Introduction
GERD is a digestive system disease that occurs when the acid-containing stomach juices from the stomach flow back up to the oesophagus. This occurs due to the failure of the valve at the lower esophageal sphincter to close properly during the arrival of food at the stomach (Kahrilas, 2008). As a result, it leads to a backwash of acidic contents in the stomach through the oesophagus into the throat and mouth. Thus, it brings about a sour taste in the mouth. GERD is not just a normal pyrosis since acid reflux is experienced more frequently over a long period (Katz, Gerson, & Vela, 2013). Therefore, if not treated, the condition can lead to several complications such as adult-onset asthma and esophagitis, among others.
Causes
This disease is caused by the frequent acid backwash from the stomach that causes the oesophagus to be inflamed. The acid backwash or reflux can be accelerated by other factors such as smoking, and eating large meals mainly at night may also cause it (Kahrilas, 2008). Eating triggers such as fried foods, alcohol, and certain medications, such as aspirin, can also worsen acid reflux (Malfertheiner & Hallerbäck, 2005). Other conditions such as obesity, scleroderma, hiatal hernia, and pregnancy can also expand the risk of getting GERD.
Symptoms
Patients with gastroesophageal reflux disease experience a variety of clinical manifestations or complications. The disease’s symptoms are widespread in Canada as they range from 2.5% to over 25% (Fedorak et al., 2010). Among the symptoms is pyrosis that comes with chest pain starting from the back of the breastbone, going up to the neck and throat that can last for long hours. The pyrosis pain gets worse after eating, especially late at night (Kahrilas, 2008). Other symptoms include nausea, bad breath and struggling to breathe, vomiting, and lumps in the throat. Acid reflux at night may also lead to laryngitis, lingering cough, and asthma.
Patients Affected
Gastroesophageal reflux disease affects people of all ages, from infants to older people. However, asthma patients have a high risk of developing gastroesophageal reflux disease. Asthma exacerbations can cause relaxation of the lower esophageal sphincter causing the contents of the stomach to flow back into the esophagus (Malfertheiner & Hallerbäck, 2005). Furthermore, some of the asthma medications, such as theophylline, may worsen acid reflux. In addition to this, patients with hiatal hernia have a high risk of contracting gastroesophageal reflux disease. This is because the hernia may lead to the weakening of the lower esophageal sphincter hence causing acid reflux.
Treatment
Gastroesophageal reflux can be treated through; antacids that neutralize the acidity in the stomach and oesophagus to stop pyrosis. H2 blockers such as nizatidine, cimetidine, and famotidine, may also be used to reduce the acidity in the stomach (Hägg & Franzén, 2021). Another treatment option is Proton pump inhibitors which inhibit a protein needed for the production of bile (Katz, Gerson, & Vela, 2013).
In Canada, Proton pump inhibitors are the most commonly prescribed drugs as the drug accounted for more than 11 million prescriptions in 2012 (Fedorak et al., 2010). In addition, prokinetics are used in treatment to enable fast emptying of the stomach hence not much acid is left behind as such, it reduces the risk of acid reflux. However, Prokinetics have severe effects and are therefore not administered to most patients (Kahrilas, 2008). Another treatment is diet and nutrition, where the patient is encouraged to eat smaller servings to prevent any more pyrosis. In this case, patients are required to eliminate any food triggers of pyrosis in their diet, such as alcohol. In addition to that, chewing food thoroughly may also help reduce pyrosis.
Conclusion
GERD is a digestive disease whereby bile or stomach acid irritates the oesophagus. It can cause several complications if it is not treated. As such, patients experiencing it can utilize the medications for treatment. This will help in reducing the acidity, thus saving them from the experience of pain. The remedies for GERD, are designed to suppress or control the production of stomach acid, therefore, they fail to address the main cause of the disease.
References
Fedorak, R. N., van Zanten, S. V., & Bridges, R. (2010). Canadian Digestive Health Foundation Public Impact Series: gastroesophageal reflux disease in Canada: incidence, prevalence, and direct and indirect economic impact. Canadian Journal of Gastroenterology, 24(7), 431-434. Web.
Hägg, M., & Franzén, T. (2021). Introducing an innovative oral neuromuscular treatment of the underlying reason for reflux caused by hiatus hernia: an aggravating factor in esophagitis. In Esophagitis and Gastritis-Recent Updates. Web.
Kahrilas, P. J. (2008). Gastroesophageal reflux disease. New England Journal of Medicine, 359(16), 1700-1707. Web.
Katz, P. O., Gerson, L. B., & Vela, M. F. (2013). Guidelines for the diagnosis and management of gastroesophageal reflux disease. Official Journal of the American College of Gastroenterology| ACG, 108(3), 308-328. Web.
Malfertheiner, P., & Hallerbäck, B. (2005). Clinical manifestations and complications of gastroesophageal reflux disease (GERD). International Journal Of Clinical Practice, 59(3), 346-355. Web.