GERD Definition Chest Pain Gerd in Babies Gerd Pillow Carafate

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GERD
 GERD  Do you want to know about it? Are you waking up with heartburn in the morning?

Then this article is for you.

let’s discuss a very common problem of nowadays that is the acidity or hyperacidity or GERD or in Ayurveda called  Amlapitta अम्लपित्त.  We will discuss in detail the causes, symptoms, risk factors and treatment of GERD and Amlapitta.

GERD Acidity hyperacidity amlapitta

What is GERD?

It is a common, treatable digestive disease in which stomach acid or bile irritates the food pipe or esophagus lining.

Meaning of GERD

It means

Gastro Esophageal Reflux Disease

It is a chronic disease and is usually self-diagnosable.

Definition of GERD

It is a digestive disorder that affects the Lower Esophageal Sphincter or LES, a ring of muscle between the esophagus and stomach

Many people have bad eating habits, including pregnant women suffering from heartburn or acidity or indigestion caused by GERD.

In Ayurveda, it may be correlated with amlapitta, a disease that occurs due to vitiation of Pitta Dosha in the body.

Many people occasionally experience Gastro Esophageal Reflux GER, but if a person experiences persistent Acid Reflux appearing more than twice a week, it may be diagnosed as GERD.

So the GERD is a long term regular occurrence of Gastroesophageal Reflux, GERD.

In the United States, about 25% of people are suffering from it.

Some facts about GERD are,

It may result from a dysfunctional valve at the top of the stomach and bottom of the food pipe, esophagus.

The stomach acid persistently and regularly flows up into the esophagus due to weak LES.

This stomach acid that reflects back into the esophagus, can cause heartburn and dangerous tissue damage.

Difference between heartburn, acid reflux, and GERD

Heartburn is the most common symptom of Acid Reflux in which burning sensation is felt in the chest or abdomen and it is not related to heart. This is felt behind the breastbone and mostly felt after eating and the can worsen while sitting or lying down.

Acid Reflux also called Gastro Esophageal Reflux or GER occurs when stomach acid comes back in the food pipe or esophagus to the mouth.

As described earlier,

GERD is a chronic acid Reflux.

Causes of GERD

In a normal digestion process, esophageal sphincter opens to allow food to pass into the stomach and closes to prevent food and acidic stomach juice from flowing back into the food pipe or esophagus.

This is a chronic problem that occurs as the sphincter at the bottom of the esophagus becomes weak or opens when it should not and allows the Acid Reflux in the esophagus causing the symptoms like heartburn

The severity of it depends upon weakness as well as the type and amount of acid brought up from the stomach and the neutralizing effect of saliva.

Due to overeating, lying down after eating or eating some specific foods, occasional Acid Reflux is quite common, but when it lasts  for a long time and worsen the symptoms it can cause GERD

Risk factors

Conditions that may increase the risk of this problem include

Overweight or obesity as the pressure of the abdomen creates the Acid Reflux.

A hiatal hernia

Here’s the bulging of the top of the stomach up into the diaphragm causing this problem.

In pregnancy

Due to the expansion of the stomach, it produces the problem.

Lifestyle factors that can aggravate the problem include

●Smoking
It is found that the nicotine present in the cigarette can relax LES muscles, causing the problem

●Eating large meals or eating late at night

●Sleeping just after taking a meal

●Eating certain foods like

◆Spicy foods

◆Fried foods

◆Stale foods

◆Cold foods

◆Chocolates

◆Alcoholic beverages

◆Sour fruits like tomato and lime

◆Excess coffee

Coffee acidity

In fact, coffee, when taken in moderate amount, is healthy for us. It is less acidic than beer, orange juice or soda as it has a pH level of 5 which is not much acidic.

Actually, coffee contains some acids which provide it with its flavor and taste and when it is consumed in a moderate amount its healthy thing for us.

The acids found in coffee

Chlorogenic acid

They are the antioxidants and are found responsible for the good taste of coffee.

Quinic acid

These are responsible for the flavour of the coffee.

Fresh coffee is the best coffee.

