Gupta Gastro Digestive Health - new tips: GERD & Reflux

Hi Im Doctor Gupta Another common question asked by my patients is concerning reflux or GERD, Gastro Esophageal Reflux Disease. GERD is essential when stomach contents whether solid or liquid are pushed into the esophagus and that causes symptoms of heartburns, regurgitation, and chest discomfort. Now how does GERD happen, what is the reason why one experiences GERD? Usually the food goes through your mouth through your food pipe and passes into your stomach. At the junction of the food pipe and the stomach, is a band of fibers called lower esophageal sphincter. Which makes it like a one way passage. So food can enter into the stomach but should not be coming back out. When this sphincter is loose or incompetent, food can easily regurgitate into your food pipe causing inflammation, ulceration, nausea, food coming into your mouth. Some people complain of sore throat, difficulty in breathing and cough especially when they lie down. So these are the typical symptoms of Gastro Esophageal Reflux Disease. Now what besides this can cause GERD? There are various medicines for asthma, blood pressure, and even narcotics and sedatives, which can, which can decrease, the tonicity or the strength of the lower esophageal sphincter and cause these symptoms. Diagnosis is usual made by upper endoscopy, where a flexible tube with a light at the end goes into your mouth, into your food pipe and stomach to take pictures and biopsies to examine whats going on. Whether there is any damage to the esophagus or not, and biopsies can be taken to prove if theres any changes in the lining of the esophagus, and that can very safely and very effectively diagnose the condition of GERD. There are other things which you should be aware of. GERD can cause inflammation and also sometimes changes in the lining of the stomach or esophagus which is called Barret's esophagus. And this is a premalignant condition and has to be screened reasonably frequently if you have that. So about close to ten percent of people who have GERD, will have Barrets and close to ten percent of people who have Barrets will have some sort of cancer of the esophagus. So almost close to 1% of people who have regular heartburn or GERD can end up with having problems in the esophagus. So get your testing done, if you really think you have these symptoms, another test that can be easily done is a barium swallow, which is very good, but will not be able to biopsy the esophagus to look for any changes, like Barrets . What are the other modifications, which I prescribe my patients? Typically patients who have GERD, I advise them to loose weight, don't wear tight clothing, there should be nothing tight around their abdominal girth, avoid coffee, chocolate, peppermint, alcohol, avoid spicy foods, don't lie down immediately after a big meal, if possible eat there to four hours before you lie down and elevate the head of your bed by about three to six inches with this behavior modification and the various medicines we have available, like antacids, H2 blockers like zantac, or proton pump inhibitors like prilosec, aciphex, dexalant, pantaprazole, and nexium, they can help decrease the acid in your stomach so there is no acid reflux in your food pipe causing these symptoms. So if you have any of these symptoms, like night cough, clearing of the throat all the time, sore throat, chest pains, heartburns and you feel food regurgitating up into your mouth, consult a gastroenterologist and be tested adequately and be treated then. Thank you.