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Heartburn, acid reflux, indigestion – these are all common symptoms of Gastroesophageal Reflux Disease (GERD). Millions of people worldwide experience these uncomfortable sensations. But what exactly is GERD, and what can you do about it?

 

This comprehensive guide aims to answer your most frequently asked questions about GERD. Whether you're experiencing occasional discomfort or dealing with chronic symptoms, you'll find valuable information and expert advice here. Let's dive in and get you the relief you deserve.

What is GERD?

 

GERD, or Gastroesophageal Reflux Disease, is a chronic condition where stomach acid flows back into the esophagus. This can cause heartburn and other uncomfortable symptoms.

 

What are the causes of GERD?

 

Most cases of GERD are due to the weakness of the lower esophageal sphincter which does not close properly leading to the flow of the acid from the stomach into the esophagus.

 

Hiatus hernia is the second common cause, as the diaphragm muscle provides good support to the lower esophageal sphincter from the outside. When a hiatus hernia occurs the LES and part of the stomach slide up into the chest away from the diaphragm.

 

The other causes include delayed gastric emptying as in patients with diabetes, this will make the food remain in the stomach for a longer time stimulating more acid secretion, some of which flows into the esophagus and causes heartburn. The same occurs when there is an ulcer or cancer at the stomach outlet preventing it from emptying its contents.

 

Can I have regurgitation without heartburn?

 

There are two types of GERD, one of them presents heartburn only, while the other presents with regurgitation, some people have both types (heartburn and regurgitation).

 

I feel a bitter sensation from my stomach to my tongue, is it GERD?

 

Yes, it is, you feel so because the acid flows back from your stomach to the tongue, causing a bitter sensation.

 

Is the difficulty in swallowing a symptom of GERD?

 

Yes, difficulty in swallowing can be a symptom of GERD, it can cause difficulty in swallowing in many ways:

 

-            Acid can cause ulcers in the lower esophagus which causes dysphagia

 

-            Strictures can complicate GERD which causes dysphagia

 

-            In rare cases, GERD causes cancer of the esophagus that causes dysphagia.

 

Can GERD Cause a Change of Voice and Throat Clearing?

 

Yes, GERD can indeed cause a change of voice and throat clearing.

 

While heartburn and indigestion are the most common symptoms, GERD can also affect the upper part of the digestive system, including the throat and vocal cords. When stomach acid travels up the esophagus and into the throat, it can cause irritation and inflammation, leading to:  

 

Hoarseness: Acid reflux can irritate the vocal cords, causing them to become inflamed and leading to a hoarse voice.  

 

Throat clearing: The constant irritation from acid reflux can trigger a persistent urge to clear your throat.  

 

It's important to note that this condition is often referred to as Laryngopharyngeal Reflux (LPR), which specifically focuses on the reflux of stomach acid into the throat and voice box.

 

Can GERD Cause a Recurrent Sore Throat?

 

Yes, GERD can be a cause of a recurrent sore throat.

 

As mentioned earlier, GERD can often manifest as laryngopharyngeal reflux (LPR), directly impacting the throat and vocal cords. Constant exposure to stomach acid can lead to chronic inflammation and irritation, resulting in a persistent sore throat.  

 

If you're experiencing a recurrent sore throat, it's essential to consult with a healthcare professional to determine the underlying cause. They can rule out other potential issues and recommend appropriate treatment.

 

Can GERD Cause Difficulty in Breathing?

 

Yes, GERD can indeed cause difficulty in breathing, especially if there is a large hiatus hernia so, the patient may feel shortness of breath after eating.

 

This symptom is often overlooked as a respiratory problem, but it's a common occurrence in people with GERD. When stomach acid travels up the esophagus and into the throat, it can irritate the airways, causing them to swell. This inflammation can lead to:  

 

-            Shortness of breath

 

-            Wheezing  

 

-            Coughing  

 

In some cases, GERD can even trigger or worsen asthma symptoms.  

 

It's important to consult with a healthcare professional if you're experiencing difficulty breathing, as it could be a sign of a more serious condition.

