Gastroesophageal reflux disease or GERD is caused by the weakening of the lower esophageal sphincter (LES). LES is a group of muscles that act as a valve to prevent the acidic contents of the stomach from refluxing into the esophagus.
It is estimated that around at least 2 out of 10 Americans experience GERD symptoms at some point in their life.
Approximately 80% of patients experience recurrence of GERD symptoms that do not progress and can be controlled with medications. The rest 20% develop complications (such as esophageal strictures) that need quick resolution by surgery to prevent the progression of the damage. Generally, long-term maintenance therapy is needed for most patients with GERD.
The damage caused by mild GERD can be possibly reversed or reduced by following a healthy lifestyle and taking medications.
What are the complications of GERD?
If GERD is left untreated, the protective lining of the esophagus gets corroded by the acid reflux and can give rise to complications. These below complications make the healing of GERD difficult:
- Esophagitis (inflammation of the esophagus)
- Esophageal ulcers (sores in the lining of the esophagus)
- Barrett esophagus (abnormal changes in the esophagus that can lead to cancer)
- Esophageal stricture (narrowing of the esophagus)
- Dental problems (wearing of the teeth enamel, dental cavities)
- Increased risk of esophageal cancer
- Asthma flare-ups (GERD worsens asthma and asthma worsens GERD)
What lifestyle changes can help prevent GERD symptoms?
Diet and lifestyle changes form the cornerstone of therapy for managing and preventing the symptoms of GERD. These include:
- Eat frequent smaller meals (instead of three large meals)
- Maintain a healthy weight (belly fat puts pressure on your stomach)
- Relax when you eat (stress triggers heartburn)
- Beat the stress (try relaxation therapies, such as deep breathing, meditation, massage, or yoga)
- Remain upright during and after eating (for at least 45-60 minutes)
- Eat at least three hours before going to bed (do not eat anything just before bed)
- Avoid tight accessories (such as tight belts, waistbands) and other clothing on your belly (these can put pressure on your stomach)
Cut down on foods that can trigger GERD. These include:
- High-fat foods (including dairy products)
- Spicy dishes
- Tomatoes
- Tomato sauce
- Garlic
- Onions
- Citrus fruits (lemons, oranges)
- Carbonated drinks
- Coffee
- Chocolate
- Peppermint
- Alcoholic drinks
- Avoid smoking
- Raise the head of your bed by at least 6-8 inches (use wooden blocks under the bedposts)
SLIDESHOW
The 14 Most Common Causes of Fatigue See SlideshowWhat medications are used to treat GERD?
Treatment of GERD aims at controlling symptoms, healing esophagitis (if present), and preventing recurrent esophagitis or other complications. The standard medications include:
- Omeprazole (Prilosec, Prilosec OTC, Zegerid)
- Lansoprazole (Prevacid)
- Pantoprazole (Protonix)
H2 blockers:
- Famotidine (Pepcid, Pepcid AC)
- Cimetidine (Tagamet, Tagamet HB)
Antacids: These provide relief more quickly than most other medicines by neutralizing the digestive acids in the stomach and esophagus.
- Aluminum hydroxide gel (Alternagel, Amphojel)
- Calcium carbonate (Alka-Seltzer, Tums)
- Magnesium hydroxide (Milk of Magnesia)
Prokinetic agents: These medicines help empty the stomach of its contents so that they do not flow back towards the esophagus. They can also improve muscle tone in the esophagus. The only one approved for use in the United States is metoclopramide (Reglan).
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