GERD

Causes:

• Lower Esophageal Sphincter (LES): GERD often results from a weakened or malfunctioning lower esophageal sphincter, a muscular ring that separates the esophagus from the stomach. When the LES doesn’t close properly, stomach acid can flow back into the esophagus.

Symptoms:

• Heartburn: A burning sensation in the chest, often after eating or at night.
• Regurgitation: Backflow of stomach contents into the throat or mouth.
• Difficulty Swallowing: Known as dysphagia, it can occur due to irritation and narrowing of the esophagus.
• Chest Pain: May be mistaken for a heart attack.
• Chronic Cough: Persistent cough, often worsened by lying down.

Risk Factors:

• Hiatal Hernia: A condition where a portion of the stomach protrudes into the chest cavity, increasing the risk of GERD.
• Obesity: Excess weight can put pressure on the abdomen, promoting reflux.
• Pregnancy: Hormonal changes and increased pressure on the abdomen during pregnancy can contribute.
• Smoking: Smoking can weaken the LES.

Diagnosis:

• Endoscopy: A flexible tube with a camera is used to examine the esophagus for signs of damage.
• pH Monitoring: Measures acid levels in the esophagus over a 24-hour period.
• Esophageal Manometry: Measures the pressure and coordination of muscle contractions in the esophagus.

Treatment:

• Lifestyle Changes: Elevating the head of the bed, avoiding large meals, losing weight, and quitting smoking can help.
• Medications:
  • Proton Pump Inhibitors (PPIs): Reduce stomach acid production.
  • H2 Blockers: Reduce acid production.
  • Antacids: Provide short-term relief by neutralizing stomach acid.
• Surgery: In severe cases, surgery may be considered to strengthen the LES or repair a hiatal hernia.

Complications:

• Esophagitis: Inflammation of the esophagus.
• Strictures: Narrowing of the esophagus due to scarring.
• Barrett’s Esophagus: Changes in the lining of the esophagus that can increase the risk of esophageal cancer.