What is GERD (Gastroesophageal Reflux Disease)

Gastroesophageal reflux disease (GERD) is a digestive disorder that affects the lower esophageal sphincter (LES) causing the reflux of gastric content.

GERD occurs when stomach acid flows back into the esophagus which is the tube that runs through the throat connecting the mouth and the stomach.

The esophagus is a muscular tube about 8 inches long. At the very end of this tube is a valve called the lower esophageal sphincter (LES) which closes the entrance to the stomach and keeps the food we eat inside it.

Normally, the LES closes after the food passes through it. However, in someone suffering from GERD, the sphincter does not function properly.

This causes the food and stomach acid to move back into the esophagus. Gastric content can even reach the throat and mouth. This produces a feeling of discomfort and causes various symptoms, such as a burning sensation in the chest, called heartburn, and an acidic taste in the throat and mouth.

GERD could be due to the lower esophageal sphincter’s weak muscles or to a hiatal hernia at the entrance of the stomach. A hiatal hernia occurs when the upper part of the stomach pushes through an opening in the diaphragm and into the chest. The diaphragm is the muscle that separates the chest and the stomach. It helps keep stomach acid and food inside the stomach.   

GERD symptoms can be easily controlled if people watch over their diet, change their lifestyle and eating habits, or take natural over-the-counter medicine. However, sometimes GERD cases can be more complicated and require further medical attention.

Acid Reflux (GERD) History

In 1925, German physicians Dr. Friedenwald and Dr. Feldman were among the first physicians who documented the first symptoms of GERD or acid reflux. They wrote a  paper discussing the possible relationship between the symptom of burning chest pain (heartburn) and a hiatal hernia.

Shortly after, the correlation became very clear.  Doctors established that a hiatal hernia can cause GERD and heartburn.

In 1934, the American gastroenterologist Dr. Asher Weslein described the relationship between acid reflux and heartburn. He also posited that the two symptoms were related to excessive stomach acid, which is the main cause behind GERD as we know it today.

In 1946, Dr. Allison described hiatal hernia as a factor in the development of gastroesophageal reflux disease.

In 1958, Dr. Bernstein and Dr. Baker indicated that there was a direct relationship between the acid in the esophagus and heartburn in patients with acid reflux.

In 1989, the first proton pump inhibitor, Omeprazole, was introduced in the market. Proton pump inhibitors reduce the production of stomach acid in patients with GERD to prevent it from refluxing into the esophagus.

Acid Reflux (GERD) Causes

GERD or acid reflux can be caused by a variety of different reasons that might include genetics, diet, and lifestyle.

However, in most cases, GERD is associated with the weak muscles in the lower esophageal sphincter (LES). This causes the stomach’s contents to flow back into the esophagus, throat, and mouth.

Another cause can be due to an imbalance in the body's function to control the location of the gastric content.

GERD can also be caused by hiatal hernia that occurs when part of the patient’s stomach bulges upward through the diaphragm and into the chest cavity. The stomach’s contents may reflux into the esophagus because the diaphragm does not separate the chest cavity and the stomach anymore.

Stress can be another factor that can cause acid reflux. This is because stress reduces the production of prostaglandins, which are chemicals that normally protect the stomach from the effects of acid.

Acid Reflux (GERD) Risk Factors

Several risk factors that can cause GERD or acid reflux such as:

•    Eating large meals or snacking around bedtime
•    Being overweight or obese
•    Laying down or bending over after a big meal
•    Eating certain types of foods, such as citrus, tomato, chocolate, mint, garlic, onions, or spicy or fatty foods
•    Drinking certain beverages, such as alcohol, carbonated drinks, coffee, or tea
•    Smoking
•    Being pregnant
•    Taking aspirin, ibuprofen, certain muscle relaxers, or blood pressure medication

Acid Reflux (GERD) Symptoms

GERD can present itself differently for each individual, but people often have symptoms of heartburn and regurgitation.

- Regurgitation: the reflux of food content and/or stomach acid into the patient’s throat or mouth.

- Heartburn: the sensation of burning chest pain. Despite its name, heartburn isn’t related to the heart. 

