GERD meaning
Gastroesophageal reflux disease (GERD) is a chronic condition in which the stomach acid or stomach contents flow back into the esophagus, causing irritation and various symptoms. GERD a common digestive disorder, and its symptoms can range from mild to severe.
Symptoms of GERD
- Heartburn: A burning sensation in the chest, often after eating, which may worsen when lying down or bending over.
- Regurgitation: The feeling of stomach contents coming back up into the throat or mouth.
- Acid indigestion: Discomfort or pain in the upper abdomen.
- Chest pain: Sometimes, GERD can cause chest pain, which can be similar to the pain of a heart attack.
- Difficulty swallowing: Over time, GERD can lead to narrowing of the esophagus, making it harder to swallow.
- Chronic cough: GERD can irritate the airways and lead to a persistent cough.
- Sore throat: The refluxed stomach acid can irritate the throat, leading to a sore throat or hoarseness.
- Dental problems: Stomach acid can erode tooth enamel, leading to dental issues.
Diagnosis of GERD
GERD diagnosis typically involves a combination of:
- Medical History: Your doctor will ask about your symptoms and medical history.
- Physical Examination: A physical examination may help rule out other potential causes of your symptoms.
- Endoscopy: EGD involves using a thin, flexible tube with a camera (endoscope) to examine the esophagus, stomach, and the upper part of the small intestine.
- pH Monitoring: 24-hour pH monitoring measures the acidity in your esophagus over a day to determine the frequency and severity of acid reflux.
- Barium Swallow X-ray: You may be asked to drink a barium solution, which will make the esophagus and stomach visible on X-rays.
GERD differential diagnosis
The following Table presents common conditions that can mimic GERD symptoms, along with key distinguishing features and suggested diagnostic approaches.
| Condition | Distinguishing Features | Suggested Diagnostic Approach |
| Peptic Ulcer Disease (PUD) | Epigastric pain often relieved by food, history of NSAID use | Upper GI endoscopy, H. pylori testing |
| Esophagitis (Infectious, Eosinophilic) | Odynophagia (painful swallowing), immune suppression in infectious esophagitis | Endoscopy with biopsy |
| Esophageal Motility Disorders | Dysphagia to solids and liquids, chest pain, no response to PPIs | Esophageal manometry |
| Angina/Coronary Artery Disease | Chest pain triggered by exertion, radiation to arm/jaw | ECG, stress test, cardiac enzymes |
| Gastroparesis | Early satiety, postprandial fullness, history of diabetes | Gastric emptying study |
| Biliary Colic/Gallbladder Disease | Right upper quadrant pain, often postprandial, nausea | Abdominal ultrasound, liver function tests |
| Functional Dyspepsia | Upper abdominal pain without clear cause, no response to PPIs | Diagnosis of exclusion, consider endoscopy |
| Esophageal Cancer | Progressive dysphagia, weight loss, persistent symptoms | Endoscopy with biopsy |
Treatment of GERD
The treatment of GERD aims to relieve symptoms, heal esophageal damage, and prevent further complications. The approach may include:
- Lifestyle Changes:
- Elevating the head of the bed to prevent nighttime reflux.
- Avoiding trigger foods and drinks (e.g., caffeine, alcohol, citrus, spicy foods).
- Eating smaller, more frequent meals.
- Losing weight if overweight.
- Not lying down within 2-3 hours after eating.
- Medications:
- Antacids: These provide temporary relief by neutralizing stomach acid.
- H2 Receptor Blockers (e.g., ranitidine, famotidine): Reduce stomach acid production.
- Proton Pump Inhibitors (PPIs, e.g., omeprazole, lansoprazole, esomeprazole, pantoprazole, rabeprazole): Stronger acid suppressors that can promote healing of the esophagus.
- Surgery:
- In cases where medications and lifestyle changes don’t provide sufficient relief, surgical options may be considered. Fundoplication is a common surgical procedure for GERD.