Reflux, also known as gastroesophageal reflux disease or GERD, is a disorder that causes a burning sensation in the chest area that may radiate toward the neck. According to the 2010 text "Current Diagnosis & Treatment Emergency Medicine," the condition develops when high-concentration acidic gastric secretions damage the lining of the throat, known as the esophagus.
History
Some patients are be more likely to have GERD than others. Patients who are pregnant, obese or have had a stroke are likely to develop reflux. Any condition that would delay the emptying of gastric contents from the stomach will predispose a person to GERD. Foods such as fatty foods, chocolate and caffeine are also known to exacerbate the symptoms, and medications called calcium channel blockers and nitrates may also worsen the symptoms of GERD.
Symptoms
Reflux and esophagitis can occur in all ages. Adults who have reflux will generally complain of some chest discomfort and burning sensation, along with a bitter tasting fluid in their mouth. Nausea, vomiting and hiccups are commonly seen with GERD. As the inflammation of the mucous lining in the throat worsens, the patient may have hoarseness and difficulty swallowing. Children will complain of the same symptoms as adults. Infants may have frequent vomiting after feedings, prolonged crying, irritability and periods of apnea. Symptoms of reflux present similar to cardiac pain seen with heart attacks. Patients should not ignore the heartburn and should be seen by a physician.
Complications
GERD left untreated can damage the esophageal lining and cause ulcers or bleeding. As tissue is damaged, scars form and can cause strictures or narrowing of the esophagus, which will make swallowing difficult. In some instances, the cells of the esophageal lining will take on abnormal shape and color--a condition called Barrett's esophagus--that can lead to cancer and is often fatal, research published in the July 2009 "Archives of Pathology & Laboratory Medicine" noted.
Medical Treatment
GERD can often be managed with medications. Common medications used to treat reflux may be a combination of antacids, H2-blockers and proton pump inhibitors. Examples of antacids are Maalox or Mylanta. H2-blockers and proton pump inhibitors are helpful in decreasing acid production. H2-blocker examples include Pepcid AC or Zantac 75. Proton pump inhibitors may include Prilosec or Prevacid.
Surgical Treatment
In cases where medications and lifestyle changes are not effective in managing GERD, there is a surgical procedure called a fundoplication that can be performed. With the procedure, the upper part of the stomach is wrapped around the esophageal sphincter to help prevent the acid reflux.
References
- "Current Diagnosis & Treatment Emergency Medicine"; McGraw Hill; 2010
- "Archives of Pathology & Laboratory Medicine"; Update on Esophagitis; Dr. Amy Noffsinger; July 2009