Other symptoms of acid reflux disease include:

•    Bloating

•    Bloody or black stools or bloody vomiting  

•    Burping

•    The sensation of having something “stuck” in your throat

•    Chronic hiccups

•    Nausea

•    Weight loss

•    Wheezing, dry cough, hoarseness, or having a chronic sore throat

Acid Reflux (GERD) Diagnosis

A doctor diagnoses a patient with GERD after checking his or her background and medical history. If the patient does not respond well to the treatment, doctors may conduct  the following exams:

•    Endoscopy: This test involves inserting a long, flexible, lighted tube with a camera down the throat. During an endoscopy, doctors may conduct a biopsy of the esophageal or stomach tissue.  Then they can examine the tissue sample under a microscope for abnormalities.

Doctors use endoscopy to check for problems in the esophagus or stomach.

•    Barium swallow (esophagram): During this test, doctors conduct an X-ray of your pharynx after you drink a solution of barium sulfate. Barium sulfate is a metallic compound that is visible on X-rays. It reveals abnormalities in the esophagus and stomach.

Doctors use this test to determine the causes of abdominal pain or the reasons behind the patient’s difficulty swallowing, blood stained vomit, or unexplained weight loss. 

•    Esophageal manometry: Doctors use this swallowing test to check the function of the esophagus and lower esophageal sphincter.

•    pH monitoring: Doctors use pH monitoring to check the level of acidity in the esophagus. They monitor pH levels by inserting a device into your esophagus and leaving it in place for 1 to 2 days to measure the pH level of the esophagus.

Natural Treatments for GERD

There are lot of various natural solutions to for acid reflux. Click on natural treatments for GERD to find a detailed list of all these natural treatments for GERD, including various natural therapies, diet programs, alternative medicine, vitamins, supplements, herbal medicine, and home remedies.

You can also go to www.aposbook.com to find all the natural treatments for any medical condition IN ONE CLICK.

Meanwhile, the natural solutions for GERD work on different aspects of this condition. Some focus by balancing the pH levels in the stomach to reduce acidity while others work on easing the symptoms by eliminating stress. These natural solutions include:

- Herbs: some herbs, such as licorice or chamomile, help reduce the symptoms of GERD and provide quick relief. Licorice helps coat the esophagus and protects it from the damaging effects of the refluxing stomach acid.

- Relaxation techniques: some relaxing techniques can reduce the stress and anxiety that can trigger GERD symptoms. 

- Food and nutrition: some foods, such as apple cider vinegar, work on balancing the pH levels in the stomach which helps treat GERD.

Medical Treatment for GERD

Several over-the-counter medications can reduce the signs and symptoms of GERD by lowering the level of acidity in the stomach. Over time, if the medications become less effective, the doctor might recommend surgery to treat the disease.

Prescription medicines that can be used to treat GERD include:

- Antacids to neutralize stomach acid: Antacids, such as Mylanta and Tums, may provide a quick relief because antacids neutralize stomach acid. However, overusing antacids can cause side effects, such as diarrhea or kidney problems.

- Medications to reduce acid production: These medications don’t provide quick relief for GERD symptoms like antacids do, but they provide longer relief by reducing acid production in the stomach.

- Medications to block acid production: These medications block acid production in the stomach and can heal damaged tissues in the esophagus.

GERD can be usually controlled with medication. However, if the patient doesn’t experience relief, the doctor might recommend the following surgeries:

- Fundoplication: To tighten the lower esophageal sphincter muscle and prevent reflux, the surgeon can either fold the upper stomach (fundus) completely or partially around the lower esophageal sphincter.

- LINX device: During surgery, doctors fit a ring of tiny magnetic beads called a LINX device around the junction of the stomach and esophagus. The magnetic attraction between the beads is strong enough to keep the junction closed to refluxing acid, but weak enough to allow food to pass through.

- Transoral incisionless fundoplication (TIF): This new procedure is performed through the mouth using a device called an endoscope and requires no surgical incision. During TIF, the surgeon repairs the lower esophageal sphincter by constricting it and creating a partial wrap around the lower esophagus.  Its advantages include quick recovery time and high tolerance.

Acid Reflux (GERD) Prevention

Visit the GERD Prevention Center to check all the information on how to prevent GERD, including the different recommendations to follow, lifestyle changes to make, and things to avoid.

These suggestions include among many others:

- Eating smaller portions

- Raising one side of the bed

- Use bigger pillow

- Avoid triggering foods

- Avoid caffeine, etc...

You can also find a detailed explanation why each one of these recommendations can help manage GERD symptoms and how it should be done.