Gastroesophageal reflux disease (GERD) is a chronic digestive disease in which stomach acid flows back (reflux) into the muscular tube that carries food from the throat to the stomach (esophagus). Problems occur when the reflux irritates the esophagus’s delicate lining and causes pain and discomfort. This condition, which is also known as acid reflux disease, can eventually damage other parts of the upper digestive tract if left untreated.
Heartburn is the associated burning sensation or pain in the chest or mid-abdomen region caused by acid reflux. It is most often experienced after eating a large meal, lying down after a meal, bending over, or while lifting large objects.
Other symptoms of acid reflux include a sour or bitter taste in the back of the throat, as the stomach acid or stomach contents flow back into the esophagus. Unexplained coughing or clearing of the throat are also signs. A sore throat or hoarse voice can be caused by stomach acid coming up as far as the throat and larynx, causing inflammation of the voice box.
Symptoms which are a cause for concern include having difficulty swallowing, choking when eating, or the sensation that food is getting stuck in the esophagus. Immediately contact your doctor if you vomit blood or have bowel movements that are red, black, or resemble tar.
Symptoms can occur in people of all ages, including infants and the elderly.
What Damage is Caused by GERD?
Although many people experience heartburn from time to time, it can become a concern if symptoms occur two or more times per week, or are painful enough to interfere with your daily routine. If this is the case, this condition may not only be causing pain but may also be damaging the surrounding tissue.
The lining of your stomach can withstand the caustic nature of stomach acid, but your esophagus, voice box, and teeth cannot. Ulcers may form in the esophagus, your voice box may become swollen, and the enamel on your teeth may begin to erode if they are constantly exposed to stomach acid.
Over time, the esophagus may become severely damaged, which may lead to a swallowing impairment (dysphagia). In the worst case scenario, leaving GERD untreated can lead to esophageal cancer. This occurs when the cells at the bottom of the esophagus are repeatedly damaged and begin to grow abnormally.
One technique that doctors use to determine the extent of damage of the esophagus and surrounding tissue is an upper GI endoscopy. Using a thin, flexible tube that is fitted with a special video camera, a specialist can view, in detail, the upper GI tract and look for any underlying issues caused by GERD. An endoscope can also be used to take a biopsy, or in some cases, treat a problem.
Some people can manage milder symptoms of GERD, find relief, and even slowly reverse the damage caused by this condition through simple lifestyle changes and over-the-counter medications. Eating smaller meals, quitting smoking, losing weight, and avoiding certain foods can improve symptoms. Taking antacids that neutralize stomach acid or medications that either reduce stomach acid production or inhibit it all together are appropriate treatments too.
Incorporating these habits can help to reduce or eliminate the symptoms of acid reflux disease from occurring and allow the body to begin healing itself. In the more severe cases, in which the damage has already occurred, prescribed medication and surgery options should be considered.
Speak with your specialist to determine what the best course of action is for your condition.
By Dr . Veerakit Apiratprachasin , Gastroenterologist and Hepatologist, Digestive Disease Center, Bumrungrad Hospital
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