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Gastro-oesophageal reflux: Treatment, symptoms, advice and help

About gastro-oesophageal reflux

The occurrence of gastro-oesophageal reflux is a common problem of the digestive system. It is characterised by backflow of digestive juices from the stomach into the oesophagus. This usually results in damage of oesophageal wall and manifests as burning pain in chest or upper abdomen. When such episodes become recurrent then the disorder is termed as Gastro-oesophageal Reflux Disease (GERD).

Gastro-oesophageal reflux: Incidence, age and sex

Gastro-oesophageal reflux is a commonly encountered digestive problem in the general population. Almost 30% to 40% of adults are afflicted with this disorder. It can be seen at any age but infants and adults are most susceptible to it.

Signs and symptoms of gastro-oesophageal reflux: Diagnosis

The predominant symptom of gastro-oesophageal reflux is intense pain which is felt in centre of chest or upper abdomen. The pain is typically exaggerated at night and may be burning or gnawing in quality. The affected individuals may sometimes experience nausea or a sour taste in the mouth. Occasionally, the only symptom of gastro-oesophageal reflux is longstanding cough, sore throat accompanied with hoarseness of voice.

It is advisable to consult a specialist when you encounter such pain in upper abdominal region. The diagnosis of gastro-oesophageal reflux can be established by detailed history and clinical examination. However, investigations like upper gastro-intestinal endoscopy or barium swallow may be required in a handful of cases.

Causes and prevention of gastro-oesophageal reflux

The food passes from mouth into food pipe also known as the oesophagus. Then it proceeds to the stomach which is a continuation of the oesophagus. In normal circumstances, a muscular band also called lower oesophageal sphincter constricts the opening of oesophagus into stomach thereby preventing any backflow of food or gastric digestive juices. However, in certain instances this band of muscles weakens and becomes ineffective. This results in reflux of gastric contents back into the oesophagus.

Certain conditions like hiatus hernia and obesity can lead to gastro-oesophageal reflux. Moreover, smoking and increased alcohol consumption is also linked to reflux problem. Furthermore, medications like beta blockers and calcium channel blockers have also been documented to lead to gastro-oesophageal reflux. This reflux problem is also an adverse affect of other drugs like anti-depressants and bronchodilators.

Individuals who are prone to gastro-oesophageal reflux are advised to avoid food products like chocolate, caffeine, spices, citrus fruits and tomato sauce. Moreover it is better to have small but frequent meals, wear loose clothes and sleep with the head end raised.

Gastro-oesophageal reflux: Complications

The most dreaded but rare complication of gastro-oesophageal reflux is Barrett’s oesophagus which is characterised by damage to the inner wall of the oesophagus due to repeated exposure to gastric acid. This damage is precancerous and may lead to cancer of oesophagus in future. Other complications include persistent cough, narrowing of food pipe, and oesophageal ulcer.

Gastro-oesophageal reflux: Treatment

The treatment of gastro-oesophageal reflux includes medications which counteract the acid juice like antacids. Such medications provide symptomatic relief but cannot cure the condition. Alternatively, other medications like proton pump inhibitors and H2 antagonists can be prescribed to suppress the production of gastric acid. Very occasionally, surgical intervention may be required in the form of a anti-reflux operation which is done laproscopically.