Reflux disease is a common problem. The common symptoms are heartburn, feeling of acid regurgitation into mouth, oral cavity problems, breathing difficulty, headache etc. With our changing lifestyle, especially in the urban population due to high stress levels, irregular meal times, eating outside food frequently, the incidence of reflux disease is now felt to be over 20-25%. The common treatment is medication to suppress the acid in the stomach. When reflux is so bad that it cannot be controlled even if acid suppressant medication or medication cannot be stopped after long term, either endoscopic or surgical treatment should then be considered. An upper GI endoscopy should be done at least once if reflux symptoms are not controlled within a few weeks of starting medication.
The causes of reflux disease include weak sphincter mechanism (valve)at the upper part of the stomach that prevents acid regurgitation. Sometimes this is associated with a hiatal hernia.
The gold standard surgery for reflux disease is Laparoscopic Nissen Fundoplication with or without repair of the hiatal hernia. In the surgery the sphincter mechanism is tightened by wrapping the fundus or the stomach at the junction of stomach with the food pipe. The wrap should not be too tight to prevent swallowing difficulty.
Most of the patients only need couple of days stay in hospital after laparoscopic anti- reflux surgery. The resolution of reflux symptoms is immediate.
Reflux Treatment in Gurgaon
Refluxes or acid refluxes occur when the acidic juices and food from the stomach are pushed back into the esophagus, causing a burning sensation in the chest. And Frequent acid regurgitation or refluxes means a possibility of gastroesophageal reflux disease or GERD.
Acid refluxes may be a normal condition happening to many of us at some point in time. But, when the frequency of acid reflux increases, that is when you will need to worry about it. Dietary changes and lifestyle modifications can help alleviate the irritating symptoms.
However, persistent acid refluxes can lead to severe complications if left untreated or undiagnosed. Knowing the symptoms and reasons for their occurrence can help the best doctor for reflux in Gurgaon or elsewhere diagnose and treat GERD.
Possible causes of GERD
One of the prime causes of GERD is the frequent occurrence of acid refluxes. The bottom of our esophagus houses a small sphincter muscle called the lower esophageal sphincter or LES. Typically, the LES relaxes while we eat or drink, allowing food or liquid to enter the stomach and closes after the food passes into the stomach. It prohibits the flow of acidic juices from the stomach into the esophagus.
In GERD, the LES closes abnormally, or the weak LES muscles relax when they shouldn’t, the acidic juices of the stomach and food move back into the esophagus or sometimes into the mouth. The backflow of the stomach acids causes irritation and inflammation of the esophageal lining.
The other causes of GERD include:
- Hiatal Hernia: The working of LES may be affected when the part of the stomach moves upwards-towards the diaphragm causing a condition called hiatal hernia. The pressure over the diaphragm does not allow the LES muscles to relax, causing regular acid reflux.
- Frequent large meals: Having large portions of food more frequently does not allow proper closing of the LES, leading to acid refluxes.
- Sleeping immediately after eating: Lying down soon after eating can cause weakening of LES muscles and GERD.
Most Common Symptoms of GERD
As mentioned earlier, regular acid reflux leads to acid indigestion and irritation of the esophageal lining creating a burning sensation in the chest region.
The other noticeable signs and symptoms of GERD include:
- Heartburn after eating food worsen during the night
- Acid regurgitation- the backlash of food and sour liquid into the esophagus and mouth
- Difficulty in swallowing
- Frequent pain and burning in the chest region
- Persistent coughing, difficulty in breathing, or Asthma
- A feeling of food or lump stuck in the throat.
- Disrupted sleep
- Soreness of the throat
- Wearing of tooth enamel due to acid regurgitation
- Laryngitis- Inflammation of the voice box, irritation, and hoarse voice.
Young children and infants can also have similar symptoms of GERD, including;
- Aversion for food
- Frequent episodes of vomiting
- Hoarse throat
- Frequent choking
- Sleeping difficulties
- Tooth enamel erosion with bad-breath
Risk Factors for GERD
If you experience acid reflux more often, you are likely to develop this condition called GERD. Other conditions that can add up to increase the risk of GERD are:
- Being overweight
- Hiatal Hernia- Bulging of the upper part of the stomach above the diaphragm.
- Pregnancy causes excessive pressure on the abdomen leading to heartburn almost every day.
- A delay in emptying the stomach or gastroparesis
- Connective tissue diseases- Lupus, scleroderma, and rheumatoid arthritis
Dietary choices and lifestyle factors increase the chances of acid reflux.
- Oily, spicy, and fatty food intake
- Certain medications
- Excess intake of caffeine and alcoholic beverages
- Eating late at night.
- Sleeping immediately after eating food
- Having frequent large meals
Diagnosis and reflux treatment in Gurgaon
If you experience any of the symptoms of acid refluxes more than twice or thrice a week, you will need to visit your physician. A physical examination followed by certain diagnostic procedures must rule out the possibility of GERD. Diagnostic procedures for GERD are:
- Upper GI endoscopy: This procedure involves the insertion of a thin, flexible tube with a light and camera through the mouth to examine the inside of the upper gastrointestinal tract. Endoscopy helps identify esophageal inflammation and erosion of esophageal lining.
- Ambulatory acid (pH) probe test: During this investigative procedure, a thin, flexible tube is passed through the nose or mouth into the esophagus to take pH measurements and detect the sequence of acid regurgitation. This tube is connected to a monitor system, recording the images of the upper GI.
- Esophageal manometry. This test measures the strength, spasms, and rhythmic contractions of the sphincter muscles while swallowing food.
- X-ray of the upper GI tract: A barium liquid is passed through the esophagus, followed by an X-ray. The X-ray can help derive pictures of the upper GI tract as the barium liquid coats the inner lining giving clear indications of GERD.