 

I have chest pain; can GERD cause this pain?

 

Of course, GERD can do so, but before we have to rule out the serious causes of chest pain like angina and myocardial infarction, you should consult the cardiologist first.

 

Acid reflux can cause chest pain because it irritates the esophagus leading to spasms of the muscles of the wall of the esophagus which causes chest pain.

 

Can GERD cause sleep troubles?

 

Yes, it can do so, some patients experience what is called nocturnal reflux symptoms, as the acid refluxes back from the stomach to the esophagus and throat during sleep, this will awaken the patient with cough and choking.

 

To avoid this, you must raise the head of the bed, so can use the reflux pillow as well, avoid eating 4 hours before going to bed, and you may take a dose of your medication that reduces the stomach acid before sleep.

 

I have GERD symptoms but when I did the endoscopy, it was normal, is the result of this endoscopy wrong?

 

Mostly the result of the endoscopy was not wrong, as 70% patient of GERD patients have no findings related to GERD in endoscopy, and diagnosis of GERD is mainly based on the presence of symptoms.

 

When do GERD patients need endoscopy?

 

There are many indications of gastroscopy in patients with GERD:

 

1-       If the patient does not respond to medical treatment, the symptoms recur after the medications are stopped.

 

2-       If the onset of symptoms is above the age of 50, endoscopy will rule out the presence of cancer.

 

3-       If there are alarming symptoms e.g. loss of weight, vomiting of blood, anemia, and difficulty in swallowing.

 

4-       If patients had symptoms of acid reflux for more than 10 years, the endoscopy would rule out complications related to GERD e.g. cancer esophagus, stricture, or Barret's esophagus.

 

5-       If the patient has a family history of cancer esophagus.

 

Did lifelong use of GERD medications cause cancer?

 

Long-term studies confirmed that these medications do not cause esophageal cancer, and it is safe, the side effects are minor, and some patients may suffer from B12 deficiency, so the patients present with tingling and numbness in the hands or feet. Also, some patients may develop small intestinal bacterial overgrowth which may lead to gaseous distension of the abdomen and diarrhea.

 

Is Apple vinegar beneficial for GERD patients?

 

Apple vinegar is not a treatment for acid reflux disease and in some patients, it may worsen the symptoms of GERD.

 

Is the GERDX treatment successful in relieving the GERD symptoms?

 

GERDX is an endoscopic treatment of GERD which is done through the gastroscope by suturing a part of the stomach around the LES. This treatment is useful for patients who do not want to stay on lifelong medications.

 

When to use the magnetic ring for treatment of GERD?

 

The magnetic ring is a new technique in which this ring is fixed around the LES by the laparoscope. This ring will allow food to pass from the esophagus to the stomach and not the reverse. This ring is useful for patients whose main symptom is regurgitation of food.

 

What is the role of surgery for GERD treatment?

 

Surgery (Nissen fundoplication) is reserved for cases with large hiatus hernia (> 4cm), or those patients not responding to medical treatment or not willing to use life-long medical treatment.

 

In this surgery, a part of the stomach is wrapped around the lower esophageal sphincter to support it, to prevent the reflux of gastric contents and acid to the esophagus.

 

Conclusion

 

Acid reflux, also known as GERD (gastroesophageal reflux disease), is a chronic disease that requires significant lifestyle changes to manage effectively. Many individuals experience heartburn symptoms due to the backflow of stomach contents into the esophagus, which can be caused by consuming fatty foods or foods and drinks that keep acid levels high. To get rid of acid reflux, it’s essential to identify foods that help relieve symptoms and avoid those that may make your symptoms worse. Over-the-counter antacids can provide temporary relief, while more severe cases may require a proton pump inhibitor to reduce acid production in the stomach.

 

Untreated chronic acid reflux can lead to more serious conditions, including esophageal cancer. Therefore, it is crucial to seek medical advice to properly diagnose GERD and explore various treatment options tailored to your needs. By making these adjustments, you can greatly improve your quality of life and reduce the symptoms associated with acid reflux and heartburn.