Heartburn / GERD: Symptoms, Complications, Treatment

GERD

Size

Email this article

Print this article

1763 Views

Current Rating
		Login to rate this article

Overview of GERD
Symptoms of GERD
Heart burn or chest pain which leads to heart attack
How GERD develops
Complications of GERD
When to seek medical care for GERD
Diagnosis of GERD
Living with GERD
GERD in elderly
GERD during pregnancy
GERD in infants and children
How can one prevent heart burn

Overview of GERD

Overview of GERD / Heart burn

Gastroesophageal reflux is a normal physiological phenomenon experienced intermittently by most people, particularly after a sumptuous meal.

Symptom of GERD

Symptoms of GERD

Gastroesophageal reflux disease patients present a variety of symptoms, most commonly heartburn and regurgitation.

Heartburn or Chest Pain Which Leads to Heart Attack

Heartburn or chest pain which leads to heart attack

Many people misunderstand the pain for being a heart attack, when they are only experiencing the common heartburn.

How GERD develops

Gastroesophageal reflux disease is usually caused by a defect in the relaxation of the lower esophageal sphincter (LES), which consequently allows the stomach contents to reflux into the unprotected lining of the esophagus.

Complications of GERD

Complications of gerd / heart burn

Only a minority of patients develops complications of GERD. One complication is the inflammation of the esophagus from stomach acid, which further leads to bleeding and ulcers, a condition called esophageal erosions or esophagitis.

When to Seek Medical Care for GERD

Most problems with heartburn are short-term and mild. However, prescription medications and more intensive intervention are needed in the presence of the following:

Heartburn several times a week

Heartburn that causes night awakenings

Difficulty swallowing

Persistence of symptoms even after taking medications

Regurgitation of blood

Weight loss

Diagnosis of GERD

Generally, GERD diagnosis is done symptomatically. Barium x ray, Endoscopy, Esophageal acid probe test diagnostics tests are carried out to confirm GERD

Living with GERD

Many people manage the discomfort of heartburn with simple lifestyle modifications and over-the-counter (OTC) medications.

Treatment of Heart burn / gerd

Treatment of Heart burn / gerd

Over the recent past years, large numbers of GERD sufferers use OTC antacids and other agents that are available without a prescription to treat the discomforts and infrequent heartburn.

GERD in Elderly

Although GERD is less symptomatic in older patients, the presentation is much more severe as this group tends to have impaired motility of the esophageal muscles, larger hiatus hernias and is more recumbent.

Older patients often have complications including

Erosive esophagitis

Peptic stricture

Barrett’s esophagitis

ENT and pulmonary complications

Endoscopy is indicated in all elderly patients with GERD regardless of symptom severity. Treatment of GERD in elderly patients is the same as in younger groups.

GERD during Pregnancy

Heartburn is a frequent complaint during pregnancy. The cause is possibly owing to hormonal changes.

Lifestyle modifications and OTC antacids are generally safe. H₂receptor blockers are considered safe but should only be used under the advice of a clinician. Proton pump inhibitors should be used during pregnancy only if clearly needed.

GERD in Infants and Children

Vomiting is the most common symptom of gastroesophageal reflux in infants. Other coexisting symptoms such as irritability, poor feeding or failure to thrive differentiates GERD from physiologic reflux.

Symptoms of GERD in pre-school children include intermittent vomiting, upper abdominal pain, night-time awakening and respiratory symptoms. Older children and adolescents with GERD exhibit symptoms similar to those seen in adults.

As in adults, treatment options for pediatric GERD include lifestyle changes, pharmacological therapy and surgery.

Lifestyle changes in infants include alterations in formula composition and infant feeding techniques. In infants and children who remain symptomatic despite dietary and lifestyle modifications, medications specially H₂RBs are recommended.

How can one prevent heartburn?

Many cases of heartburn can be prevented by simple lifestyle modifications in the diet and daily activities similar to those recommended after the problem occur. Such as:

Keep ideal body weight.

Avoid foods and drinks such as tomatoes, citrus fruits, garlic, spicy and oily foods, alcohol, tea and coffee that trigger the problem (a study by Stanford University researchers disputes the effect of coffee, acidic and spicy foods in causing heartburn).⁹

Eat frequent small meals instead of three large meals.

Avoid eating just before exercise.

Stop smoking.

Avoid analgesics such as aspirin, ibuprofen and other nonsteroidal antiinflammatory drugs.

Avoid lying down for 2–3 hours after eating.

Also read

Antacids

Faq and answers bout gerd

Written by: Healthplus24 team
Date last updated: May 08, 2012

^ Top of Page

References

A Gallup Survey on Heartburn across America. Princeton, NJ: The Gallop Organization; 1998.
Goh KL. Changing epidemiology of gastroesophageal reflux disease in the Asian-Pacific region: an overview. J Gastroenterol Hepatol. 2004; 19 (Suppl 3): S22–S25.
Fass R. Erosive esophagitis and nonerosive reflux disease (NERD): comparison of epidemiologic, physiologic, and therapeutic characteristics. J Clin Gastroenterol. 2007; 41(2): 131–137.
Pilotto A, Franceschi M. Gastro-esophageal reflux disease in the elderly. In: Pilotto A, Malfertheiner P, Holt P, eds. Aging and the Gastrointestinal Tract. Interdisciplinary Topics in Gerontology Basel: Karger Press, 2003; 32: 100-117.
Jarzab A, Stopyra J, Fyderek K. The role of small intestinal bacterial overgrowth in the pathogenesis of gastroesophageal reflux. Gastroenterology. 2003; 124: A-411.
Mohammed I, Nightingale P, Trudgill NJ. Risk Factors for Gastro-oesophageal Reflux Disease Symptoms: A Community Study. Aliment Pharmacol Ther. 2005; 21(7): 821–827.
Heartburn/GERD – Causes (2007). Mayoclinic.com.
Richter JE, Falk GW. Barrett’s esophagus and adenocarcinoma. The need for a consensus conference. J Clin Gastroenterol. 1996; 23(2): 88–90.
Kaltenbach T, Crockett S, Gerson LB.Are lifestyle measures effective in patients with gastroesophageal reflux disease? An evidence-based approach. Arch Intern Med. 2006; 166(9): 965–971.
Piesman M, Hwang I, Maydonovitch C, Wong RK.Nocturnal reflux episodes following the administration of a standardized meal. Does timing matter? Am J Gastroenterol. 2007; 102(10): 2128–2134.
Khoury RM, Camacho-Lobato L, Katz PO, Mohiuddin MA, Castell DO. Influence of spontaneous sleep positions on nighttime recumbent reflux in patients with gastroesophageal reflux disease. Am J Gastroenterol. 1999; 94: 2069–2073.
So JB, Zeitels SM, Rattner DW. Outcomes of atypical symptoms attributed to gastroesophageal reflux treated by laparoscopic fundoplication. Surgery. 1998; 124(1): 28–32.