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Tips to ward off GERD

Tips to Ward off GERD – Gastroesophageal Reflux Disease

Gastroesophageal refers to stomach and reflux means to flow back or return. Hence, Gastroesophageal Reflux Disease or GERD means the backwash of stomach acid and occasionally stomach contents into the esophagus causing irritation to the lining of the esophagus and leaving it inflamed.

GERD, a chronic digestive disorder, also called acid reflux or heartburn is a common condition many experience from time to time. But, when the symptoms show up at least twice a week or interfere with daily life or when the doctor confirms damage to the esophagus, you may be diagnosed with GERD.

Again most can mitigate the discomfort caused by GERD by adopting suitable lifestyle changes and taking over the counter medications. Then, for some stronger medication or even surgery is required.

More than 10 million cases occur in India every year ranging from infancy to 60 and above and are most prevalent in ages between 19 to 60 years and over.

GERD is usually self diagnosable. Symptoms include burning sensation in the chest after eating food and the pain worsens when lying down. And commonly one feels full too fast, has discomfort in the chest, in the upper abdomen or sore throat.

One may experience recurrent vomiting, belching, nausea or regurgitation. Food might taste bitter or sour in the mouth.  And there can be severe dry cough.

Based on the above symptoms, doctors may prescribe Ambulatory acid (pH) probe test. A device is sent in through the mouth into the stomach to measure the amount of acid for 24 hrs. The device identifies how much and for how long acid from the stomach regurgitates into the esophagus.

Treatment for GERD usually begins with over the counter medications to control acid. In the absence of relief in a few weeks, the doctor may initiate other treatments including medications and surgery.

Over the Counter Medications

Antacid to Neutralize Stomach Acid

Antacids such as Gelusil, Gaviscon, Rolaids, Maalox and Mylanta can provide quick relief by diluting the acid in the stomach. These can in no way fix an inflamed esophagus. Also, overuse of these can cause diarrhea or constipation.

Medications to Reduce Acid Production

Also called H-2-receptor blockers, these include: Cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR) or ranitidine (Zantac). These don’t act as fast as antacids but do provide relief for longer time by decreasing the acid production up to 12 hrs.

Medications to Block Acid Production and Heal Esophagus

These over-the-counter proton pump inhibitors include lansoprazole (Prevacid 24 HR) and omeprazole (Prilosec, Zegerid OTC) and are stronger blockers of acid production than H-2-receptor blockers. So these allow more time to the damaged esophagus to heal.

Persistence of heartburn for longer than two or three weeks and other symptoms not relenting despite taking the over the top medications the doctor then will have to prescribe stronger medications.

Prescription strength medications

Prescription Strength H-2-Receptor Blockers and Proton Pump Inhibitors

These include prescription-strength cimetidine (Tagamet), famotidine (Pepcid), nizatidine (Axid) and ranitidine (Zantac).

Prescription-strength proton pump inhibitors include esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec, Zegerid), pantoprazole (Protonix), rabeprazole (Aciphex) and dexlansoprazole (Dexilant).

These medications are well tolerated by the body but using them long term, you may risk bone fracture or vitamin B-12 deficiency.

Medications to strengthen the lower esophageal sphincter

Baclofen, by decreasing the frequency of relaxations of the lower esophageal sphincter decreases esophageal reflux.  This is not much effective as the proton pump inhibitors but might be used in severe reflux disease. But, it has significant side effects, commonly fatigue or confusion.

GERD medications are sometimes combined to increase their effectiveness in treating the reflux disease.

Home Remedies to Treat GERD

The natural methods treat GERD better than the PPIs, H2-receptor-blockers and the antacids as they aid the body in functioning properly. This is not minimizing the medical advice concerning finding out acid levels and ensuring that the stomach and the esophagus are structurally intact and optimally functioning.

Apple Cider Vinegar

Vinegar is an acid about pH 5. So, it helps with heartburn by lowering the pH of the stomach contents to improve digestion and reduce build up of pressure. This home remedy is used by many though there is no research to back it up. Also there is no downside to using it.

Add 2 tsp of apple cider vinegar to ¼ cup of water and drink. Repeat every five minutes until the heartburn subsides. Or, you can drink it before meal to preempt the acid reflux.

Lemon Juice

Lemon juice is pH 2 making it more acidic than vinegar. However, just like the apple cider remedy drinking it once may not be enough. Squeeze the lime into a glass and drink it straight or add it to ¼ glass of water and drink.

Betaine HCL

Hydrochloric Acid is the main component of the stomach acid. It is secreted by the cells in the stomach lining in response to eating and drinking. Due to stress, age, infections, nutrition deficiencies and other things enough of it might not be made in the stomach thus leading to the fermentation of food and heartburn.

However, if you are already on H2-blockers, PPIs or on long term NSAIDs talk to your doctor to wean off from these drugs before you start out on Betaine HCL as a solution.

You can use this as a daily supplement to help the stomach work optimally and never have a heartburn.

Baking Soda

Baking soda is a base and not acid. It works by neutralizing the acid in the stomach and can offer fast relief from heartburn.

Mix ½ tsp of baking soda in ¼ cup of water, drink it. Wait for 5-7 minutes. Incase there is still pain, repeat until heartburn subsides.

We request patients never to go for self medication. Please contact our doctors if your symptoms persist.