From GERD Symptoms to Causes: A Complete Guide to Gastroesophageal Reflux Disease

Lately, Katie has been suffering heartburn, a nagging cough, and an unsettling feeling of acid reflux. Caught between family, work, and life’s demands, she often brushed her symptoms off as stress-related. She knew, however, as her discomfort grew, it was time to take action. With a busy schedule, making the call to book an appointment was challenging. That is when she stumbled upon Cellmaflex, a very user-friendly platform that lets her book an appointment, online, without any phone calls, with a gastroenterologist.

During her visit, Katie learned that her symptoms were characteristic of Gastroesophageal Reflux Disease (GERD), a condition currently afflicting millions around the globe. Today’s blog will take you through a detailed and all-inclusive look into GERD, including what GERD is, GERD symptoms, stages, risk factors, complications, and various available treatments.

What is Gastroesophageal Reflux Disease (GERD)?

Gastroesophageal reflux disease, or GERD for short, is an illness in which stomach acid returns periodically into the oesophagus – the tube connecting the mouth to the stomach. The backwash is termed acid reflux, which might irritate the oesophageal lining. Such backflow can cause many uncomfortable symptoms as well as complications. The condition develops when the gastroesophageal sphincter fails to close completely and causes leakage of stomach content into the lower part of the oesophagus.

According to the report published by National Centre for Biotechnology Information, globally, there were 783.9 million cases worldwide in 2019.

GERD is more prevalent in females than in males and rises with age. In patients older than 50 years, GERD prevalence is related to increased age.

What are the Causes of GERD?

GERD is caused by frequent acid reflux. When you swallow, a circular band of muscle surrounding the bottom of the oesophagus relaxes in order to let food and liquid into the stomach. Then, it closes. If the sphincter relaxes less than it should or is weakened, stomach acid can spray back into the oesophagus. Acid backwash constantly irritates the lining of the oesophagus, frequently causing the area to become inflamed.

GERD symptoms include:

Backwash: You may experience acid, food or liquids backwashing from your stomach into your throat after eating. This is also known as regurgitation. You may notice the sour taste of the acid.

A burning feeling: Acid literally burns the tissues in your oesophagus. If it feels like it’s in your chest, it’s called heartburn. If it feels closer to your stomach, you might call it acid indigestion.

Noncardiac chest pain: Some people feel pain in their oesophagus that doesn’t feel like burning. Oesophagus pain triggers the same nerves as heart-related pain does, so it might feel like that.

Nausea: Backwash or acid reflux may lead to your disgust at food or nausea, although it has been a long time since you last ate. You could feel as though food is left to be digested.

Sore throat: If acid flows back into your throat, it can cause pain. You may feel like you have a lump in your throat, or like it’s hard to swallow. Acid flowing back into your throat usually happens at night.

Asthma-like symptoms: GERD can cause asthma-like symptoms, including persistent coughing, wheezing, and shortness of breath. Acid droplets going into your airways can make them constrict.

Your GERD symptoms may be worse:

• At night or when lying
• After rich fatty foods
• After forward bending
• After smoking or alcohol consumption.

Stages of GERD

Stage 1: Mild GERD
Only once or twice a month, there is minimal acid reflux. GERD symptoms at this stage can often be managed with diet and lifestyle modifications along with over-the-counter medication to help alleviate acid reflux as necessary.

Stage 2: Moderate GERD
Symptoms in this stage are chronic and recurring and hence, prescribed medication is required as acid reflux occurs often. Symptoms do interfere with activities of daily living.

Stage 3: Advanced GERD
Here, symptoms are also very painful and do not have improvement even when taken the prescription medication. It would therefore interfere with quality of life and your doctor may prescribe GERD surgical intervention at this point.

Stage 4: Pre-cancer or cancer
After several years of untreated severe GERD symptoms, the oesophagus may develop a condition called Barrett’s oesophagus, which is a precancerous condition. Left untreated, precancerous lesions may progress into oesophageal cancer.

Symptoms at Each Stage

Mild stage, the symptoms are:
Heartburn and regurgitation occurring infrequently (less than once a week).

Moderate stage, the symptoms are:
Heartburn and regurgitation occurring a few times a week.

Advanced stage, the symptoms are:
Heartburn, regurgitation, atypical GERD.

Pre-cancer or cancer stage, the symptoms are:
Heartburn, regurgitation, atypical GERD, dysphagia (difficulty in swallowing), endoscopic findings of strictures, Barrett’s oesophagus, oesophageal cancers.

