GERD Management

Gastroesophageal reflux disease (GERD) is when acid from the stomach flows back up into the oesophagus (the tube connecting the stomach and the mouth).

This causes the lining of the oesophagus to get irritated and uncomfortable, resulting in heartburn and sometimes even chest pain, hoarseness and trouble swallowing.

An endoscopy may be performed for complete diagnosis.

GERD can be managed with medications and lifestyle modifications, without surgical interference.

What Are The 4 Stages Of GERD?

GERD can be broken into different stages based on severity instead of different types.

Stage 1: Mild GERD

Acid reflux symptoms usually occur once or twice a month and may be managed by basic lifestyle and diet changes. Medication acquired from over-the-counter pharmacies may be utilised to minimise the symptoms.

Stage 2: Moderate GERD

If the symptoms occur more frequently and to a point where prescription medication should be taken daily, GERD can be staged as moderate. The GERD symptoms at this stage may also affect your daily life.

Stage 3: Severe GERD

Painful symptoms are seen at this stage and prescription medication does not offer relief or improvement. The quality of your daily life may be affected and medical practitioners may suggest surgical correction for GERD.

Stage 4: Cancer (Includes Precancer)

If GERD symptoms have been left untreated for years, the oesphagus may develop a precancerous stage called Barret’s oesophagus. These lesions may then progress, if left untreated, to full oesophageal cancer.

How Do You Treat GERD Acid Reflux?

If diet and lifestyle changes do not improve the symptoms of GERD, there are 3 main avenues of treatment for GERD.

Nonprescription Medications:

Nonprescription, over the counter medication may include antacids, which may neutralise the acid in the stomach. Calcium carbonate is an active ingredient in antacids which generally provides an effective and quick relief response. Take care, however, as overuse of antacids may cause diarrhoea or kidney problems.

Medication that decreases the production of stomach acid-histamine (H-2) blockers work slower than antacids but they have the benefit of lasting longer and giving longer relief.

Proton pump inhibitors (PPIs) are stronger than H-2 blockers and allocates more time for the oesophagus to heal on its own.

Prescriptions:

Stronger PPIs may be prescribed but these cause more side effects such as nausea, headaches, and diarrhoea. In some rare cases, it has been found to cause low levels of B-12 vitamins and low levels of magnesium. The same can be said about prescription-strength H-2 blockers but they have been proven to be tolerated well and the symptoms seen are mild.

Surgery:

If you find yourself at stage 3 or 4 of GERD and the long-term use of medications is causing too many side effects, a long-term solution of surgery may have to be considered.

There are 3 different procedures medical practitioners will consider:

• Fundoplication, where the top of the stomach is wrapped around the lower part of the oesophageal opening/sphincter. This will prevent reflux due to the strengthened muscle.
• The LINX device is a small ring consisting of beads made of magnetic material and this is wrapped around the meeting point between the stomach and the oesophagus.
• During transoral incisionless fundoplication (TIF), the lower part of the oesophagus is tightened by wrapping it using polypropylene fasteners.

What Triggers Acid Reflux?

The major triggers of acid reflux symptoms are:

• Alcohol
• Spicy food
• Fried foods
• Beef
• Chocolate
• Soda/fizzy drinks
• Tomatoes
• Oranges
• Coffee
• Dairy products
• Garlic and onion
• Fish oil
• Salt and pepper
• Peppermint
• Vinaigrette

Besides food triggers, other triggers may include obesity, smoking, a sedentary lifestyle, certain medication, and pregnancy.

Frequently Asked Questions