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October 2010
GERD Mentality
Gastro–Esophageal Reflex Disease
Dr. S.M. Ravindranath
Gastro – Esophageal Reflux Disease (GERD) is a digestive disorder caused by acidic stomach juices flowing from the stomach into the food pipe (esophagus).

All of us suffer from pain or discomfort in the upper abdomen at some stage in our life. Looking at the ones that make it to a hospital or clinic on that count, it would be almost 30 percent of the patient attendance at a family doctor’s. And their common problem? Dyspepsia - the loose term encompassing a range of symptoms, including upper abdominal (tummy) pain, heartburn, upper abdominal bloating, nausea and increased belching.

From the Heart
The most common GERD symptom is heartburn. Also called acid indigestion, it is described as a burning chest pain moving up to the neck or throat, behind the breast bone. And it can prolong for as long as two hours.

GERD is mistaken for heart attack, at times. Do seek medical attention immediately if the pain is severe, accompanied by sweating, light headedness, nausea and the pain radiating to the left arm, etc.

Discovering the Cause
GERD occurs due to the laxity of the sphincter muscle (that contracts to close the opening) at the junction of the stomach and food pipe (esophagus). Normally if the lower esophageal sphincter is normal, it prevents acidic food reflux.

Unhealthy lifestyle habits also contribute to GERD: being overweight, overeating, alcohol, smoking, having food that is too spicy, chocolates, etc.

In addition to a complete medial history and examination, the best way to diagnose is by performing an upper gastrointestinal endoscopy (passing a flexible thin lighted tube to view the inside of the food pipe, stomach and duodenum). Occasionally, more tests like esophageal manometry and pH monitoring may be required, especially before surgery.

If GERD is discovered to be present, your doctor grades it according to its severity (Grade A, B, or C), and advises further treatment based on it.

The Way Out
Your doctor may advise acid reducing agents, sphincter tightening drugs and motility regulators, in various combinations or alone. Majority of the patients would get better with these and may require a repeat of this whenever symptomatic.
A small percentage may require surgical measures to tighten the sphincter - preferably through a minimally invasive approach called laparoscopic fundoplication.
But these come along with self-help instructions – lifestyle modifications that can go a long way to help you.
  1. Reduce weight.
  2. Raise the head of the bed by six inches.
  3. Eat small frequent meals.
  4. Avoid spicy food and chocolate.
  5. Reduce caffeine drinks and citrus juices.
  6. Quit smoking.
  7. Avoid alcohol.
  8. Eat two hours before sleeping.
Dr. S.M. Ravindranath is Director Medical Services, Senior Consultant Laparoscopic & GI Surgeon at Apollo BGS Hospitals, Mysore

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