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What is GERD (Gastroesophageal Reflux Disease)

By Dr. Alok Gupta in Laparoscopic / Minimal Access Surgery , Bariatric Surgery / Metabolic , Department of General Surgery and Robotics

Oct 08 , 2024 | 2 min read

Gastroesophageal Reflux Disease (GERD) is a common condition that impacts millions globally, yet it is frequently misinterpreted. It happens when stomach acid flows back into the oesophagus, the tube that connects your mouth and stomach. This backflow, known as acid reflux, irritates the lining of the oesophagus and leads to a variety of symptoms and complications. While occasional acid reflux is common, GERD is diagnosed when these episodes occur frequently—typically more than twice a week.

Symptoms of GERD

The symptoms of GERD can vary significantly among individuals but commonly include:

Heartburn
A sour or bitter taste in the mouth
Difficulty swallowing
Chronic cough
Sore throat
Chest pain

It’s crucial for patients to recognise that GERD symptoms can overlap with more serious conditions, such as heart disease, so seeking medical advice is essential.

Causes of GERD

Several factors can contribute to the development of GERD:

Lower Esophageal Sphincter (LES) Dysfunction: The LES is a muscular ring at the base of the esophagus that normally prevents stomach contents from flowing back up. If this sphincter is weakened or relaxes inappropriately, GERD can occur.
Obesity: Excess body weight can create pressure in the abdominal area, causing stomach contents to flow back into the esophagus.
Pregnancy: Hormonal changes and pressure from the growing uterus can lead to GERD symptoms in expectant mothers.
Hiatal Hernia: This happens when a part of the stomach pushes through the diaphragm into the chest cavity, potentially interfering with the function of the lower esophageal sphincter (LES).
Dietary Factors: Some foods and beverages, like spicy foods, citrus, chocolate, caffeine, and alcohol, can trigger or worsen GERD symptoms.
Smoking: Tobacco can weaken the LES and reduce saliva production, which helps neutralise stomach acid.

Diagnosing GERD

Diagnosis of GERD usually begins with a thorough medical history and physical examination. Here are a few common diagnostic approaches:

Symptom Assessment: Doctors will enquire about how often symptoms occur and their intensity, along with any lifestyle habits that might play a role in GERD.
Trial of Medication: A temporary trial of proton pump inhibitors (PPIs) or H2 receptor antagonists may be prescribed to see if symptoms improve, supporting the diagnosis.
Upper GI Endoscopy: In some cases, an upper endoscopy may be recommended to visually examine the esophagus and stomach for inflammation, strictures, or other abnormalities.
pH Monitoring: This test measures the amount of acid in the esophagus over 24 hours and can help confirm a GERD diagnosis.
Esophageal Manometry: This test evaluates the function of the esophagus and the LES, assessing how well they are working.

Conclusion

GERD is a manageable condition, but understanding its symptoms, causes, and diagnostic methods is key for patients. If you or someone you know is experiencing symptoms of GERD, encourage them to consult a healthcare professional for proper evaluation and treatment. Early intervention can prevent complications and improve overall quality of life.