Gastroesophageal Reflux Disease

Gastroesophageal Reflux Disease also known as Acid Reflux is a back

flow of duodenal or gastric contents into the esophagus (a tube that allows
food to pass through the pharynx towards the stomach). Since the refluxed or
regurgitated liquid generally contains pepsin (an enzyme that aids in digestion
of proteins in the stomach) and acid, the liquid can damage and inflame the
esophageal lining. GERD or Acid Reflux is a chronic condition – meaning
once it occurs it is typically a life long disease.

A degree of acid reflux is quite normal in adults and in some children

but excessive reflux may occur because of pyloric stenosis (this condition is
where there is a narrowing of the pylorus which is the lower part of the
stomach through which food and other stomach contents go through to enter
the small intestine), a motility disorder or an incompetent lower esophageal
sphincter (LES). The occurrence of this condition often increases with age.

Now that you know what Acid Reflux is just follow through with this
simple guide to learn more about Acid Reflux and how to manage such
condition.

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Manifestations

Since Acid Reflux occurs mostly in normal individuals, they tend to fail
to notice what symptoms they have that would indicate that they are suffering
from such condition. To give you an idea on what the symptoms of GERD is,
followed below are the general manifestations of acid reflux.

♣ Pyrosis: a burning sensation over the chest where the esophagus is

directly located.

♣ Dyspepsia: indigestion or a vague feeling of abdominal discomfort.

♣ Pain on swallowing or difficulty in swallowing

♣Hyper salivation: excessive saliva production

♣ Chronic cough and chest pain (same as stated above, burning

sensation over the chest).

A pending heart attack has the same symptoms which is there are
diagnostic examinations to qualify such symptoms as GERD. Diagnostic tests
for Acid reflux include 12 to 36 hour esophageal pH monitoring. This is to
evaluate the degree of acid reflux in a person. Other tests which may be
done are barium swallow or endoscopy.

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Managing Acid Reflux

There are various approaches to the assessment and management of

Acid Reflux. The approach of the treatment would depend on the severity of
the symptoms, the frequency of symptoms, the person’s response to the
treatment and preventing complications.

Take note that if you do have Acid Reflux, managing this condition
begins with avoiding factors that may cause esophageal irritation or may
decrease esophageal sphincter pressure.

One simple treatment for GERD is life style changing which would
include an arrangement of several changes in habit. Diet for GERD will be
discussed later in this book.

Acid reflux occurs mostly at nighttime and is more injurious. It is easier

for reflux to occur because individuals are lying down due to the fact that
gravity is not opposing the reflux as opposed to when a person is standing up.
Due to the lack of the effect of gravity, the refluxed fluid is able to travel further
up the esophagus and remain there for a longer period of time while the
person is still assuming a flat position on the bed. Thus the management for
this is to slightly elevate the head of the bed 6 to 8 inches which is
accomplished by placing blocks under the bed’s feet at the head of the bead
or sleeping with a wedge placed directly under the upper body. This simple
maneuver raises the esophagus above the stomach partially restoring the
effects of gravity. It has also been noted that reflux occurs less frequently if a
person lies on his left side than on his right side.

As a management for decreasing esophageal pressure, maintaining a

normal body weight proportionate to your height will do. Avoiding tight clothes
also helps relieve pressure.

Surgical management is only advised if medical management is

unsuccessful. This involves a fundoplication which is wrapping a portion of
the gastric fundus around the sphincter area of the esophagus. This is
performed by a surgeon through laparoscopy.

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Medications

Medications are only intended and prescribed by physicians if

esophageal reflux persists despite the life style changes.

♣ Antacids: These are medicines taken by mouth and relieve

indigestion, sour stomach and heart burn by neutralizing excess
stomach acids.

♣ Histamine Receptor Blockers/ Anti histamines: These are drugs that

block receptors so that histamine messages are not received
(histamine is a vital protein that is involved in many allergic reactions).
These are best taken 30 minutes before meals so that the histamine
antagonists will be at peak levels in the body right after the meal when
the stomach is dynamically producing acid. These are best taken at
bedtime to repress night time production of acid.

♣ Prokinetic Agents: these medications accelerate gastric emptying

which include Domperidone, Bethanecol, Cisapride and
Metoclopramide.

♣ Gastric acid Proton Pump Inhibitors: These medications block the

secretion of acid into the stomach by acid secreting cells. This works
best than anti histamines since PPI shuts off the production of acid
longer and more completely. It is best for treating the symptoms of
heart burn and also good at protecting the esophagus from refluxed
fluid giving the esophageal lining time to heal.

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Diet Plans

Changes in eating habits are favorable in treating Acid Reflux. Since

reflux is worse right after meals this is because the stomach is distended with
food during that time and transitory relaxations of the LES (lower esophageal
sphincter) are more frequent. Therefore it is recommended that earlier and
smaller meals be given to reduce the amount of reflux. The reasons as
follows:

♣ Smaller meals produce lesser distention of the stomach.

♣ A smaller and earlier meal by bed time is more probable to have
emptied from the stomach than a heavier meal.

This results to a reflux that is less likely to occur when a person with
Acid reflux disorder lies down.

As stated in the management for acid reflux is to avoid factors that

lessen the pressure in the LES. Some food causes such reduction of
pressure in the LES and should be avoided. Those foods are listed as
follows:

♣ Chocolate

♣ Caffeine/ caffeinated beverages

♣ Carbonated beverages

♣ Alcohol

♣ Peppermint

Aside from the foods that should be avoided, it as recommended to

have a low fat, high fiber diet since fatty foods reduce the pressure in the LES
and promote acid reflux. Smoking should also be stopped or at least gradually
tapered.

Avoid foods that would aggravate the symptoms of acid reflux. Acid
containing and spicy foods are examples.

Contrary to the belief of some that chewing gum increases acid

production, it actually does not. Chewing gum stimulates the production of
bicarbonate containing saliva thus increasing the rate of swallowing. Saliva
after being swallowed neutralizes the acid in the esophagus thus lessening
effects of acid reflux. Though it is not quite clear how chewing gum relieves
heartburn, chewing gums right after meals is something you should try.

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