There it is, your favorite food is calling you from the buffet but you hesitate. You know there will be a price to pay if you enjoy its wonderful taste. You will experience the severe searing burning sensation that travels up the middle of your chest to the back of your throat, leaving that brackish taste in your mouth. It will be the dreaded heartburn, or GERD.
Gastroesophageal reflux disease, or GERD, is caused by the back flow or reflux of stomach acid into the esophagus. The esophageal lining then becomes inflamed and sometimes damaged, possibly resulting in more serious conditions. The specific cause of GERD is unknown, but there are many factors that exacerbate the symptoms, including certain foods, smoking, obesity, pregnancy and having a hiatal hernia.
During normal digestion, food travels through the esophagus to the stomach. The food is propelled forward through the digestive tract by wavelike motions called peristalsis. At the junction of the esophagus and stomach is a ring of muscle called the LES or lower esophageal sphincter, which when working properly, keeps food in the stomach. However, sometimes the ring may be too relaxed or weak, and it allows reflux to occur.
Some symptoms of GERD include upper abdominal pain, burning chest pain, sore throat, persistent cough, painful or difficult swallowing, feeling like there is a lump in the throat or hoarseness. However, if you ever experience food getting stuck in the throat, chest pain, choking, vomiting blood or dark-colored stools you should be seen by a health care provider immediately.
GERD is typically diagnosed by clinical symptoms and response to medication. However, it can also be confirmed by endoscopy, an esophageal pH study and esophageal manometry which measures the LES strength to determine if it is working correctly.
If GERD remains untreated, complications can occasionally take place. These include ulcers, esophageal scarring or strictures, Barrett's esophagus, aspiration pneumonia, or esophageal cancer. Barrett's esophagus occurs when the normal esophageal cells are replaced by intestinal cells. Individuals with Barrett's esophagus have an increased risk of developing esophageal cancer and must be closely monitored with repeated endoscopy exams.
Treatment for GERD depends on the severity of the symptoms. Mild GERD can often be remedied by lifestyle modifications, such as dietary changes, stopping smoking and weight loss. Foods to avoid include caffeine, chocolate, alcohol, fatty foods and peppermint. Additionally, over-the-counter antacids may be beneficial for mild symptoms.
More severe symptoms may require treatment with prescription medications that decrease stomach acid. These medications are known as H2 antagonists and proton pump inhibitors. If however, GERD symptoms persist with prescription medication use, surgical intervention may be necessary. The most common surgical procedure is called the Nissen fundoplication, but as always, surgery should be the last option.
Ultimately, you and your health care provider will need to decide on the proper treatment options specific for your condition. For further information please refer to the National Library of Medicine at http://www.nlm.nih.gov/medlineplus/gerd.html.
Gastroesophageal Reflux Disease (GERD)
Nov 18, 2009 | By
