GERD

Posted by Winnie Melda on November 9th, 2018

Introduction

            Many people in the United States as well as in the entire world continue to battle with GERD.  This is a chronic digestive disease that occurs when stomach acid or, stomach content, flows back into the food pipe. The backwash always irritates the lining of the esophagus leading to GERD (American College of Gastroenterology, 2016). Some people always manage GERD discomfort with lifestyle changes as well as over-the-counter prescriptions.  On the other hand, others can need stronger medications or surgery as a way of reducing the symptoms

Occurrence and Prevalence

            Acid reflux and heartburn stand as common digestive conditions experienced by many people. When such signs and symptoms surface at least two times each week or interfere with daily life, or when the doctor observes damage to the esophagus, one may be diagnosed with this condition. According to medical records, 60% of the adult population experiences some GERD within a year period and 20% to 30% present weekly symptoms (Pietrangelo, 2015). In the United States, around seven million people have some GERD symptoms. In 2004, for instance, around 20% of US population recorded reflux symptoms that surfaced at least weekly.   Hospitalizations based on obesity diagnoses increased in the United States by 112% between 1996 and 2004.  Medically, Obesity is linked to GERD development as well as symptoms frequency (Bernick, 2004).

Etiology

            GERD originates from frequent acid reflux characterized by stomach acid or bile back up into the esophagus (Chandrasoma & DeMeester, 2006). When a person swallows food, the lower esophageal sphincter relaxes to allow food content to flow down the stomach and closes again. However, if the valve weakens or relaxes abnormally, stomach acid can end up flowing back up into the esophagus, leading to frequent heartburn. The constant acid backwash can irritate the esophagus lining leading to esophagitis. The inflammation can end up wearing away the esophageal lining, leading to complications like bleeding, narrowing esophagus or Barrett's esophagus.

Morbidity and Mortality

            Irrespective of the increased application of health alternatives and resources, GERD especially with medical treatment continue to rise.  In many cases, GERD Surgery is associated with early mortality and usually fails to prevent fatal outcomes.

Diagnosis and Testing

            GERD diagnosis always base on some factors. The first one is an observation of symptoms where the doctor can diagnose GERD basing on frequent heartburn as well as other symptoms. The second alternative is carrying out a test to monitor acid amount in the esophagus (Katz, Gerson & Vela, 2013).  Usually, Ambulatory acid (pH) probe tests use a device to measure acid for 24 hours. This device identifies when, and for how long, stomach acid regurgitates into the esophagus. Among the monitors is a thin, flexible tube that’s threaded through the nose into the esophagus. The tube gets connected to a small computer that is worn around the waist or with a strap over the shoulder. The other type is a clip which is placed in the esophagus during endoscopy. This transmits a signal to a small computer that is worn. After two days, the probe falls off to be passed as the stool. Doctor can request stopping taking GERD medications in order prepare for this kind of test.

            If one has GERD and is a surgery candidate, he may also undergo other tests, like upper digestive system X-ray.  This is sometimes referred to as upper GI series or barium swallow that involves taking a chalky liquid that coat and fills digestive tract inside lining. The coating enables the doctor to observe a silhouette of the esophagus, stomach as well as the duodenum. The other test includes carrying out an endoscopy to visually examine the inside of the esophagus as well as stomach where the doctor collects biopsy for other tests. The last test involves measuring the esophagus movement. Manometry helps to measure the movement as well as the esophageal pressure.

Management of GERD

            Treating heartburn, as well as other signs and GERD symptoms, usually start with over-the-counter treatments that regulate acid.  When the affected person does not experience comfort within a few weeks, the doctor can recommend other options such as other treatments and surgery. The initial treatments to control heartburn include antacids that neutralize stomach acid (McCance & Huether, 2015). Among them are Maalox and Mylanta which provides quick relief.  On the other hand overusing some antacids can lead to side effects like diarrhea and constipation.    The other treatments include medications to reduce acid production.   The drugs include H-2-receptor blockers which provide longer relief and can decrease acid production in the stomach for even 12 hours. The last treatments include medications that block acid production and treat the esophagus. An example is the proton pump inhibitors which are stronger blockers of acid production when compared to H-2-receptor blockers.  Examples of the over-the-counter proton pump inhibitors are the Prevacid 24 HR and Prilosec, Zegerid OTC (Longo, Kasper, Jameson, Fauci, Hauser & Loscalzo, 2012). When a patient experiences persistent heartburn despite initial options, the doctor can opt for prescription-strength medications. These include prescription-strength H-2-receptor blockers, prescription-strength proton pump inhibitors or medications to strengthen the lower esophageal sphincter. Medications can be combined for more effectiveness. Surgical procedures and other procedures are also used if medications fail. If medication proves unhelpful or one wants to avoid long-term use of medication, more-invasive procedures can be used. They include surgery to reinforce the lower esophageal sphincter or surgery to strengthen the lower esophageal sphincter.

Lifestyle Change and Home Remedies

            Change in lifestyle can also help to reduce heartburn frequency.  Some of the management options in this respect include maintaining a healthy weight.  The reason is that excess pounds always put pressure on the abdomen, pushing up the stomach and making acid to back up into the esophagus. Another lifestyle management options include avoiding tight-fitting clothing since they put pressure on the abdomen as well as the lower esophageal sphincter. Foods and drinks that trigger heartburn must also be avoided. Eat smaller meals. Avoid overeating by eating smaller meals. One can also avoid lying down after a meal, elevating the head of the bed and avoiding smoking.

Alternative Medicine

            Currently, no alternative medicine treatments have been proved to reverse esophagus damage or treat GERD (Patti, 2016). Nevertheless, some alternative therapies can offer some relief if combined with doctor's medication. Some of the options include the use of herbal remedies such as slippery elm, licorice, chamomile, and marshmallow.  The other alternative is relaxation therapies and acupuncture.

Conclusion

            As a chronic disease, GERD stands as one of the health problems that face many people. There are several options that can help deal with this condition ranging from treatment, surgery to an alternative medication. For better management of this condition, need to seek doctor’s attention is important. 

References

American College of Gastroenterology. (2016). Acid reflux. Retrieved from           http://patients.gi.org/topics/acid-reflux/

Bernick, L. (2004): Caring For Older Adults: Practice Guided by Watson’s Caring-Healing           Model. Nursing Science     Quarterly, 17(2), 128-134. doi: 10.1177/0894318404263374.

Chandrasoma, P., & DeMeester, T. R. (2006). GERD: Reflux to esophageal adenocarcinoma.       Amsterdam: Elsevier / AP.

Longo, D.L., Kasper, D.L., Jameson, J.L., Fauci, A.S., Hauser, S.L., & Loscalzo, J. (Eds.):           (2012). Harrison's Principles of     Internal Medicine (18th ed.). United States: McGraw-        Hill.

Katz, P. O., Gerson, L. B., & Vela, M. F. (2013): Guidelines for the diagnosis and management   of gastroesophageal reflux disease. The American Journals of GASTROENTEROLOGY,     108, 308-28. Doi: 10.1038/ajg.2012444.

McCance, K. L. & Huether, S. E. (2015). Pathophysiology: The biologic basis for disease in          adults and children, (7th ed.). St. Louis, MO: Mosby. \

Patti, M. G. (2016).  Gastroesophageal reflux disease. Medscape. May 02, 2016. 

Pietrangelo, A. (2015). GERD by the numbers: facts, statistics & you. Healthline. March 2, 2015.         

Sherry Roberts is the author of this paper. A senior editor at MeldaResearch.Com in custom nursing essay writing services services if you need a similar paper you can place your order for college essay writing services.