Burning, chest pain, regurgitation… Nearly one in 10 people regularly suffer from gastroesophageal reflux disease or GERD. This is the involuntary movement of stomach contents into the esophagus.
Gastroesophageal reflux abbreviated GERD corresponds to the involuntary rise of stomach contents into the esophagus. 5 to 10% of adults suffer from GERD on a daily basis, according to the French National Society of Gastro-Enterology.
What is gastroesophageal reflux disease (GERD)?
Gastroesophageal reflux is caused by esophageal sphincter dysfunction, valve located at the junction of the esophagus and stomach. Normally, the sphincter, a true protective valve, prevents stomach contents from flowing back into the esophagus. When a dysfunction exists, the sphincter can allow gastric juices to pass from the stomach into the esophagus. “There is then a acidity from the stomach that goes up into the esophagusand causes burns and irritation”, explains Olivier Spatzierer, gastroenterologist and hepatologist. It can be associated with a cough, sore throat, otitis, or even pulmonary symptoms such as asthma attacks.“. Over time, there may be damage to the esophagus, because this organ is not protected against the acidity of the stomach.
What are the typical symptoms of GERD?
Many manifestations can suggest gastroesophageal reflux. First, there are the stomach pains, or epigastric burns which occur when gastric juices rise towards the esophagus from the stomach. They are generally associated with heartburn. It’s about a burn occurring in lying position, located behind the sternum and increasing in intensity after the meals.
• Reflux and cough
Gastroesophageal reflux can lead to ENT symptoms: “A hoarseness of the voice, difficulty swallowing or even a cough and pain which may suggest angina pectoris” specifies the specialist.
• Reflux with mucus
Having reflux with phlegm is not worrying: in fact, during gastroesophageal reflux, the gastric fluid which rises towards the throat also increases the production of mucus, and therefore phlegm.
• Reflux in case of pregnancy
During pregnancy, there are a lot of hormonal changes in a woman’s body. Among others,“the sphincter is a little more open because the stomach is a little rounder”, explains Olivier Spatzierer. Additionally, digestion may be slowed due to hormonal changes. “All this means that, when the interior of the esophagus opens a little, the capacity of the acid to rise is greater. We therefore have liquid rising up to the esophagus, causing burns. ” This can be debilitating, distressing and needs to be treated. “There are treatments, and a change in diet can be beneficial” : eat smaller portions, but more frequently, chew food well, and do not eat or drink too much before bedtime.
• Reflux at night
“Gastroesophageal reflux is favored in the lying position”, explains the doctor. In addition, they can cause lung damage: asthma, even shortness of breath at night which can resemble asthma attack.
• Reflux in babies
“Because of the immaturity of the sphincter, it happens that infants, generally less than 3 months old, have reflux,” explains the specialist. These regurgitations often take place after meals. A liquid diet, changes in position and compression of the abdomen make reflux easier. “We need to check that it is not something else, for example esophagitis, which is much more serious.” This disease causes blood in reflux, agitation, crying… “In this case, we must make a diagnosis with different types of examinations, and give medication”he specifies.
What causes GERD?
The causes of gastroesophageal reflux are generally anatomical : “There is generally a malfunction of the lower esophageal sphincter, which separates the esophagus from the cardiac region of the stomach,” indicates the specialist. There may also be a hiatal herniaabdominal hypertension… Certain medications can also be the cause, as can certain substances, such as nicotine, alcohol, caffeine, etc.
• Stress
It’s best to avoid tension and stress which makes reflux symptoms worse. A calm sleep and repairer can help dissipate it: for this, deep breathing exercises combined with a hot bath can help you relax. Playing sports also helps relieve tension and provides a feeling of well-being.
• Overweight
Fat overload in the abdominal area aggravates the pressure on the stomach and consequently gastric manifestations. For obese people, it is advisable to lose weight. You should also know that clothing and belts that are too tight increase the pressure on the abdomen and encourage reflux.
• Tobacco
Tobacco also increases gastric acidity, you should try to stop in case of gastroesophageal reflux.
What medications should you avoid for GERD?
Certain medications can cause or worsen the symptoms of gastroesophageal reflux: acetylsalicylic (aspirin) and the non-steroidal anti-inflammatories (NSAIDs) are particularly not recommended. It is better to consult your doctor: because other medications, such as those intended to treat osteoporosis, are also not recommended.
Treatment to calm gastric reflux
Medicines sold in pharmacies without a prescription must not not be taken for long periods. Certain medications can provide relief to people with heartburn. THE antacids neutralize the acidic contents of the stomach. These are salts (aluminum, calcium, magnesium) which locally neutralize the acidity of the stomach contents. They are to be taken from the start of symptoms reflux. Alginates form a viscous gel that protects the lining of the esophagus against acids. “H2 antihistamines, histamine H2 receptor antagonists, inhibit stomach acid secretions. However, there is controversy over side effects. Care must be taken when prescribing them, and the benefit/risk balance must be weighed. “advises the specialist.
Complications of GERD
“As a result of having acidity in the esophagus, the internal walls have erosions, because they are not made to withstand such acidity, and this leads to inflammation (esophagitis), even ulcers,” says Olivier Spatzierer. “Without treatment, when acidity rises onto the mucous membranes, it can lead to endobrachyesophagus, a narrowing of the lower esophagus called peptic stenosis, even cancers.” There are signs to know : pain when swallowing, hoarse voice which makes it difficult to speak, dry cough and recurrent, violent gastric pain accompanied by vomitingweight loss, coughing up blood etc… It is essential to consult if the Manifestations appear suddenly from the age of 50.
What to eat with GERD?
To avoid reflux, it is best to eat slowly and calmly: taking the time to chew food well helps avoid overloading the stomach. It is advisable to avoid acidic foods of course, as well as meals that are too fatty, which are synonymous with risk factors for reflux. In fact, the latter reduce the power of the esophageal sphincter, promoting reflux. THE whole milk, chocolate, spices and herbs, citrus fruits, mint, onions, cold meats are not recommended. “You should also avoid going to bed immediately after eating, advises the doctor. If possible, it should bow a little to avoid raising the acidity.”
What to drink in case of GERD?
It is not recommended to drink too much fluid during meals. Drink a half hour approximately before meals allows meals to take up less space in the stomach. Carbonated drinks should be avoided because of the bloating they can cause, which can aggravate gastroesophageal reflux. Alcoholic beverages, such as wine, beer or strong alcohol, contribute to the relaxation of the esophageal sphincter and thus increase the risk of reflux. When these drinks are consumed on an empty stomach, that is to say on an empty stomach, the risk of reflux increases. Finally, coffee and tea should also be avoided, because they promote relaxation of the esophageal sphincter, the cause of reflux, and irritate the esophageal mucosa.
On the health forum: discussions about reflux (GERD)
To remember
► Gastroesophageal reflux is caused by a dysfunction of the esophageal sphincter.
► It is best to avoid tension and stress which aggravate reflux symptoms.
► Medications sold in pharmacies without a prescription should not be taken for long periods of time.
► Whole milk, chocolate, spices and herbs, citrus fruits, mint, onions, cold meats are not recommended.
► Alcoholic beverages, such as wine, beer or strong alcohol, increase the risk of reflux.
Thanks to Dr Olivier Spatzierer, Gastroenterologist and Hepatologist.