Acid Reflux (GERD): Symptoms, Causes & Treatment

Gastroesophageal reflux, or GERD, happens when there is recurrent acid reflux from the stomach to the esophagus, causing a burning sensation on the throat and chest region, known as heartburn. Other symptoms can include constant burping, indigestion or a dry cough.

The severity of the inflammation, as well as of the symptoms, depends on the acidity of the gastric content when it comes into contact with the mucosa of the esophagus. When that happens, the lining of the esophagus, that it's not prepare to deal with that amount of acidity, gets inflamed, causing all of the characteristic symptoms of GERD.

GERD symptoms are rather uncomfortable, and therefore it is recommended to visit a gastroenterologist as soon as possible. The doctor will be able to do a complete examination and indicate the most suitable treatment.

How Acid Reflux Happens on GERD
How Acid Reflux Happens on GERD

Main Symptoms

GERD symptoms can arise in a question of minutes or a few hours after eating, and they mainly include:

  • A burning sensation that affects the throat and/or the chest;
  • Bloating stomach;
  • Frequent burping;
  • Indigestion;
  • Dry cough after eating;
  • Difficulty swallowing food;
  • Recurrent asthma crisis or infections of the superior airways.

These symptoms tend to get worse when the person bends down to get something from the floor or when the person remains in a horizontal position after a meal, as what usually happens in bed, at night.

Constant reflux can cause intense inflammation in the walls of the esophagus, called esophagitis, which if not treated correctly, can increase the risk of cancer.  

Symptoms in Babies 

Some symptoms that can indicate this condition in babies include frequent vomiting, restless sleep, difficulty breastfeeding and gaining weight, and hoarseness due to the inflammation of the larynx.  

In addition, babies can also develop repetitive ear infections due to a frequent inflammation of the airways, or even aspiration pneumonia, due to the entry of food into the lungs.  

What Causes GERD

GERD happens when the gastroesophageal sphincter, which is a muscle in the shape of a ring that normally closes the stomach and prevents the gastric content from coming back up, does not work properly, allowing the acidic content to reach the esophagus during digestion.

How To Diagnose GERD

Diagnosis for gastroesophageal reflux (GERD) must be done by a gastroenterologist, pediatrician, or a G.P., that normally starts by assessing all of the symptoms.

In addition, some tests will also be necessary to confirm the diagnosis and to check the severity of the reflux, such as a digestive endoscopy, an esophageal manometry or a 24 hour gastric pH measurement.

Treatment Options

Treatment for GERD usually includes the use of medication to prevent or relieve symptoms, such as:

  • Domperidone, that accelerates stomach emptying, preventing symptoms;
  • Omeprazole or Esomeprazole, to reduce the amount of acid in the stomach, preventing or relieving symptoms;
  • Antiacids, that neutralize the acidity already present in the stomach, relieving symptoms.

However, treatment should also include some simple lifestyle changes, specially to the diet plan. Generally speaking, a person who suffers from GERD should reduce alcohol consumption, as well as fatty foods such as fried foods or processed foods, since these types of food tend to aggravate symptoms. In addition, the last meal of the day should happen at least 2 to 3 hours before bedtime, to avoid going to bed with a full stomach.

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References

  • SOCIEDADE PORTUGUESA DE GASTROENTEROLOGIA. Doença de refluxo gastro-esofágico: normas de orientação clínica. 2012. Available on: <https://www.spg.pt/wp-content/uploads/2015/11/NOC_drge.pdf>. Access in 06 Jan 2021
  • JUNIOR, Luiz João A. Doença do refluxo gastroesofágico. JBM. Vol 102. 6 ed; 31-36, 2014
  • PUCCINI, Flávia R. S.; BERRETIN-FELIX, Giédre. Refluxo gastroesofágico e deglutição em recém nascidos e lactentes: revisão integrativa da literatura. Rev. CEFAC. Vol 17. 5 ed; 1664-1673, 2015
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