Gastroesophageal Reflux Disease (GERD)

Gastroesophageal reflux disease ( GERD ) refers to the chronic symptoms that occur as a result of the hydrochloric acid in the stomach entering the oesophagus. This phenomenon, also called acid reflux, results in the damage of the mucosal lining of the esophagus.

If the reflux reach higher and into the throat, it is called laryngo-pharyngeal reflux disease. The rear of the throat, and the nasal passages, are extremely sensitive to this acid onslaught. This in turn can lead to long- term airway problems, ear infections, hoarseness and sinusitis.

The anatomy of the human body will reveal that esophagus is a strong, muscular pipe that connects the throat to the stomach. The Lower Esophageal Sphincter (LES) is a valve attached to the lower end of the esophagus, which keeps the stomach opening closed, most of the time. At intervals it relaxes to allow the entry of food, but prevents the backward journey (reflux) of the food to the esophagus.

In some people, the LES is weak causing it to relax spontaneously, thereby, allowing the reflux of the stomach acid back into the esophagus. This causes 'heartburn', a sensation that has nothing to do with the heart. Also called pyrosis or acid indigestion, heartburn is a burning sensation in the esophagus which can often be painful. This pain begins in the chest but may radiate to the throat, neck and jaw. It may even mimic asthma and is also indicated as one of the causes of chronic cough.

Most individuals experience heartburn at some time or the other in their lifetime but if someone experiences the sensation more than twice a week, that person is likely to have GERD. It is possible to have GERD without experiencing heartburn. But other symptoms such as choking sensation or chest pain may be present.

Chronic heartburn can be quite serious, and may lead to ulceration or corrosion of the esophagal lining, leading to a condition called Erosive Esophagitis(EE). Sometimes esophageal cancer may also result. Reflux changes may also be non-corrosive, leading to a condition called non-erosive reflux disease.

In severe or chronic cases diagnostic tests, such as upper endoscopy, are employed to evaluate the underlying causes.

On the positive side, GERD can be treated and controlled with the help of antacids, prescribed medications, dietary alterations and lifestyle changes.