Gastroesophageal Reflux Disease (GERD) is a condition caused by the reduced tone of the lower esophageal sphincter muscle. As a result, when the intraabdominal pressure increases there is a reflux of solids and liquids. This physiological dysfunction can cause a spectrum of injuries varying from simple inflammation of the esophagus (esophagitis) to adenocarcinoma (esophageal cancer).
GERD is a multifactorial condition and is caused by several factors such as dietary habits, excessive exercise regimen, smoking, alcohol consumption, obesity, hiatal hernia, pregnancy, H. Pylori infection, and wearing tight-fitting clothes. Dr. Cany Bailey, MBBS (Junior Medical Officer, Community Health, Bangalore Baptist Hospital) says that even long periods of fasting can cause GERD as it causes irritation by the acid in the stomach. In addition, excess food consumption to break the fast also causes the increased secretion of gastric acid, leading to the symptoms of GERD.
GERD causes a wide range of clinical features such as heartburn, dysphagia, belching, excessive salivation, sour taste in the mouth, tooth erosion, choking due to the reflux irritating the larynx, and hoarseness of the voice. Additionally, there are some rare clinical symptoms such as chest pain mimicking angina, asthma, and recurrent chest infections.
However, GERD can be managed and treated by primary, secondary, and tertiary preventive strategies.
Primary health promotion interventions for GERD include:
- Losing body weight
- Avoid fatty and oily foods, citrus fruits, caffeinated drinks, tea, garlic, onions, tomato sauces, excessive spices, excessive salt in the diet, and mint
- Adopt frequent small meals
- Elevate the head of the bed to alleviate nocturnal symptoms of GERD
- Avoid late-night snacking before retiring to bed and taking meals at the right time
- Smoking cessation and avoiding alcohol
- Avoid excessive workouts, weightlifting, stooping, and bending at the waist
Secondary preventive strategies for GERD include:
- Taking 10 to 15 ml antacids 3 hours after meals and at bedtime.
- If the symptoms are not alleviated with antacids then take histamine receptor antagonists like cimetidine and ranitidine and proton pump inhibitors like omeprazole, lansoprazole, and pantoprazole.
However, if the condition is aggravated and cannot be managed with primary and secondary interventions, a tertiary preventive strategy for GERD is adopted. It includes undergoing a surgery called antireflux surgery also known as laparoscopic fundoplication.
Therefore, it is always better to avoid the formation of GERD among all age groups by following a healthy lifestyle which includes an excellent diet with adequate nutrients and a regular exercise regimen.
(MSM)
