What is Gerd?
Gastro-esophageal reflux disease or acid-reflux disease is a condition in which the contents of the stomach reflux backwards into the esophagus (food pipe). Since the stomach contents are acidic in nature, this damages the inner lining of the food pipe and causes symptoms of heartburn, pain, etc.
Some amount of reflux of stomach contents is normal in all individuals but not everyone develops GERD. The main reason behind this is that only in some individuals this refluxed fluid is more acidic and remains in the esophagus for longer duration thus causing GERD. Dietary causes and certain faulty habits are frequently responsible for initiating this condition in individuals who are prone to develop it.
At the junction of the food pipe (esophagus) and the stomach is a muscular gateway (called lower esophageal sphincter or LES). Under normal circumstances, this sphincter remains contracted so that no contents of the stomach can go back into the esophagus but when this sphincter becomes relaxed due to any reason or is weak, it may allow the contents of the stomach to flow back into the esophagus causing inflammation of the lining of the oesophagus. There can also be many other causes of GERD which will be discussed in details later.
Chronic long-standing GERD may cause certain complications that have been described below:
- Esophageal erosions: Inflammation of the esophagus, ulcers or breaks in the lining of the esophagus can occur due to repeated contact with refluxed acid from the stomach.
- Esophageal strictures: Repeated damage to the esophageal lining caused by acid reflux forms a scar tissue (stricture). These strictures can trap food and cause difficulty in swallowing.
- Barrett’s esophagus: In some patients, the normal esophageal lining, or epithelium, may be replaced with abnormal epithelium. This condition is called Barrett’s esophagus and it has been linked to cancer of the esophagus.
- Inflammation of the vocal cords due to refluxed acid; this may lead to hoarseness of voice.
- Lung (pulmonary) aspiration, asthma and chronic pulmonary disease may also be caused by GERD.
GERD – Lifestyle Changes
Patients of GERD can benefit immensely if they follow the following set of instructions and incorporate these into their daily lives. These changes in lifestyle can bring under good control most of the symptoms of GERD and can significantly alleviate the symptoms of GERD.
- Don’t eat at least 2-3 hours before bedtime. This will help emptying of the stomach before the person goes into the reclined position and will prevent the reflux.
- Don’t lie down right after eating at any time of day.
- Keep the head end of your bed elevated by at least 6 inches with blocks because gravity helps in preventing the reflux of the acid from the stomach.
- Don’t eat large meals; instead opt for smaller, more frequent meals throughout the day.
- Give up smoking because smoking weakens the lower esophageal sphincter and increases reflux.
- Avoid alcohol because it increases the likelihood that acid from your stomach will back up.
- Reduce your weight if you are overweight because obesity increases the chances of reflux of the acid.
- Avoid fatty, greasy foods, chocolate, caffeine, spicy foods, citrus foods and other things which worsen your heartburn.
- Avoid remaining in stooped posture; keep an upright posture when standing or sitting.
- Be cautious with over-the-counter painkillers as these might worsen your complaints, always ask your physician before taking any such medication.
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