a few tests to determine if it was GERD (Gastroesophageal Reflux Disease) :

• Ambulatory pH Monitoring: This measures how long and how much acid is coming into the throat. This involves attaching a small device to the body and recording the amount of acid coming into the throat for about 24 hours.
• Upper Endoscopy: A tube with a small camera is inserted through the mouth to check for inflammation or ulcers in the throat (esophagitis).
• Esophagram: This involves taking several X-rays after you drink a contrast liquid, such as barium . This liquid allows the esophagus and stomach (oesophagus and stomach) to be clearly visible on the X-ray.

These tests can help the doctor see how severe the GERD is and decide what the best treatment is.

GERD Treatment: How did Chamari get better?

Chamari's treatment began with small changes in her lifestyle. Then she started taking medication. Here are some of the things that helped her get better:

Lifestyle changes

Chamari found that her GERD was largely controlled with small changes:

• Eating small, frequent meals reduced the pressure on the stomach.
• Stopping eating at night and not lying down for two to three hours after eating.
• Keeping the head of the bed slightly elevated reduced the amount of acid coming up at night.
• If you are a smoker , quitting cigarettes will bring you great relief over time.

Medicines

When lifestyle changes alone weren't enough, Chamari's doctor prescribed her some medications:

• Proton Pump Inhibitors (PPIs): Drugs such as Omeprazole and Esomeprazole , which reduce the amount of acid produced in the stomach.
• H2 Receptor Blockers: Examples include Ranitidine and Famotidine . These work quickly, but provide short-term relief .
• Antacids: These provide quick relief when the problem arises.

Talking to the doctor regularly, adjusting the medication dosage, and avoiding side effects helped him.

Treatment by surgery

For some people, GERD can be so severe that it doesn't respond to medication or lifestyle changes. For those people, surgery is required. Chamari didn't need surgery. However, there are surgical procedures for people with severe GERD , such as fundoplication (a surgery to strengthen the LES) or the LINX reflux management system.

What happens if GERD is not taken care of properly?

Chamari learned that GERD can cause problems if not treated properly:

• Esophagitis: Inflammation of the esophagus (food pipe), which can cause sores and bleeding.
• Esophageal Stricture: The esophagus becomes narrow, making it difficult to swallow food.
• Barrett's Esophagus: Continued exposure to acid causes changes in the cells of the esophagus, increasing the risk of developing cancer.
• Dental problems: Acid can cause tooth decay.

How do I know if I have GERD?