Gerd: Symptoms, Causes and Treatment in Cape Town

You may think that acid reflux is normal, and to an extent it is. It happens to everyone once in a while, depending on what they ate.

It usually happens to people after eating a big meal or a spicy dish.

However, it becomes a concern when it begins to happen after nearly every  meal.

This then turns into GERD or Gastroesophageal Reflux Disease.

The stark difference between normal acid reflux and GERD is that in GERD patients, the refluxed liquid acid contains more acid and stays in the oesophagus longer, thus, causing damage.

 

What is GERD?

GERD or gastroesophageal reflux disease is a condition wherein a patient experiences acid reflux more than twice a week.

It is a condition in which the acidified liquid content of the stomach backs up into the oesophagus.

The liquid can inflame and damage the lining (oesophagitis) although visible signs of inflammation occur in a minority of patients.

The regurgitated liquid usually contains acid and pepsin that are produced by the stomach.

 

 

This condition can lead to other complications such as ulcers and strictures of the esophagus, throat and laryngeal inflammation, and inflammation and infection of the lungs, among others.

Unfortunately, GERD is usually a chronic condition. It means that once a patient gets it, it’s life-long. So what causes GERD in the first place?

 

Causes of GERD

GERD is caused by the weakening of the LES, or the lower oesophageal sphincter.

The lower oesophageal sphincter is a circular band of muscle at the end of your oesophagus.

When it becomes weak, the stomach contents rise up to the oesophagus.

What weakens the lower oesophageal sphincter?

It’s a number of factors, including:

• Increased pressure on your abdomen caused by extreme weight gain, could be due to obesity or pregnancy
• Smoking or inhaling second-hand smoke for a long period of time
• Abnormal oesophageal contractions
• Slow or prolonged empty state of the stomach
• Certain medicines such as:
  • Some types of asthma medication that can make a person more sensitive to allergens
  • Calcium channel blockers (usually used to treat high blood pressure)
  • Anti-histamine
  • Pain killers
  • Sedatives
  • Anti-depressants
• Hiatal hernia. A hiatal hernia is a condition wherein the opening in your diaphragm lets the upper part of the stomach move up to your chest. This, in turn, weakens the lower oesophageal sphincter.

 

Symptoms of GERD?

GERD patients tend to brush off their symptoms and pin it on usual acid reflux.

However, it’s best to note any changes in the body to determine the problem.

Here are several symptoms to look out for and to help identify GERD:

• Heartburn
• Difficulty in swallowing
• A bitter or sour taste at the back of the mouth
• Chronic coughing
• Bad breath
• Nausea
• Constant chest pain or upper stomach pain
• Vomiting
• Oral health damage (rotting of teeth or wearing away of teeth)

It’s evident that the symptoms are primarily oral, given the nature of the sickness.

When visiting the dentist, they may also note the symptoms or the signs – heed their advice and have a doctor check out your symptoms.

If you’ve had any of these symptoms constantly for more than two weeks, it’s time to visit a doctor.

 

GERD Diagnosis

If you are experiencing symptoms of GERD, find a trusted gastroenterologist in Cape Town to go in for a consultation.

Gastroenterologists are trained to perform several tests to diagnose GI diseases with accuracy.

There are many ways doctors can diagnose GERD.

Doctors sometimes recommend different tests to diagnose the sickness or to at least rule out other conditions.

Here are some of these tests:

• Barium Swallow Radiograph

The barium swallow radiograph is a special type of X-ray that allows doctors to see whether or not liquid is refluxing up the oesophagus.

It can also show any abnormalities or damage to the oesophagus. The test is done by making the patient drink a special solution of barium. This solution shows up under an X-ray.

 

• Gastric Emptying Scan

A gastric emptying scan can help show if a patient’s stomach is emptying too slowly, thus possibly causing GERD.

It’s done by letting the patient drink milk or eat scrambled eggs with a tracer in it.

With the use of a specialized machine, doctors can view the tracker and see how fast it passes through the stomach.

 

• 24-Hour Impedance Probe Study

As the name suggests, this test lasts for 24 hours.

The procedure starts when the doctor inserts a tiny tube through the patient’s nose and down the oesophagus up to their stomach.

It will stay in the patient’s body for 24 hours, monitoring the oesophagus’ acid levels as the patient goes through their daily motions.

 

• Gastroscopy

In Cape Town, another test or procedure is offered by Dr. Eduan Deetlefs.

As a seasoned Gastroenterologist, Dr. Deetlefs has seen his fair share of GERD cases.

In his clinic, one of the ways they can diagnose GERD is through gastroscopy.

Gastroscopy is also often referred to as an upper endoscopy, OGD, or oesophago-gastro-duodenoscopy.

It is a procedure that allows the doctor to view a patient’s oesophagus, stomach, and small intestine using a tiny camera.

With the use of a numbing spray or general anesthesia to relax the patient, the doctor inserts a thin plastic tube called the endoscope down the patient’s throat.

During the endoscopy, the doctor may find abnormalities or tissue growth and may use tweezers or forceps to remove said growth.

 

It will be sent to the laboratory for a biopsy to determine whether the damage was caused by acid reflux or not.

The doctor who performs the procedures has special training in using an endoscope to examine the upper GI system, looking for inflammation (redness, irritation), bleeding, ulcers, or tumors.

Of the four tests, the most thorough and encompassing is the gastroscopy or upper endoscopy, as it allows the doctors to catch the most subtle findings that could possibly be life-altering.

 

How to Prepare for Your Tests

If you do decide to go and get a gastroscopy, your doctor will give you a few things to do to prepare for the tests.

Gastroscopy requires patients to fast starting 8 pm the night before the appointment and only drink clear water up until 3 hours before the procedure.

This is to allow the doctor to see the oesophagus clearly. The procedure itself only takes 10 to 20 minutes; the next 2 hours are used for the patient to recover under the guidance of a trained medical officer.

Very rarely do complications happen but some possible complications include torn tissues and minor bleeding from the biopsy.

These are very rare and can easily be taken care of by the team.

 

GERD Treatment

GERD is a chronic condition, however, there are many proven ways to alleviate it.

Lifestyle changes are one, this includes:

• quitting smoking
• avoiding alcohol
• losing weight if you are overweight
• wearing loose-fitting clothes
• avoiding carbonated beverages
• avoiding foods that trigger reflux

Acid reflux and GERD symptoms prevention diet with trigger foods and anti-inflammatory healthy food.

There are medical options like the prescription of anti-acids like the Maalox, Mylanta, and Riopan, H2 blockers, like cimetidine, Proton Pump Inhibitors, and Prokinetics.

On the other side, there are also surgical options like fundoplication and endoscopic techniques.

Whichever you decide to go for, it’s best to find a trusted and experienced Gastroenterologist in Cape Town who can answer your questions clearly, recommend appropriate solutions, and perform tests with precision and expertise.