Gastroesophageal reflux disease (GERD) happens when stomach acid frequently flows back into the tube connecting the mouth and stomach, which is called the esophagus. This backwash can irritate the lining of the esophagus. Many people feel acid reflux from time to time. GERD is nominal acid reflux that happens at least twice a week, or moderate to severe acid reflux that happens at least once a week. Most people can control the discomfort of GERD with lifestyle changes and over-the-counter medicines. But some people with GERD may require stronger drugs or surgery to ease symptoms of GERD.
Symptoms of GERD
Common signs and symptoms of GERD involve:
1) A burning sensation in the chest, typically after eating, which might be worse at night
2) Chest pain
3) Difficulty in swallowing
4) Regurgitation of food or sour liquid
5) The sensation of a lump in the throat
If you have nighttime acid reflux problem, you might also feel:
GERD caused by frequent acid reflux. When you swallow, a circular band of muscle around the bottom of the esophagus relaxes to permit food and liquid to flow into the stomach. Then the sphincter closes again.
If the sphincter relaxes abnormally or weakens, stomach acid can flow back up into the esophagus. This constant backwash of acid irritates the lining of the esophagus, sometimes causes GERD to become inflamed.
Complications of GERD
Over time, complications of GERD can create:
1) Narrowing of the esophagus: Damage to the lower esophagus from stomach acid makes scar tissue to form. The scar tissue narrows the food pathway, producing problems with swallowing.
2) An open sore in the esophagus: Stomach acid can wear away tissue in the esophagus, creating an open sore to form. An esophageal ulcer can bleed, cause pain, and make swallowing difficulties.
3) Precancerous changes to the esophagus: Damage from acid can make changes in the tissue lining the lower esophagus. These changes are related to an enhanced chance of esophageal cancer.
The doctor might be able for the diagnose of GERD based on a physical test and history of the signs and symptoms. To confirm a diagnosis of GERD, or to identify for complications, the doctor might suggest:
1) Upper endoscopy: The doctor places a thin, flexible tube equipped with a light and camera down the throat to test the inside of the esophagus and stomach. Test results can sometimes be average when reflux is present, but an endoscopy may identify inflammation of the esophagus or other complications. An endoscopy can also be used to collect a sample of tissue to be examined for complications like Barrett’s esophagus.
2) Ambulatory acid probe test: A monitor is inserted in the esophagus to detect when, and for how long, stomach acid regurgitates there. The monitor links to a small computer that you wear around the waist or with a strap over the shoulder. The monitor might be a thin, flexible tube that is threaded through the nose into the esophagus or a clip that is inserted in the esophagus during endoscopy, and that gets passed into the stool after about two days.
3) Esophageal manometry: This test measures the rhythmic muscle contractions in the esophagus when you swallow. Esophageal manometry also measures the coordination and force exerted by the muscles of the esophagus.
4) X-ray of the upper digestive system: X-rays are taken after you drink a chalky liquid that coats and fills the inside lining of the digestive tract. The coating permits the doctor to see a silhouette of the esophagus, stomach, and upper intestine. You may also be asked to swallow a barium pill that can assist diagnose a narrowing of the esophagus that may bother with eating.
Treatment of GERD
The doctor is likely to suggest that you first try lifestyle modifications and over-the-counter medicines. If you do not feel relief within a few weeks, the doctor might recommend prescription medicine or surgery for the treatment of GERD.