Gastroesophageal Reflux Disease Symptoms, Diagnosis & Treatment

Most patients with GERD experience an increase in the severity of symptoms (usually heartburn or coughing and choking) while sleeping or attempting to sleep. If the acid backs up as far as the throat and larynx, the sleeper will wake up coughing and choking.

If feeding and positional changes do not improve GERD, and the infant still has problems with feeding, sleeping, and growth, a doctor may recommend medications to decrease the amount of acid in the infant’s stomach. Sometimes, a more severe and long-lasting form of gastroesophageal reflux called gastroesophageal reflux disease (GERD) can cause infant reflux. In people with GERD, the LES is weak and either does not close completely or may open at inappropriate times. As a result, acid and bile can flow back up into the esophagus-especially while laying down. Heartburn and indigestion are both common conditions.

Gastroesophageal reflux disease (GERD) is the chronic, more severe form of acid reflux. Heartburn is a symptom of acid reflux and GERD. Stomach abnormalities. One common cause of acid reflux disease is a stomach abnormality called a hiatal hernia, which can occur in people of any age. A hiatal hernia happens when the upper part of the stomach and LES (lower esophageal sphincter) move above the diaphragm.

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Several different abnormalities of the LES have been found in patients with GERD. Two of them involve the function of the LES. The first is abnormally weak contraction of the LES, which reduces its ability to prevent reflux. The second is abnormal relaxations of the LES, called transient LES relaxations. They are abnormal in that they do not accompany swallows and they last for a long time, up to several minutes.

Proton pump inhibitors (omeprazole, lansoprazole, pantoprazole, esomeprazole, and rabeprazole) are all highly effective in treating reflux symptoms. These medications act by blocking the final step of acid production in the stomach and are typically taken once or twice daily prior to meals.

All of the medications discussed above have specific treatment regimens, which you must follow closely for maximum effect. Usually, a combination of these measures can successfully control the symptoms of acid reflux. For neutralizing acid, over-the-counter medications such as Maalox®, Tums®, and Pepto-Bismol® may subdue symptoms. Another product, Gaviscon®, neutralizes stomach acid and forms a barrier to block acid rising into the esophagus. Some find that these non-prescription antacids provide quick, temporary, or partial relief but they do not prevent heartburn.

If symptoms persist despite medical treatment, a comprehensive evaluation should be completed prior to considering surgery. The surgery for treating reflux disease is known as fundoplication. In this procedure, a hiatal hernia, if present, is eliminated and part of the stomach is wrapped around the lower end of the esophagus to strengthen the barrier between the esophagus and the stomach.

The tablets are best taken after meals (when the stomach is distended) and when lying down, both times when reflux is more likely to occur. Foam barriers are not often used as the first or only treatment for GERD. Rather, they are added to other drugs for GERD when the other drugs are not adequately effective in relieving symptoms. There is only one foam barrier, which is a combination of aluminum hydroxide gel, magnesium trisilicate, and alginate (Gaviscon).

During laparoscopy, a small viewing device and surgical instruments are passed through several small puncture sites in the abdomen. This procedure avoids the need for a major abdominal incision. H2 antagonists are very good for relieving the symptoms of GERD, particularly heartburn. However, they are not very good for healing the inflammation (esophagitis) that may accompany GERD. In fact, they are used primarily for the treatment of heartburn in GERD that is not associated with inflammation or complications, such as erosions or ulcers, strictures, or Barrett’s esophagus.

If the acid only backs up as far as the esophagus the symptom is usually experienced as heartburn. Johns Hopkins minimally invasive surgeon Gina Adrales answers important questions about gastroesophageal reflux disease (GERD) including the most common symptoms and the recovery process. Your doctor is able to evaluate whether you have GERD, the severity of your reflux, the presence of non-acid reflux and the correlation between your reflux and symptoms.

Typically, 95 percent will outgrow the symptoms by the time they reach 1 year of age. Children with developmental and neurological conditions, such as cerebral palsy, may experience reflux and GERD for longer time periods.

There are a number of steps you can take to prevent the reflux of stomach acid into the esophagus through the lower esophageal sphincter (LES), which over time can damage the esophageal lining and can lead to a host of illnesses, including throat cancer. A new technology allows the accurate determination of non-acid reflux. This technology uses the measurement of impedance changes within the esophagus to identify reflux of liquid, be it acid or non-acid.

This becomes possible by the contraction of the lower esophageal sphincter and closure of the flap valve. In the presence of an acute angle of His, the stomach fundus inflates by air and balloons up under the diaphragm dome after eating. The pressure from the inflated fundus transmits to the flap valve and seals the stomach.

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