Gastroesophageal Reflux Disease (GERD)

Prepared by Dr Ooi Eng Keat and Dr Hoe Chee Hoong

Consultant Gastroenterologist

Gleneagles Penang

What is Gastroesophageal Reflux Disease (GERD)?

GERD, also known as acid reflux, is a digestive disorder where contents from the stomach flows back into the oesophagus (food pipe). This reflux action can cause irritation and tissue damage to the oesophagus. The acid may also irritate the vocal cord or trigger lung inflammation.

Causes & Risk Factors

There are several reasons for GERD with no one sole cause. GERD is often attributed to weak or faulty lower oesophageal sphincter, which is the muscular valve between the stomach and oesophagus. In a weakened or damaged state, the lower oesophageal sphincter may allow acid to flow back to the oesophagus.

There are several risk factors that contribute to the condition, such as:

• Diseases like Zollinger-Ellison Syndrome and Scleroderma
• Smoking
• An increase in the production of gastrin, which is a stomach acid-regulating hormone
• Obesity
• Pregnancy
• Use of certain medications

Symptoms

The most common symptom that GERD produces is heartburn. Typically, a burning sensation of the chest that spreads from the stomach to the throat is felt. Other symptoms include:

• A bitter taste in the mouth (acid regurgitation)
• Bloated tummy
• Constant burping
• Feeling of a lump in the throat
• Voice hoarseness
• Pain and difficulty swallowing
• Discomfort or pain in the chest
• Persistent cough
• Persistent sore throat

Treatment

Treatment of GERD varies depending on the severity of the condition. Lifestyle changes for those suffering mild GERD symptoms include:

• Avoiding eating late in the evening or night
• Avoiding food that induces acid reflux
• Eating in smaller portions
• Maintaining a normal and healthy weight
• Quitting smoking
• Raising your bed head
• Avoiding wearing tight clothes that put pressure on the stomach
• For moderate and severe symptoms that do not respond to lifestyle changes, prescription medication may be administered.

Complications and Related Diseases

• Barrett’s Oesophagus characterised by long-lasting GERD
• Increased risk of oesophageal cancer
• Inflammation of the vocal cords
• Lung damage including pulmonary fibrosis and bronchiectasis
• Blockage (stricture) of the oesophagus caused by scar tissues that develop due to recurrent ulcerations

Ulcers in the oesophagus caused by stomach acid burns