Overview
What is it? GERD is a condition that occurs when the lower oesophageal sphincter (LES), a circular muscle that acts as a valve between the oesophagus and stomach, doesn’t close properly. As a result, stomach acid and contents flow back into the oesophagus, causing irritation and inflammation.
Why it happens? Several factors can contribute to the development of GERD, including:
- Weakness or relaxation of the LES: This can be caused by factors such as obesity, pregnancy, smoking, and certain medications.
- Hiatal hernia: This occurs when part of the stomach moves up into the chest through
- Delayed stomach emptying: When the stomach takes longer than usual to empty its contents, there is a higher risk of GERD.
- Certain foods and beverages: Spicy, fatty, or acidic foods, as well as caffeine, alcohol, and carbonated drinks, can all increase the risk of GERD.
How frequent is GERD?
GERD is a very common condition, affecting up to 20% of adults in the Western World. It can occur at any age, although it is more common in older adults.
Diagnosis
GERD is typically diagnosed based on the patient’s symptoms and medical history. In some cases, additional tests may be needed to confirm the diagnosis or rule out other conditions. These tests may include:
- Upper endoscopy: This test involves inserting a flexible tube with a camera through the mouth and into the oesophagus and stomach to look for signs of inflammation or damage.
- Oesophageal pH monitoring: This test measures the amount of acid in the oesophagus over a 24-hour period.
- Oesophageal manometry: This test measures the pressure and function of the oesophagus.
Treatment
The goal of GERD treatment is to relieve symptoms and prevent complications such as oesophagitis, strictures, and Barrett’s oesophagus. Treatment options may include:
- Lifestyle changes: This may include weight loss, avoiding trigger foods and beverages, quitting smoking, and elevating the head of the bed.
- Medications: Over-the-counter antacids, H2 blockers, and proton pump inhibitors (PPIs) can all help reduce acid production and relieve symptoms.
- Surgery: In severe cases, surgery may be necessary to strengthen the LES and prevent reflux.
Key Points
- GERD occurs when stomach acid and contents flow back into the oesophagus due to a weak or relaxed LES.
- Factors that can contribute to GERD include obesity, pregnancy, smoking, certain medications, hiatal hernia, delayed stomach emptying, and certain foods and beverages.
- GERD is a very common condition.
- Diagnosis is typically based on the patient’s symptoms and medical history, although additional tests may be needed in some cases.
- Treatment options may include lifestyle changes, medications, and surgery, depending on the severity of symptoms