What is Gastroesophageal Reflux Disease or GERD?
By Dr. Krishna Meka, Bronson Gastroenterology Specialists in Kalamazoo and Battle Creek.
As seen in Scene Magazine, April 2022
Krishna Meka, DO
Many of us have had instances where something we eat just doesn’t settle right. The result can be an irritating, and sometimes painful, bout of heartburn or acid indigestion. Roiling stomach acid that backs up into the esophagus is called reflux and it can irritate and damage the lining of the esophagus.
When acid reflux becomes a chronic occurrence, it is quite possible that it is gastroesophageal reflux disease. With an incidence of twenty percent, GERD is one of the most commonly diagnosed digestive issues in the United States, according to the National Institutes of Health (NIH). The occurrence may be even higher with individuals treating undiagnosed issues with over the counter medication. While the most common symptoms of GERD are heartburn and acid reflux, other symptoms may include:
- Chest pain
- Dental erosion
- Chronic cough
- Difficulty swallowing
- Sleep disruption
60 to 70 percent of individuals with GERD have non-erosive GERD, or NERD. This means that even though the reflux can be uncomfortable, there is no current injury to the esophagus. Chronic, severe GERD can lead to erosive esophagitis (EE). At this stage, there is detectable damage and inflammation to the cells of the esophagus. This condition occurs in approximately 30 percent of individuals with GERD. The NIH reports that women who are newly diagnosed are more likely to have NERD, while men are more likely to have EE.
6 to 12 percent of patients diagnosed with GERD have a more serious, sometimes life-threatening condition called Barrett esophagus (BE). Patients with BE have significant inflammation, erosion of the lower portion of the esophagus and difficult, painful swallowing. BE requires urgent attention and treatment to stop further damage. The NIH also noted that men with longstanding symptoms of GERD have a nearly ten percent higher incidence of Barrett’s esophagus than women.
Several risk factors have been associated with the increased risk of developing GERD. Some of the risk factors include:
- Excess weight
- Tobacco use
- Excess alcohol consumption
- Lower socioeconomic status
- Medication interactions
Mild, infrequent bouts of heartburn or acid reflux are often treated with over-the-counter medications to neutralize, reduce or block acid production. Lifestyle changes are also often necessary. These can include:
- Weight loss
- Changes to diet including
- Elimination of chocolate, alcohol, caffeine, spicy foods, citrus and carbonated beverages
- Smaller portion sizes at meals
- Avoiding eating at least 3 hours before bedtime
- Quit smoking
- Elevating the head while sleeping
Lifestyle changes are the first line of defense against GERD. Such changes can make a big difference in the quality of life for those suffering from GERD. This is especially true when part of a comprehensive care plan and counseling under the care of a doctor.
Individuals who are experiencing frequent, severe occurrences of heartburn or acid reflux or those who need to take over-the-counter medications more than twice a week should see a doctor. GERD can more easily be treated and controlled with an early diagnosis. Without diagnosis and treatment, GERD symptoms often become more frequent and more severe. Complications and damage to the esophagus also increase the longer GERD goes untreated.
A doctor will use your ongoing symptoms and a physical exam to help diagnose you. Tests that may be used to diagnose GERD can include:
- Upper endoscopy – a flexible tube with a camera used to examine the esophagus and stomach
- A capsule endoscopy – a pill sized camera that passes through your digestive system and send pictures remotely to a receiver
- An X-ray of your digestive system
- An acid (pH) probe test – monitors stomach acid and effects on the esophagus
- Esophageal manometry – measures muscle contractions and swallowing in the esophagus
Individuals with diagnosed GERD that cannot control symptoms through lifestyle changes may experience relief through other methods including:
- Prescription-only medical therapy – the doctor may prescribe a prescription-strength medication to control stomach acid production if over-the-counter options are not helpful
- Surgical options to tighten the sphincter between the esophagus and stomach that can help to limit the amount of stomach acid entering the esophagus
Untreated GERD is not only an uncomfortable, unnecessary condition; it can lead to additional medical issues. If you are living with the ongoing discomfort and disruption that you believe may be GERD, have a conversation with your doctor. It may be time to make changes to your lifestyle or see a specialist about possible medical interventions to help stop GERD and treat the damage.
Krishna Meka, DO, is a physician at Bronson Gastroenterology Specialists. The Battle Creek office is located at 3770 Capital Avenue, Suite A. You can reach Bronson Gastroenterology Specialists at (269) 349-2266.
About the Author
Dr. Krishna Meka
Dr. Krishna Meka is a gastroenterologist at Bronson Gastroenterology Specialists in Battle Creek and Kalamazoo. He believes that patient empowerment and evidence-based medicine are essential when formulating a diagnostic or treatment plan.
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