GERD Awareness Week - November 23-29

GERD Awareness Week is November 23-29, it was first established by the International Foundation for Gastrointestinal Disorders (IFFGD)  in November 1999. This event is noted on the United States National Health Observances Calendar as the timing of GERD Awareness week coincides with the Thanksgiving holiday in the United States, which is an accepted moment of overindulgence and dietary indiscretion for much of the public.

But what are we to watch out for?

GERD

So what is GERD really? GERD, or gastroesophageal reflux disease, is a disorder that occurs when the stomach contents reflux into the esophagus, causing symptoms or difficulties.

Over time, it can lead to Barrett's esophagus, a precancerous condition where the makeup of the tissue that lines the lower esophagus changes and if not detected, or treated early, can eventually develop into esophageal cancer.

The most prevalent symptom of GERD is chronic heartburn, but there are additional symptoms that might be connected with it. The following are some of the signs and symptoms:

• Belching
• Difficulty or pain when swallowing
• Dysphagia (the sensation of food sticking in the esophagus)
• Chronic sore throat
• Laryngitis
• Inflammation of the gums
• Erosion of the enamel of the teeth
• Chronic irritation in the throat
• Hoarseness in the morning
• A sour taste
• Bad breath

How Common is GERD?

GERD is a relatively frequent condition. The illness and its symptoms affect 20% of the population of the United States. GERD may affect people of any age, although some are more susceptible than others. After the age of 40, for example, your odds of developing GERD, mild or severe increases.

You’re also more likely to have it if you’re:

• Overweight or obese.
• Pregnant.
• Smoking or are regularly exposed to second-hand smoke.
• Taking certain medications that may cause acid reflux.

GERD is generally a treatable disease, though serious complications can result if it is not treated properly.

What Causes GERD?

GERD is a result of a weak lower esophageal sphincter. That weakness allows the contents of your stomach to flow back up into your esophagus.

There are a variety of factors that can weaken your esophageal sphincter, including:

• overeating
• being overweight
• pregnancy
• smoking or regular exposure to secondhand smoke
• hiatal hernia (part of the stomach protrudes into the diaphragm muscle)

Certain foods and beverages can trigger GERD. Some of the more common food triggers include:

• fried or fatty foods
• citrus
• chocolate
• coffee
• carbonated beverages
• drinks containing alcohol

Some medications can cause GERD, too. Among them are:

• alpha-blockers
• anti-inflammatories
• sedatives
• nitrates

If you're taking medication and experiencing GERD symptoms, talk to your doctor or pharmacist. They can discuss switching or stopping your medication but don't stop taking a prescribed medication without consulting your doctor first.

4 Stages of GERD

Reflux illness is a long-term disorder that progresses with time. Treatment choices are determined by the stage of the disease. The degree of reflux into the esophagus determines the illness stage. This, in turn, is determined by the frequency and duration of the reflux episodes. Here are 4 stages of GERD expounded by an article from the Houston Heartburn and Reflux Center. 

1. Mild GERD: Patients experience mild symptoms once or twice a month. Treatment relies on lifestyle changes and over-the-counter acid-suppressive medications.
   
   
2. Moderate GERD: Patients experience more frequent symptoms requiring daily prescription acid-suppressive medications. Untreated GERD symptoms affect patients’ daily activities and are associated with esophageal inflammation.
   
   
3. Severe GERD: Patients with severe GERD have poorly controlled symptoms on prescription medications. Their quality of life is substantially lower. Patients are more likely to have erosive esophageal inflammation. A thorough evaluation by a GERD expert is highly recommended. A successful anti-reflux procedure that restores the integrity of the lower esophageal sphincter cures GERD and improves patient quality of life.
   
   
4. Reflux-induced precancerous lesions or esophageal cancer: Stage 4 is the result of many years of untreated severe reflux. 10% of patients with long-term GERD progress to stage 4. They develop a pre-cancerous condition called Barrett’s esophagus. Barrett’s esophagus may progress to cancer if untreated. There are different modalities of treatments for Barrett’s esophagus aimed at preventing progression to cancer. Close follow-up and management by a reflux expert are highly recommended.

Diagnosis and Treatment

To manage and relieve symptoms of GERD, your doctor might encourage you to make certain lifestyle changes, like:

• maintaining a moderate weight, if applicable
• quitting smoking, if you smoke
• avoiding big, heavy meals in the evening
• waiting a few hours after eating to lie down
• elevating your head during sleep (by raising the head of your bed 6-8 inches)
• relieve stress, since stress and anxiety levels may contribute to GERD symptoms so taking upon yoga, meditation or stress-relieving activities can be of help in managing GERD symptoms
• avoiding trigger foods e.g. coffee, soda, citrus, onions, mint

Seek immediate medical attention if you have difficulty swallowing or breathing. Consider it an emergency if:

• you’re vomiting large amounts
• you have projectile vomiting
• your vomit contains green or yellow fluid
• your vomit looks like coffee grounds

GERD Outlook

You can control the symptoms of GERD. If you adjust your eating and sleeping habits and take medications when needed, you should be able to get your GERD symptoms to a manageable level.

Treatment with over-the-counter antiacids and some lifestyle adjustments as mentioned above can typically provide relief. However, if you get heartburn more than twice a week and simple lifestyle adjustments aren't helping—Don't allow chronic heartburn to keep you from living your life. If you think you could be suffering from GERD, see your doctor.

Sources:

https://www.webmd.com/heartburn-gerd/guide/understanding-gerd-prevention

https://my.clevelandclinic.org/health/diseases/17019-gerd-or-acid-reflux-or-heartburn-overview

https://www.healthline.com/health/gerd#dietary-triggers