What is it about ?
Gastroesophageal reflux disease (GERD for short) is a disease that causes the acidic contents of the stomach to rise (reflux) into the esophagus. This causes pain and other problems. The name is derived from Latin: “gaster” meaning the stomach and “oesofagus” the esophagus
The main cause of this reflux is a problem with the muscle ring (sphincter) between the esophagus and the stomach (lower esophageal sphincter). Normally, this sphincter relaxes to allow food to pass into the stomach and contracts to prevent it from rising in the other direction. In the event of reflux, this sphincter relaxes temporarily and inadequately, and stomach contents can then move up into the esophagus.
What is its frequency?
Gastroesophageal reflux disease is common. One to two people in 10 suffer from it in Belgium.
How to recognize it?
the ‘burning’ (pyrosis) is the main symptom of GERD. Three in four people with GERD have it.
- Heartburn is a stinging or unpleasant sensation that begins in the hollow just below the breastbone or behind the breastbone, and runs towards the neck.
- It usually occurs after a meal or while lying down.
- It is particularly associated with large meals, foods high in fat, chocolate, coffee, strong alcoholic drinks (spirits) and acidic fruit juices.
- It increases when you bend over, lift a heavy object, or wear tight clothing.
The other main symptom is regurgitation : the contents of the stomach involuntarily rise (reflux) towards the mouth. You don’t have nausea, it’s not vomiting.
Other symptoms are a lumpy feeling in the throat, pain and / or difficulty swallowing, and excessive saliva production.
GERD can also lead to a chronic cough, sore throat, hoarseness, and tooth enamel damage.
How is the diagnosis made?
The doctor will start by asking you questions. This is usually sufficient to make the diagnosis.
The examination of the stomach which makes it possible to look into the stomach with a camera inserted through the mouth (gastroscopy) is not automatically prescribed. This is only done in certain cases, for example:
- Possibility of stomach ulcer;
- Person over 50-55 years of age who has these symptoms for the first time;
- Weightloss ;
- Vomiting blood.
If the doctor finds it desirable to perform this examination, he will refer you to a specialist in the gastrointestinal system (gastroenterologist).
What can you do ?
Raise the head of the bed about four inches, and avoid clothing that is too tight around the waist. In the evening, do not eat too late, try to consume small portions, if necessary at a higher frequency. If you are overweight, it is recommended that you try to achieve a healthy weight. Ideally, it is advisable to stop smoking.
Certain foods could make symptoms worse. For example citrus fruits, strong alcoholic drinks, tomatoes, coffee, onions, spices, fatty or fried foods, chocolate and mint. But this point remains controversial. So far, there is no evidence that stopping these foods will reduce the problems. Reactions also vary from person to person. So it’s up to you to find the products that make your symptoms worse. If you find any, try to avoid them.
What can your doctor do?
The doctor will give you the advice mentioned above. He may also prescribe medication for you.
Antacids neutralize acid. They are on sale in pharmacies without a prescription. But in general, they are not enough if the symptoms are very severe.
There are medicines that slow down the production of acid in the stomach:
- Ranitidine, an H2 antihistamine;
- ‘Proton pump inhibitors’ (PPIs).
Usually the doctor will prescribe a PPI, but ranitidine can be used for a short time or when needed.
The dose and duration of treatment with PPI depends on several factors. It is generally advisable to gradually reduce these drugs after 1 to 2 months, then to use them only if necessary and at the lowest dose to work.
If the drugs do not help, the doctor will refer you to a specialist in the gastrointestinal system (gastroenterologist) for further examinations.
Want to know more?
- Gastroesophageal reflux disease – mongeneraliste.be – SSMG – Scientific Society of General Medicine
- Gastroesophageal reflux disease (video) – GI Society – Canadian Society of Intestinal Research
- Stop smoking. It’s possible – Tabacstop – Foundation against cancer
- Calculate your Body Mass Index (BMI)
- Stomach ache … What to do?, Here, Where to find on this page of INAMI – National Institute for Sickness and Invalidity Insurance
- Antacids – CBIP – Belgian Center for Pharmacotherapeutic Information
- Ranitidine – CBIP – Belgian Center for Pharmacotherapeutic Information
- Proton pump inhibitors (PPI) – CBIP – Belgian Center for Pharmacotherapeutic Information
Are you looking for more specialized help?
- Smoking Assistance Center (CAF®) – FARES – Respiratory Affections Fund
- Tobacco specialists – FARES – Respiratory Affections Fund
- Find a registered dietitian – Professional Union of French-speaking dieticians
- Find a nutritionist doctor – Belgian Society of Nutritionist Doctors
Source