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Gastroesophageal reflux disease (GERD) is a condition in which the stomach contents, such as acid, bile and digesting food, “reflux” or flow backwards into the esophagus. A small amount of reflux is normal but when it occurs often enough to cause damage, that is considered disease.
“A good rule of thumb is if someone experiences heartburn more than twice a week, that is significant,” says Dr. Tim Edison of Surgical Associates of Neenah. “GERD is a common condition but it can cause serious disease and has a variety of symptoms which are not always obvious. Significant reflux occurs in 10-20% of the US population.”
What are symptoms?
Heartburn is the most common symptom, followed by regurgitation (that feeling of stomach contents flowing up into your mouth or back of throat). Difficulty or painful swallowing can occur and these are often signs of trouble in reflux patients. Other symptoms include chest pain, severe mouth-watering, the feeling of a lump in your throat, and nausea.
What are complications and serious problems from reflux
The most serious complication of reflux is esophageal cancer. This occurs in less than 1% of reflux patients. Cancer is usually preceded by a condition known as Barrett’s esophagus which is a precancerous condition occurring in about 10% of reflux patients. Other conditions caused by reflux include strictures or narrowing of the esophagus causing food to get stuck, laryngitis and asthma.
How is GERD diagnosed
GERD is usually diagnosed when symptoms of heartburn are present. If a patient has had GERD symptoms for a few years or if they have what is known as alarm features which include trouble swallowing, bloody vomiting, anemia, weight loss, painful swallowing or vomiting, an upper endoscopy should be done. Upper endoscopy is a routine test which uses a skinny flexible camera placed through the mouth while the patient is sleeping to examine the esophagus. Painless biopsies can be taken to evaluate for precancerous changes and any narrowed areas can be dilated to allow for normal swallowing. This is the best test to check for esophageal cancer or precancerous Barrett’s esophagus.
How does diet influence Reflux
Reflux and its associated complications are worse in obese people, tobacco users, folks who eat before going to bed, eating chocolate, peppermint, fatty foods, using caffeine or carbonated drinks.
Treatment
Typically a step-up approach is used. Dietary and lifestyle modification is first such as the dietary items described above, along with weight loss. It is also suggested that someone with this condition elevate the head of his/her bed 4-6 inches. For persons suffering from heartburn once a week, over the counter medications can be used as needed.
For more frequent heartburn, try Pepcid twice daily or take an over the counter Omeprazole (Prilosec) once daily. At this point, and very importantly, your primary care physician needs to know about these symptoms and especially if any warning signs are occurring such as trouble swallowing, weight loss, bleeding etc then referral to a specialist for upper endoscopy should be done.
“If unchecked, the most serious complication this can lead to is esophageal cancer,” say Dr. Edison. “The most simple test for this type of cancer is an endoscopy. It’s a simple test where we insert a tube in your throat while you are under. We examine the area and take biopsies if needed. The we can tell if surgery is a treatment option for you.”
If you are in need of GI surgery contact Dr. Edison at Surgical Associates of Neenah. All surgeons at Surgical Associates of Neenah are trained in robotic-assisted surgery which offers our patients reduced recovery time, smaller scaring, and shorter hospital stays. Our surgeons also lead the area’s highest level trauma center. You do not need a referral to contact our surgeons.
