Understanding GERD: Causes, symptoms, and solutions

Gastroesophageal reflux is a common digestive disorder that affects millions of people worldwide. It occurs when stomach acid and partially digested food flow back into the oesophagus, causing a range of uncomfortable symptoms.

In his latest online article, Mr Paul Goldsmith explores the causes, symptoms, and treatment options for gastroesophageal reflux, commonly known as GERD (Gastroesophageal Reflux Disease).

The mechanics of GERD

To understand GERD, it's essential to grasp the normal workings of the digestive system. When you eat, food travels from your mouth down the oesophagus to the stomach through a muscular tube called the lower oesophageal sphincter (LES). The LES acts as a one-way valve, preventing stomach contents from flowing back into the oesophagus. However, in individuals with GERD, this valve becomes weak or relaxes inappropriately, allowing stomach acid and contents to reflux into the oesophagus.

Causes of GERD

Hiatal hernia: One common cause of GERD is a hiatal hernia, where a portion of the stomach protrudes through the diaphragm, weakening the LES's ability to prevent acid reflux.

Diet and lifestyle: Consuming large meals, acidic or spicy foods, caffeine, and alcohol can trigger or exacerbate GERD symptoms. Being overweight or obese also increases the risk.

Pregnancy: The pressure on the abdomen during pregnancy can weaken the LES, leading to GERD symptoms.

Smoking: Tobacco smoke can relax the LES and contribute to GERD.

Certain medications: Some medications, like antihistamines, calcium channel blockers, and sedatives, can weaken the LES or irritate the oesophagus, promoting GERD.

Common symptoms

GERD can manifest in various ways, and the severity of symptoms can vary among individuals.

Common signs and symptoms include:

Heartburn: A burning sensation in the chest that often worsens after eating or when lying down.

Regurgitation: The feeling of sour-tasting fluid or food rising in the throat or mouth.

Dysphagia: Difficulty swallowing or a sensation of a lump in the throat.

Chronic cough: A persistent cough, particularly at night.

Laryngitis: Inflammation of the voice box, leading to hoarseness and voice changes.

Chest pain: Chest pain that can mimic heart-related issues, causing anxiety.

Treatment options

Managing GERD often involves a combination of lifestyle modifications, dietary changes, and medications. In severe cases, surgical intervention may be necessary. Here are some treatment options:

Lifestyle Modifications

Diet: Avoid trigger foods such as citrus fruits, tomatoes, chocolate, spicy foods, and caffeine.

Portion control: Eat smaller, more frequent meals to reduce pressure on the LES.

Weight management: Losing excess weight can alleviate symptoms.

Medications

Antacids: Over-the-counter antacids can provide short-term relief by neutralising stomach acid.

H2 Blockers: Histamine-2 receptor blockers reduce acid production.

Proton pump inhibitors (PPIs): These medications block acid production more effectively than H2 blockers and are often prescribed for severe GERD cases.

Surgery: For individuals who do not respond to other treatments or have severe complications, surgical options such as fundoplication, LINX and more recently RefluxStop may be considered to strengthen the LES and prevent reflux.

Gastroesophageal reflux disease is a common condition that can significantly impact an individual's quality of life. Understanding its causes, symptoms, and treatment options is essential for managing and alleviating the discomfort it brings. Lifestyle modifications, dietary changes, and medication can often help control GERD effectively. If you suspect you have GERD or are experiencing persistent symptoms, it's crucial to consult a healthcare professional for a proper diagnosis and personalised treatment plan. With the right approach, most individuals with GERD can find relief and enjoy a better quality of life.

Mr Paul Goldsmith is an esteemed general surgeon with over 15 years of experience. You can schedule an appointment with Mr Goldsmith on his Top Doctors profile.