Symptoms of GERD

Every person may not feel distressed of acid Reflux disease symptoms in the same way,

The common signs and symptoms of this disease include

●Heartburn a burning sensation in the chest usually after eating and it may worsen at night.

●Chest pain that may be confused with the heart pain

Chest Pain in GERD

Non-cardiac chest pain is felt due to gastric oesophagal Reflux disease that may be mistaken for angina or heart disease.

The patient feels the pressure of squeezing pain behind the breastbone.
Some people may experience this pain spreading to the neck left arm or back

This pain can last for a few minutes to hours

In the United States, about 25% of people suffer from this type of non-cardiac chest pain that is found to be related to the problem of the oesophagus.

●Difficulty in swallowing

●The feeling of food coming back into the mouth that is bitter or sour

●The sensation of a lump in the throat

If you feel nighttime Acidity  following symptoms may also be found

●Hoarseness of voice

●A sore throat

●A cough that won’t go away

●Asthma

People suffering from asthma are at a higher risk of developing this disease as asthma attacks can cause the lower oesophagal sphincter to relax, thus allowing stomach contents to flow back into the oesophagus.

On the other hand, this disease can worsen the asthma attacks irritating the Airways and lungs and resulting in progressively more serious asthma

Also, irritation trigger allergic reactions to make airways more prone to environmental conditions as cold air or smoke.

●GERD Nausea

This is the main symptom of this disease.

The Sourness of backing food along with frequent burping and coughing initiates nausea and sometimes vomiting.

Secondly, indigestion and heartburn that is another symptom of this disease can contribute to nausea.

In severe cases with nausea and heartburn, blood vomiting may also occur.

It can be treated easily by a combination of lifestyle changes home remedies and medications.

●Silent GERD

In the Acid Reflux due to acidity, we may feel some symptoms of heartburn and acidity, but in some people the symptoms of Reflux  are not obvious so why it is called silent Gerd.

Also, laryngopharyngeal Reflux is known as silent reflux this does not cause any symptoms

Contents of the stomach could flux up your oesophagus into your throat and Vice voice box and even into our nasal passages you might never know it before it becomes serious.

As its meaning silent GERD very few symptoms most of the people don’t experience heartburn

Common symptoms may be

●Bitter taste in throat

●Sore throat burning sensation in the throat

●Frequently feeling of need to clear throat

●Feeling of post nasal drip from the nose into the throat.

Children and infants may experience silent GERD frequently as their upper and lower oesophagal sphincter muscles are not strong enough to get close every time.
This may improve with age.

GERD in Babies

It is a common practice for infants to spit up after a meal, but frequent vomiting associated with discomfort and difficult feeding and weight loss is considered to be caused by this problem.

The cause is seen as described in silent GERD that is the weak oesophagal muscles that can improve with age

GERD in Children

In the same way, children can have this problem, due to a weak digestive system and weak muscles that can improve by having healthy habits of food and muscles become stronger with the passage of time.

Tests for GERD

This problem can be well diagnosed with the help of a few tests as follows

1. Bravo PH monitoring can check for acid in the oesophagus. In this device is inserted into the oesophagus and left in place for 1to 2 days to measure the amount of acid in the oesophagus.

2. Computed tomography or CT scans

CT Scan can be done by using x-ray equipment and computer processing to produce a two-dimensional image of the body where the patient lies on the table straight through a machine.

Sometimes contrast dye is also used to improve the computer image. In that case, the patient is told to stop 1eating or drinking for 4 to 6 hours before performing this test.

3. With the help of esophageal manometry
  
The function of the esophagus and lower esophageal sphincter can be checked.

4. Barium  swallow or Esophagram,

Can be helpful for checking ulcers meaning of the esophagus. In this solution swallowed to help structures show up on in an X-Ray. The patient should be advised not to take water or food before 8-10 hours.

5. Endoscopy can be done to look for the problems in esophagus or stomach.

A Long flexible, lighted tube with a camera is inserted down the throat, after spraying in anaesthetic in the back of the throat.

6. Biopsy

While performing endoscopy a biopsy material may be taken to check samples of tissue to check for infection or abnormality under a microscope.