Risk Factors Associated with GERD

Conditions that may increase the risk of GERD include:

• Obesity
• Bulging of the top of the stomach up above the diaphragm, known as a hiatal hernia
• Pregnancy
• Connective tissue disorders, such as scleroderma
• Delayed stomach emptying

Things that can make acid reflux worse include:

• Smoking
• Eating large meals or eating late at night
• Eating certain foods, such as fatty or fried foods
• Drinking certain beverages, such as alcohol or coffee
• Taking certain medicines, such as aspirin

Complications from Untreated GERD

Chronic inflammation in the oesophagus over time can cause:

• Esophagitis: This is an inflammation of the oesophagus caused by exposure to stomach acid. The stomach acid attacks the tissues in the oesophagus. The inflammation may cause an open sore that is known as an ulcer which can sometimes bleed. Esophagitis causes severe pain and might make it hard to swallow.
• Narrowing of the oesophagus, called an oesophageal stricture: Narrowing of the oesophagus, technically known as oesophageal stricture. Scarring and resulting narrowing of the lower oesophagus usually occur from damage caused by the stomach acid itself. The scar tissue extends across the path of the food, causing problems with swallowing.
• Precancerous changes to the oesophagus, known as Barrett oesophagus:
  Acid damage can cause changes in the tissue lining the lower part of the oesophagus. These changes are associated with an increased risk of oesophageal cancer.
• Laryngopharyngeal reflux: Some patients who have GERD develop what is called LPR reflux that goes up your oesophagus into your throat. Acid can creep into your throat when you’re sleeping. It can make your throat swell, you may become hoarse, you may get vocal cord nodules, and you are actually aspirating acid particles into your airways.
• Asthma: The acid irritates airways that have underlying asthma or can trigger asthma in individuals without any predisposition to respiratory ailments. Tiny acid particles irritate your bronchial tubes and make them contract. Constriction of your bronchial tubes results in cough and breathing difficulty.

How is GERD Diagnosed?

A gastroenterologist will evaluate your oesophagus to diagnose GERD. Tests may include:

• Esophagram: An esophagram also known as Barium Swallow, is a type of X-ray exam. It takes moving X-rays (fluoroscopy) of your oesophagus while you swallow. For the test, you swallow a chalky liquid called barium.
• Upper Endoscopy: Your doctor will look inside your oesophagus through a thin tube passed down your mouth while you are asleep under light sedation.
• Esophageal pH Test: This measures the amount of acid in your oesophagus using a very small wireless receiver. Your doctor will place it inside your oesophagus when having an endoscopy done.
• Oesophageal manometry: This examination measures your oesophageal muscle activity, using pressure sensors inserted inside a nasogastric tube. It can help confirm if your LES (Lower Oesophageal Sphincter) or other muscles are malfunctioning.

Treatment for GERD

Effective treatments for GERD include:

• Lifestyle Changes: Change to diet, weight loss, and keeping the head elevated at sleeping can lessen GERD symptoms.
• Medications: The primary management and healing of the damage in the oesophagus are carried out with the medications prescribed by the healthcare provider as needed.
• Surgical Interventions: In severe cases, a surgical intervention such as fundoplication may be recommended for fortifying the LES.

How Cellmaflex Helps Patients?

Cellmaflex is an all-in-one digital healthcare hub for the patients. With Cellmaflex, patient can sign up free and easily find a suitable healthcare provider. In one click, patients can browse through the directory of the specialists they can see, check the availability of their preferred doctors, and even book appointments online without having to make any calls or waste hours in waiting rooms.

Direct results of the tests can be accessed by the patients, and they may access test results anywhere at any time. In addition, patients can locate pharmacies nearest to them through Cellmaflex. This ensures prompt availability of various medications and supplements that may aid in better management.

Cellmaflex empowers patients to take charge of their health with smooth appointment scheduling, rapid viewing of test results, and even hassle-free coordination with specialists for the required care. Cellmaflex provides patients with the support they need every step of their journey.

GERD affects millions worldwide, entering daily life discreetly yet potentially leading to complications without treatment. And as illustrated with Katie’s account, starting down the road toward treatment may be difficult. But it is never harder with platform like Cellmaflex facilitating access to care. It is far more than treating GERD symptoms for management; right and timely consultation can prevent irreversible damage and restore quality of life. Take control of your health today by signing up on Cellmaflex and booking an online appointment with your desired doctor. Don’t wait for the GERD symptoms to worsen, book your appointment now on Cellmaflex, and recover faster with the care you deserve.

Disclaimer: Please note that the information is strictly for informative purposes. It is not intended to be used in lieu of professional medical advice, inclusive of diagnosis or treatment. It is strongly advised that you seek a doctor’s medical advice on any treatment or medical condition that you learn about.