Gastro-esophageal Reflux Disease: Diagnosis, Treatment and Management

What is GERD?

 GERD stands for gastro-esophageal reflux disease. It is also known as gastro-oesophageal reflux disease (GORD), gastric reflux disease, or acid reflux disease. It is common, but it’s a chronic disorder that effects the digestive system. Basically, it’s like acid reflux but is more serious and long-lasting. GERD occurs when stomach acid repeatedly flows back into the esophagus due to a weakened or abnormally relaxed sphincter, which causes irritation and inflammation. A level of GERD is an ordinary physiological procedure, and the esophagus can be susceptible to acidic gastric substance up to 5% of the time. These occurrences are normally concise and don’t cause symptoms. GERD turns into a disease when the acid reflux turns out to be progressively unmistakable bringing about symptoms and/or problems. There are many factors that can increase one’s risk for GERD. This include; pregnancy, obesity, scleroderma, delayed stomach emptying, smoking cigarettes, hiatus hernia, and etc. There are also foods and beverages that can trigger GERD. For instance; chocolate, coffee, alcoholic beverages, fried or fatty food, and etc. Additionally, certain medications cause GERD too. Including; sedatives, nitrates, alpha blockers, anti-inflammatories, and calcium channel blockers. Furthermore, there are many symptoms of GERD. Indigestion and heartburn being the most common. However, in some cases heart burn can be a sign of another serious condition. Additionally, other symptoms include; respiratory problems, difficulty swallowing, belching, nausea and vomiting, abdominal pain, and etc. 15%-30% of the population has had GERD. The number of hospitalizations for GERD has increased. This mainly includes women, babies, and children 2-years-old to 17-years-old.

Testing and Diagnosis

 There are many tests available to diagnose GERD. Examples include; standard endoscopy, endoscopy with tissue biopsy, esophagogastroduodenoscopy (EGD), X-ray with barium swallow, ambulatory acid (pH) monitoring probe test, esophageal motility test. An endoscopy is operated to look at the stomach and esophagus by imbedding a long, narrow and adaptable tube down a patient’s throat, generally while the patient is tranquilized. There is an light and camera toward the end of the tube to take photos. Endoscopies are significant for looking at harm done by gastric reflux. Five to ten times each year GERD patients might be encouraged to have endoscopies. For increasingly precise testing of how damaged the esophageal lining tissue is, a biopsy can be done. An esophagogastroduodenoscopy (EGD) is a sort of endoscopy performed when a patient does not react to prescribed medications to treat GERD or has extreme symptoms. The X-ray with barium swallow is otherwise called an upper gastrointestinal series. The digestive tract is coated by the barium to outline the shape of the esophagus and duodenum. X-ray pictures are then taken of the upper gastrointestinal tract with the barium covering. The ambulatory acid (pH) monitoring probe test is the most ideal test. By taking measures of the acidity in the esophagus this test decides to what extent a patient has been encountering gastric reflux. In this test, a dainty and adaptable tube with a pH screen toward the end is imbedded in the nose and down the esophagus. The screen detects the pH level in the esophagus all through a 48-hour time frame and the dimensions are recorded in a little device worn on the hip. During the testing, patients are advised to refrain from taking their GERD medication. An esophageal motility test analyzes the motility and tension of the throat. A narrow and adaptable tube is imbedded in the nose and down the throat. To find out the severity of the patient’s GERD, a probe toward the end of the tube evaluates the manner in which the esophagus moves.

Treatment Options

There are ways to treat GERD. Antacids are one way. Alone, it doesn’t actually heal the damaged esophagus, but it does neutralize stomach acid. However, overusing them can come with side affects that include diarrhea and maybe even kidney problems. Then you have medications that are used to reduce acid production known as H-2 receptor blocker. Examples includes; cimetidine, famotidine, nizatidine, and ranitidine. For up to 12 hours they can decrease production of acid. On the other hand, they don’t act as quickly as antacids. In addition, there’s also medication that aids in blocking production and healing the esophagus. These are known as proton pump inhibitors which are stronger than H-2 receptor blockers. OTC proton pump inhibitors includes; lansoprazole and omeprazole. Furthermore, there are prescription strength medications as well. For instance; prescription-strength H-2-receptor blockers, prescription-strength proton pump inhibitors, and medications that strengthens the lower esophageal sphincter. Equally important, there are also surgery options. First, fundoplication is a surgery in which the fundus is wrapped around esophagus and sewn into place to tighten the muscle which aids in preventing reflux. Secondly, there’s a LINX device which is a ring of magnetic titanium beads wrapped around the lower esophageal sphincter. The magnetic attraction is strong enough to keep from allowing reflux acid into the junction, but weak enough to make a way for food to enter.

Plan of Action

Reducing reflux acid is not a big problem. There are steps people can take in order to remain not a victim of GERD or help with their condition if they are a condition of GERD. Maintaining a healthy weight is one. Having excess weight can push up one’s stomach, that then causes acid to reflux into the esophagus. Also, refrain from smoking so the lower esophageal sphincter will continue to function properly. Thirdly, wait a couple hours before lying down or going to bed after a meal. Fourthly, eat slowly and be sure to chew food thoroughly before swallowing. Moreover, avoid foods and drinks that trigger reflux acid. As well as, clothes that fit too tight around the waist area.

Works Cited

• GERD Tests & Diagnosis | Gastroesophageal Reflux Disease. (n.d.). Retrieved from https://www.availclinical.com/clinical-trials/gastroesophageal-reflux-disease/gerd-tests-diagnosis/
• Cheston, H., & Woodland, P. (2019). Gastro-oesophageal reflux disease and hiatus hernia. Medicine, 47(5), 263–268. https://doi.org/10.1016/j.mpmed.2019.02.011
• Gastroesophageal reflux disease (GERD). (2018, March 09). Retrieved from https://www.mayoclinic.org/diseases-conditions/gerd/diagnosis-treatment/drc-20361959