Can Gerd be cured?

In mild cases, lifestyle changes and healthy food habits can allow the body to heal itself.

But in some cases, there may be a need for some antacid medications. These medications can cure the problem.

But in severe cases where the muscle damage is Irreversible, the problem becomes a lifetime.

Sometimes it can be cured with surgery

How to treat Gerd permanently naturally

People having a mild problem can be treated successfully by Lifestyle changes such as

●Quitting smoking

●Cut on alcohol

●Losing weight

●Eating smaller portions of meals

●Staying upright for a few hours after meals.

●Elevate your head side bed up to 6 to 8 inches so that Acid Reflux cannot occur

A simple extra pillow will not help in this, as we need to elevate the complete upper body while with a pillow the only neck can be elevated, however, special wedge-shaped GERD pillow can work.

●Wear loose clothing to avoid pressure on the stomach

●Avoid wearing belts.

● Avoiding certain foods which can Trigger symptoms these include

Avoiding

◆Citrus fruits

◆Excess caffeine

◆Excess alcohol

◆Excess coffee

◆Colas and other carbonated drinks

◆Chocolates

◆Fried and spicy foods

◆Onions

◆Tomato sauce

◆Peppermint

●Using Gerd pillow

GERD pillow

You can use a wedge pillow while sleeping on your side or on your back without causing tension in the head and neck. It’s available in the market. It is elevated between 30 to 45 degree that is 6 to 8 inches at the top

GERD pillows for this problem are uniquely designed, however, with the passage of time the shape and for may change, so you like we have to replace another one after a few years.

These Lifestyle changes can lower the risk of long-term damage to the esophagus throat or teeth

But sometimes Lifestyle changes are not enough and some medications are needed.

Treatment

OTC (over the counter) medication

Antacids

these neutralize stomach acid and provide fast-acting relief in mild or acid Reflux some antacids come in liquid form that helps to go the lining of the esophagus and help to reduce the amount of acid in the stomach.

Overuse of these antacids may cause diarrhea, constipation, and imbalance in electrolytes gifts antacids contain calcium

Oral suspension medicines

The main medicine in this category is Carafate.

Carafate for Gerd

It is a liquid suspension that coats the  inner lining of the esophagus, but it is short lived in effectiveness because with one coating it is not going to do much

It is described in people who have symptoms less than a couple of times a week or month

Used to treat The symptoms like nausea, diarrhea and ulcers in the throat stomach and intestine

3. Anti-gas anti-flatulence

Some patients may feel bloating but being and heartburn

Overcome these symptoms, some Gasex is phasing are used that helps to relieve pressure, bloating and gas in the digestive tract

These medicines usually come in tablet form and work breaking up gas Bubbles making them easier to eliminate.

H2 receptor blockers

These were previously available only with a prescription eg. Pepcid AC and Zantac

These work by shutting off the production of acid in the stomach they are effective in mild Reflux can be used in people who have symptoms only a couple of times a month.

Proton pump inhibitors (PPIs)

Prilosec

These block acid production and help him in healing damage in the esophageal lining and can be used for the people who are having more frequent and severe symptoms.

The line of caution for the patients is to pay attention to the frequency and severity of the symptoms and to visit a doctor if they suspect that symptoms have aggravated because it can cause severe complications if left untreated.

Warning symptoms of complications include

●Trouble In swallowing

●Unexplained weight loss
●Anaemia
●And the drastic increase in mild symptoms

Chronic GERD causes the permanent narrowing of the esophagus leads to trouble in swallowing

In some cases, they may be changed in the lining of the esophagus due to Gerd called Barrett’s esophagus – it may lead to cancer.

Surgery

It is the last option if lifestyle changes and medications don’t work and there is some damage to lower oesophagal sphincter.

Dear friends, you have gone through the acidity problem according to modern medicine or allopathy.

We will discuss the Ayurveda concept of GERD or amlapitta in next article.

Stay tuned friends.
Eat Healthy Stay Healthy
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Dr Seema Gupta
Senior Ayurvedic Medical Officer

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