Gastroesophageal Reflux Disease (GERD): What Doctor’s need to know

GERD is a chronic disorder of the digestive system caused by the lower esophageal sphincter not closing properly. This can allow gastric acid, bile into esophagus, causing inflammation and, in some cases, tooth erosion.

GERD occurs more commonly in individuals who are:

Overweight or obese because of increased pressure on the abdomen.

Pregnant women due to increase pressure on lower abdomen.

Taking medications, including some asthma medications, calcium channel blockers, antihistamines, sedatives, and antidepressants.

Smoking and being exposed to second-hand smoke.

Note: GERD is almost never caused by the production of too much acid. It is caused by abnormal reflux of gastric contents into the esophagus.

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Signs and symptoms of GERD

Typical esophageal symptoms include the following:

Heartburn
Regurgitation
Dysphagia

Abnormal reflux can cause atypical (extraesophageal) symptoms, such as the following:

Coughing and/or wheezing
Hoarseness, sore throat
Otitis media
Noncardiac chest pain
Enamel erosion or other dental manifestations

A history of nausea, vomiting, or regurgitation should alert the physician to evaluate for delayed gastric emptying.

How GERD Is Diagnosed?

How is GERD treated?

Treatment of GERD involves a stepwise approach. The goals are to control symptoms, to heal esophagitis, and to prevent recurrent esophagitis or other complications.

The treatment is based on -

(1) Lifestyle modification and

(2) Control of gastric acid secretion through medical therapy with Antacids or H2 receptor blockers or PPIs or Surgical treatment with corrective anti-reflux surgery.

Note: Among the PPI, Dexlansoprazole Delayed Release capsule has been shown to be highly efficacious in healing erosive esophagitis, maintaining healed esophageal mucosa and controlling symptoms of patients with non-erosive reflux disease (NERD) and highly effective in improving nocturnal heartburn associated with GERD and bothersome regurgitation.