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Gastro oesophageal reflux disease (GERD)

GERD is a condition where reflux of gastric contents into oesophagus results in symptoms and/ or complications. GERD is objectively defined by the presence of characteristic mucosal injury seen at endoscopy and/or abnormal esophageal acid exposure demonstrated on a reflux monitoring study.

What causes GERD?

As the food enters your stomach, it passes through a ring-shaped muscle called the lower esophageal sphincter (LES). A strong and healthy LES opens to let food into the stomach and closes to prevent food and stomach acid from backing up. When the LES muscle is weakened, food and stomach acid can move back up into the esophagus and throat, causing reflux. Stomach acid from reflux can irritate the esophagus and cause heartburn, indigestion, and trouble swallowing.


There are many factors that can cause GERD. The common reasons include:

  • overweight or obese
  • eat a high-fat diet
  • drink a lot of carbonated beverages such as soda pop and beer.
  • use alcohol
  • use tobacco products
  • have a hiatal hernia or damage to your esophagus
  • Aging
  • Pregnancy


What are the symptoms ?

The typical symptoms for GERD include heartburn and regurgitation. Heartburn is the most common symptom and is described as a retrosternal burning sensation rising from epigastrium up toward the neck. Regurgitation is the effortless return of gastric contents upward toward the mouth, often accompanied by an acid and bitter taste. Some individuals may experience (non-cardiac) chest pain, chronic cough and hoarseness of voice in conjunction with the above symptoms.


How is GERD treated?

Lifestyle modification

You can reduce the irritation of your esophagus and often even correct mild forms of GERD with a few lifestyle changes:

  • Don’t lie down for up to 4 hours after eating. Avoid having meals close to bedtime.
  • Don’t bend over at the waist either.
  • Elevating head of bed for at night
  • Avoid foods that cause symptoms. These include alcohol, coffee, fatty foods, spicy foods, chocolate, onions, tomato sauce, carbonated beverages, and mint.
  • Avoid wearing tight clothing
  • Take smaller meal
  • Stop smoking
  • Loss extra weight


Medical treatment

Proton pump inhibitor (PPI) has been the mainstay of treatment for GERD. Appropriate administration of PPI is important to achieve the maximal efficacy. In certain situations where PPI is not suitable, H2 receptor antagonists can be used as alternatives. Please consult the doctors for the most appropriate treatment.


What if I don’t treat my GERD?

If you don’t treat GERD, complications can occur. These include ulcers, bleeding, and anemia. Over time, GERD can cause scarring and narrowing of the oesophagus making it difficult to swallow. It can also cause a condition called Barrett’s oesophagus, which has the potential to progress to cancerous condition. If you have symptoms of GERD, see your doctor. Treatment can usually prevent these complications.


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