Gastroesophageal Reflux Disease (GERD) : Symptom, Risk Factor, Diagnosis, Treatment, And Drug

Gastroesophageal Reflux Disease (GERD) is a chronic condition of mucosal damage caused by stomach acid coming up from the stomach into the esophagus.The esophagus is a muscular tube connecting the throat (pharynx) with the stomach.The stomach is a muscular organ located on the left side of the upper abdomen.The stomach receives food from the esophagus.GERD is caused by a failure of the lower esophageal sphincter.Reflux can be present without symptoms.

The Symptoms of Gastroesophageal Reflux Disease (GERD) :

• Heart burn (a burning sensation in the chest)
• Regurgitation 
• Difficulty or pain when swallowing
• Chest pain
• Nausea
• Increased salivation (water brash)
• Dry cough
• Sore throat or hoarseness
• Inflammation of the gums
• Bad breath

The Risk Factors of Gastroesophageal Reflux Disease (GERD) :

• Obesity
• Smoking
• A high blood calcium level
• Dry mouth
• Asthma
• Diabetes
• Scleroderma and Systemic sclerosis
• Pregnancy
• Hiatal hernia
• Visceroptosis or Glenard syndrome
• Zollinger-Ellison syndrome
• Delayed stomach emptying
• The use of medicines, such as prednisolone

Diagnosis of Gastroesophageal Reflux Syndrome (GERD) :

Some tests are done to diagnose GERD.

• Esophagogastroduodenoscopy  (EGD) is to examine the lining of the esophagus, stomach and duodenum.
• X-Ray of the upper digestive system.
• Endoscopy is to examine the inside of the esophagus.
• Ambulatory Acid (pH) Test is to monitor the amount of acid in the esophagus.
• Esophageal Impedance Test is to measure the movement of substances in the esophagus.

Treatment of Gastroesophageal Reflux Disease

1. Medications

• Proton Pump Inhibitors (PPIs) are to block acid production and heal the esophagus.They are stronger than H-2 Receptor Blockers.Proton pump inhibitors include Omeprazole (Prilosec, Zegerid OTC) dan Lansoprazole (Prevacid 24 HR).
• H-2 Receptor Blockers are to reduce acid production.They decrease acid production from the stomach for up to twelve hours.They also provide longer relief.H-2 Receptor Blockers include Nizatidine (Axid AR), Ranitidine (Zantac), Cimetidine (Tagamet AB), and Famotidine (Pepcid AC).
• Antacids are to neutralize stomach acid.They provide quick relief.Antacids include Mylanta, Rolaids, Maalox, Gelusil, Gaviscon, and Tums.The side effects of antacid are diarrhea and constipation.
• Sucralfate needs to be taken multiple times a day, thus limiting its use.It has a similar effectiveness to H-2 Receptor Blockers.

Prescription-Strength Medications are used for longer than two or three weeks or for the symptoms are not relieved.

• Baclofen is to strengthen the lower esophageal sphincter, decrease the frequency of  relaxations of the lower esophageal sphincter, and decrease gastroesophageal reflux.It can treat severe reflux disease.Its side effects are confusion and fatigue.
• Prescription-Strength Proton Pump Inhibitors include Dexlansoprazole (Dexilant), Esomeprazole (Nexium), Pantoprazole (Protonix), Rabeprazole (Aciphex), Lansoprazole (Prevacid), and Omeprazole (Prilosec, Zegerid OTC).

2. Surgery

• Laparoscopic Fundoplication (Nissen Fundoplication) is a surgical procedure to treat gastroesophageal reflux disease.It strengthens the valve between the esophagus and stomach (lower esophageal sphincter)
• Linx Device consists of a series of titanium beads, each with a magnetic core, connected together with titanium wires to form a ring shape.The Linx device is surgically implanted around the lower esophageal sphincter to strengthen a weak sphincter.The Linx device helps in preventing stomach contents from flowing back into the esophagus.It cannot prevent the movement of food or liquids down the esophagus into the stomach.

3. Lifestyle

• Stop smoking
• Don't lie down after a meal
• Avoid-tight-fitting clothing
• Elevate the head of the  bed about 6 to 8 inches
• Lose weight
• Decrease alcohol intake
• Decrease caffeine intake
• Avoid Theophylline

Drugs for Gastroesophageal Reflux Disease

• Mylanta
• Rolaids 
• Maalox
• Gelusil
• Gaviscon
• Tums
• Nizatidine (Axid AR)
• Ranitidine (Zantac)
• Cimetidine (Tagamet AB)
• Famotidine (Pepcid AC)
• Dexlansoprazole (Dexilant)
• Esomeprazole (Nexium)
• Pantoprazole (Protonix)
• Rabeprazole (Aciphex)
• Lansoprazole (Prevacid)
• Omeprazole (Prilosec, Zegerid OTC)