It is the disorder of the lower esophageal sphincter that allows the acidic stomach fluids to flow back from the stomach to the lower part of the esophagus causing irritation.
The patient experiences heartburn (a burning chest pain beginning behind the breastbone and moving upward to the neck and throat. Many people say it feels like food is coming back into the mouth leaving an acid or bitter taste). Rarely stench mouth, cough, sore throat or pain during swallowing can coexist.
What Causes GERD
- Hiatal Hernia: the muscular membrane separating the chest from the abdomen has an opening through which the upper part of the stomach moves up to the chest leading to impaired function of the lower esophageal sphincter.
- Obesity, pregnancy, and other conditions that can lead to increased abdominal pressure
- Abnormal esophageal sphincter
- Fatty foods, coffee, red wine, chocolate
Prolonged esophagus irritation by the acidic gastric juices cause esophagitis. Esophagitis can lead to ulcer formation, stenosis and the Barrett’s esophagus which is a condition that increases the likelihood of esophageal cancer.
The diagnosis is confirmed with gastroscopy.
Further examinations when needed include:
Esophageal pH metering (a thin catheter with an acid sensor at his tip is passed through the nose, down the back of the throat)
Barium x-ray of the esophagus.( The patient drinks a chalky colored liquid that contains barium. It coats the walls of the esophagus and stomach, and is visible on x-rays)
The main treatment of gastro esophageal reflux disease is currently pharmaceutical.
Oral medication that reduce gastric acidity are administrated relieving the patient symptoms.
If the pharmaceutical therapy fails, surgical operation is performed. The surgery is performed laparoscopically and it aims to create an artificial sphincter by wrapping or plicating the upper part of the stomach around the lower end of the esophagus. The patient is relieved permanently from the symptoms, the possible complications and the dependence on drugs.