Management of GERD: A Complete Guide from Pain to Prevention

GERD, or acid reflux, occurs when stomach acid flows back into the esophagus. While it can affect individuals of any age, it is most common in adults aged 20 to 40. The primary symptom is heartburn, and if left untreated, GERD can irritate or inflame the esophageal lining. Chronic reflux exposes the lower oesophagus to gastric contents for extended periods, resulting in persistent symptoms.

What causes GERD?

The primary cause of GERD is frequent acid reflux, where stomach acid flows back into the esophagus. Normally, the lower esophageal sphincter, a circular muscle, relaxes to allow food and drink into the stomach and then closes to prevent backflow.

If the lower esophageal sphincter becomes weak or does not function properly, stomach acid can flow back into the esophagus. Over time, this can weaken or irritate the lining of the esophagus.

 

What are the symptoms of GERD?

GERD symptoms start with frequent heartburn and acidity. Other symptoms include:

• Regurgitate acid (when acid stomach content goes back up and reaches the mouth)
• Frequent sour taste in the mouth.
• Bloating
• Nausea and burping
• Dry cough especially late night
• Feeling a lump in the throat while swallowing food.
• Sore throat and pain while swallowing food.
• Feeling chest pain (Experience severe chest pain, need immediate medical attention sometimes)
• Shortness of breath, asthma.

Risk factor of GERD:

Certain health conditions may increase the risk of GERD, including:

• Eating an unhealthy diet often.
• Pregnancy
• Hiatal hernia
• Reduce LES (lower esophagus sphincter) pressure.
• Connective tissue disorders.
• Delayed or abnormal clearance rate of esophageal acid.

 

Other lifestyle factors may increase the risk of GERD:

·       Overeating and eating large meals

·       Eating a late-night dinner

·       Smoking or tobacco

·       Beverages like soda, coffee, and alcohol

·       Lack of physical activity.

·       High-flavoured or fried food.

 

Diagnosis of GERD:

·         Upper endoscopy: A flexible tube with a camera is inserted into the esophagus to inspect the lining and take tissue samples if needed (biopsy).

·         Ambulatory pH testing: Measures acid levels in the esophagus using a small wireless capsule or probe.

·         Esophageal manometry: Assesses muscle function and coordination in the esophagus and lower esophageal sphincter.

·         Barium swallow test: The patient swallows barium liquid, and X-rays track its movement through the throat and esophagus to evaluate function.

 

Treatment of GERD or reflux disease

Managing GERD involves a comprehensive approach that includes changes in diet, lifestyle adjustments, medication, and sometimes surgical intervention.

Lifestyle changes:

·         Eating dinner early and staying upright afterward helps use gravity to speed up stomach emptying and reduce acid reflux.

·         Avoid or limit foods that trigger acid production, such as alcohol, chocolate, coffee, tea, tomatoes (and ketchup), mint, carbonated drinks, and citrus fruits and juices.

·         Steer clear of high-fat and fried foods.

·         Maintain a healthy weight, as excess weight increases pressure on the stomach.

·         Opt for smaller, more frequent meals instead of large or late meals, which can raise stomach pressure.

• Medications:

Antacids neutralize stomach acid to prevent reflux. Other drugs like H2 blockers (e.g., famotidine, cimetidine) reduce acid production for longer relief. Always consult a doctor before taking any medication.

·         Surgery:

Surgery is a last resort for chronic GERD. The most common is laparoscopic fundoplication, where the stomach is wrapped around the lower esophageal sphincter to prevent reflux. Other options include the LINX device, which uses magnetic beads to keep the junction closed, and Transoral Incisionless Fundoplication (TIF), a newer method that tightens the sphincter using fasteners.

Conclusion

In today’s fast-paced lifestyle, many of us fall short when it comes to maintaining healthy eating habits and regular physical activity. As a result, acid reflux has become a common concern, often presenting with symptoms like indigestion, a burning sensation in the chest, and regurgitation. While these symptoms can be uncomfortable, they are often manageable—especially when addressed early with simple lifestyle changes.

However, if acid reflux occurs frequently and begins to interfere with your daily life, it may indicate a more serious condition such as Chronic GERD (Gastroesophageal Reflux Disease). In such cases, it’s important to consult a gastroenterologist for a thorough evaluation and appropriate treatment.