Gerd symptoms, causes, diagnosis, and treatment electricity history timeline


In addition to esophageal concerns, GERD can lead to other complications involving the head, neck, and airways such as asthma, chronic laryngitis, narrowing of the airways around your larynx (voice box), dental cavities, and chronic sinus infections. Causes

GERD is caused by the reflux of gastric contents into the esophagus. Normally, reflux is prevented by the lower esophageal sphincter (LES), a ring of muscle located at the junction of the esophagus and the stomach. Most of the time, the LES is contracted in order to close the opening and to form a barrier between the stomach and esophagus. The LES transiently relaxes when you swallow to allow food to pass into the stomach. It also relaxes when you belch to allow gas to escape.

In most cases of GERD, the LES transiently relaxes when it’s not supposed to, thus allowing a brief interval of time in which the stomach contents can enter the esophagus. It is not clear why so many people develop frequent, transient relaxations of the LES.

Less commonly, GERD can be produced when the LES becomes chronically flaccid, allowing reflux to occur at almost any time. LES pressure can be reduced—and reflux encouraged—by gastric distention (a full stomach), smoking, numerous medications, drinking alcohol, caffeine, and several kinds of food, especially fatty foods and chocolate.

Diagnostic testing is usually done only when you fail to respond to therapy or if your doctor suspects that one of the more serious complications of GERD may have occurred. Tests often used in diagnosing GERD may include endoscopy, 24-hour pH monitoring, esophageal manometry, and barium swallow X-rays. Treatment

In general, if you have only mild symptoms, your doctor will recommend such modifications and perhaps suggest an over-the-counter (OTC) medication. Antacids don’t prevent or improve GERD, but they can be taken for occasional symptom relief. Commonly used antacids include Gaviscon, Maalox, Mylanta, Rolaids, and Tums.

• Histamine-2 blockers (H2 blockers): H2 blockers help limit the production of stomach acid, so that stomach contents cause fewer symptoms when they reflux into the esophagus. H2 blockers begin working within an hour, becoming the most effective between one and three hours after taking a dose, and their effectiveness persists for up to 12 hours, They’re more useful when they’re taken regularly for a 2- to 4-week course of therapy. H2 blockers include Axid (nizatidine), Pepcid (famotidine), Tagamet ​ (cimetidine), and Zantac (ranitidine).

• Proton pump inhibitors (PPIs): PPIs work by inhibiting the pump in gastric cells that produce stomach acid. They are the most potent acid inhibitors and are more effective than H2 blockers at eliminating symptoms and healing esophagitis. However, they tend to cause more adverse effects, so most doctors will try an H2 blocker first. The PPIs include Prevacid (pantoprazole), Nexium (esomeprazole), and Prilosec (omeprazole) .

If your symptoms don’t improve with lifestyle changes and prescription medications, your doctor may recommend surgery, though that is rare. The most common type is fundoplication, which is when the upper part of your stomach is wrapped around the LES in order to strengthen it and prevent reflux. Endoscopic techniques and implantation of a ring of magnetic beads called a LINX device, may also be considered. Caregiving

If you are caring for someone with GERD, there are ways you can help your loved one deal with his or her symptoms at home. You can talk about and help her avoid foods that may trigger heartburn, encourage him to wear loose clothing, use medication as needed, encourage her to exercise, and keep his head elevated at night.

GERD is a common gastrointestinal disorder that is usually reasonably mild, but it can cause serious complications if it’s left untreated. If you have symptoms of GERD, you should work with your doctor to make sure you have the correct diagnosis and to make sure you receive a treatment regimen that will get rid of your problem before it worsens. Fortunately, with appropriate lifestyle modifications and the medications available today, the large majority of people with GERD can be successfully treated before an annoying problem becomes a dangerous one.

Kahrilas PJ, Shaheen NJ, Vaezi MF, American Gastroenterological Association Institute, Clinical Practice and Quality Management Committee. American Gastroenterological Association Institute Technical Review on the Management of Gastroesophageal Reflux Disease. Gastroenterology. October 2008;135(4):1392-1413,1413.e1-5. doi:10.1053/j.gastro.2008.08.044.

Ness-Jensen E, Lindam A, Lagergren J, Hveem K. Weight Loss and Reduction in Gastroesophageal Reflux. A Prospective Population-Based Cohort Study: the HUNT Study. The American Journal of Gastroenterology. March 2013;108(3):376-82. doi:10.1038/ajg.2012.466.