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GERD (Gastroesophageal Reflux disease)

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What is GERD?

Gastroesophageal reflux disease, or GERD for short, is a chronic illness in which stomach acid frequently refluxes back into the oesophagus, leading to symptoms such as heartburn and complications

Symptoms of GERD ?

Heartburn: A burning sensation in the chest and throat.

Regurgitation: The feeling of acid backing up into the throat or mouth

Difficulty Swallowing: A sensation of food sticking in the throat.

Chest Pain: Unease or pain that could resemble pain in the heart

Chronic Cough: A chronic cough that frequently occurs at night.

Sore Throat: Inflammation or irritation of the throat or oesophagus.

Vocal cord irritation: This results in hoarseness or changes in voice

Feeling of a lump in the throat: The sensation of something lodged in the throat, like a lump

Causes of GERD ?

Hernia: A hiatal hernia is a condition in which the upper portion of the stomach pushes through the diaphragm into the chest. It can weaken the LES and aggravate GERD.

Weak Lower Oesophageal Sphincter (LES): Some people may naturally have a weak LES, which makes it easier for stomach acid to reflux back into the oesophagus.

Obesity: Carrying too much weight, particularly in the abdomen, can put strain on the stomach and hasten the onset of GERD.

Smoking: Smoking can cause the LES to relax and thus aggravate GERD.

Specific Foods and Drinks: A number of foods and drinks, such as chocolate, coffee, alcohol, citrus fruits, spicy and fatty foods, can cause or exacerbate symptoms of GERD.

Delayed Stomach Emptying (Gastroparesis): Disorders that interfere with the stomach’s ability to empty can aggravate gastric reflux disease (GERD).

Connective Tissue Disorders: Scleroderma is one type of connective tissue illness that can impact the LES and aggravate GERD.

Specific treatments: A number of drugs, such as calcium channel blockers, antihypertensive drugs, and several asthma treatments, may exacerbate the symptoms of GERD.

Treatment for GERD

Surgical treatment

Laparoscopic Nissen Fundoplication:
This is a minimally invasive treatment that involves multiple tiny abdominal incisions.
The procedure is carried out with specialist surgical instruments and a laparoscope (which is a thin, flexible tube equipped with a camera) The upper part of the stomach is wrapped around the lower oesophagus to create a valve which reinforces the LES.
Laparoscopic Toupet Fundoplication:
The Toupet operation entails wrapping the stomach around the lower oesophagus, much like the Nissen fundoplication. Only the sides and back of the oesophagus are covered by the partial wrap used in this surgery.
This method can be applied when a full wrap (as in Nissen) is not required or could result in dysphagia, which is trouble swallowing.

Non- surgical treatment

1. Lifestyle Modifications: - Dietary Adjustments: Steer clear of foods and drinks that can aggravate acid reflux disease (GERD), Avoid citrus fruits, chocolate, caffeine and alcohol.
- Meal Timing: Avoiding lying down or going to bed right after eating, and opting for smaller, more frequent meals as opposed to large ones.
- Weight management: Reducing excess weight is important because obesity raises the risk of GERD.
2. Drugs: - Antacids: By neutralizing stomach acid, over-the-counter antacids can offer immediate relief. - H2 Blockers: These medications, which decrease the formation of stomach acid.
- Prokinetic Agents: By speeding up the stomach's emptying, these drugs lessen the chance of acid reflux.
3. Modifications to Diet and Behaviour: Steer clear of late-night snacks: Eating right before bed might exacerbate symptoms of GERD.
- Giving Up Smoking: Smoking weakens the LES, which increases the risk of GERD. - Reducing Alcohol Intake: Drinking too much alcohol might cause the LES to relax.:
4. Oesophageal pH Monitoring: -: To determine the extent of acid reflux and inform treatment choices, pH monitoring will be used in certain circumstances.

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The diagnosis is usually made based on symptoms, and to determine the severity of acid reflux, testing such as endoscopy and pH monitoring will be performed.

When symptoms are severe and complications develop,

Although GERD is typically a chronic illness, medicines and lifestyle modifications will effectively manage symptoms.

Although heartburn is a typical GERD symptom, GERD is a long-term illness including frequent and persistent acid reflux

It is possible to manage GERD symptoms by avoiding foods and drinks that provoke the condition, such as spicy foods, coffee, and alcohol.

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