Acid reflux treatment in Gurgaon includes diet, lifestyle changes, and medications available over-the-counter, prescribed medications- H2 blockers, proton pump inhibitors, and medications to strengthen the LES muscles. Surgical procedures are considered a last resort when the above options cannot help or when long-term medications are to be avoided.
- Fundoplication: A minimally invasive surgical procedure, where LES is tightened or reinforced by wrapping the lower esophageal region. This laparoscopic procedure prevents recurrent episodes of acid reflux.
- LINX device implantation: During this treatment procedure, a tiny ring of magnetic beads is implanted at the junction of the stomach and esophagus by a minimally invasive procedure. LINX allows proper closing of the junction but is weak enough to permit food to pass through.
- Transoral Incisionless fundoplication (TIF): TIF is a new procedure performed endoscopically. Here, LES is tightened with polypropylene fasteners benefitting a quick recovery and high tolerance.
In cases of GERD caused due to hiatal hernia, TIF with laparoscopic hiatal hernia repair is performed.
How to Prevent GERD
GERD is a highly preventable disease. If you are experiencing mild symptoms of acid refluxes, diet and lifestyle changes can invariably prevent severe GERD symptoms and GERD complications- Barrett's Esophagus, Esophageal stricture, the onset of asthma, Sinusitis, and ulcers.
Some of the ways to prevent GERD are mentioned below.
- Try to maintain a healthy weight and avoid overeating.
- Eating small frequent meals is the key.
- Reduce the amount of fat intake. Opt for lean meat, fat-free options.
- Do not hit the bed as soon as you have your meal. SIt straight or upright for at least one hour after eating.
- It is required to have your dinner early and wait for three hours to sleep.
- Avoid wearing tight clothes that can tighten your belly region causing acid regurgitation.
- Sleep with your head in an elevated position using extra pillows or above the level of your heart.
- Say no to smoking and alcohol intake that can pop up acid reflux symptoms.
- Cut down on foods that cause acid backflow- oily, spicy, tangy, chocolates, caffeine, and more.
- Lastly, make sure to take your prescribed medications for acid refluxes regularly to avoid complications like GERD.
If you are in Gurgaon, and acid regurgitation is irritating you or bothering you, you must visit Dr. Vikas Singhal, the best doctor for reflux in Gurgaon. He is an exceptional gastrointestinal surgeon specializing in laparoscopy and bariatric surgeries. Under him, you are in safe hands to get a comprehensive acid reflux treatment in Gurgaon.
GERD or chronic acid reflux is not a life-threatening or hazardous condition in and of itself. However, long-term acid reflux, if left untreated, can lead to more serious health issues:
Esophagitis is an irritation and inflammation of the esophageal lining that can cause ulcers, heartburn, chest pain, bleeding, and difficulty swallowing.
Barrett's esophagus: The damage that acid reflux can inflict over time can affect the cells in the esophageal lining. Barrett's esophagus is often a primary risk factor for esophagus cancer.
Esophageal cancer: There are two forms of cancer that develop in the esophagus. Adenocarcinoma typically develops in the lower esophagus. This type can arise as a result of Barrett's esophagus.
Strictures: Strictures occur when the injured lining of the esophagus scars, preventing food and liquid from reaching the stomach and interfering with eating and drinking.
GERD affects various people in different ways. The major symptoms include chronic heartburn and acid regurgitation. Some people have GERD without experiencing heartburn. Instead, they have chest pain, hoarseness in the morning, or difficulty swallowing. You may feel as if you have food caught in your throat, as if you are choking, or as if your throat is constricted. Dry cough and poor breath can also be symptoms of GERD.
The following are the most prevalent symptoms:
- Food comes back into your mouth from the esophagus, causing regurgitation.
- The feeling as if there is food stuck in your throat.
- Chest ache.
- Having difficulty swallowing.
- Hoarseness and sore throat.
Symptoms in Infants and children suffering from GERD include:
- Small bouts of vomiting occur frequently.
- Excessive weeping and aversion to eating (in babies and infants).
- Other respiratory (breathing) problems.
- Acidic sour flavor, especially when lying down.
- The throat is hoarse.
- A choking sensation that may cause the infant to awaken.
- Poor breath.
- Sleeping difficulties after feeding, particularly in newborns.
Medication to suppress stomach acid is the most common treatment. Many over-the-counter (OTC) and prescription drugs are available to treat GERD. If you aren't obtaining relief from over-the-counter medications, you may be able to receive a prescription for stronger medications (H2 blockers, proton pump inhibitors, and LES muscle-strengthening medicines).
Endoscopic or surgical treatment should be explored when reflux is so severe that it cannot be controlled even with acid suppression medication or when medication cannot be stopped after a long period of time. If reflux symptoms do not improve after a few weeks of starting medication, an upper GI endoscopy should be performed at least once.
Laparoscopic Nissen Fundoplication is the gold standard procedure for reflux disease. It is a minimally invasive surgical technique for correcting acid reflux by implanting a new valve mechanism at the bottom of your esophagus. The surgeon wraps the upper half of the stomach (the fundus) around the esophagus's lower segment. The upper half of the stomach (the fundus) is wrapped around the lower segment of the esophagus by the surgeon. This strengthens the lower esophageal sphincter, preventing food from refluxing into the esophagus.
The duration of an acid reflux episode varies from person to person. Acid reflux causes heartburn in some people for only a few minutes, while it might endure for hours in others. Even though your heartburn symptoms have subsided, they may reappear within a few hours if you lie down or lean over. Heartburn symptoms generally disappear after the food that caused them has been eaten. Food normally passes through the stomach and small intestine in 2-5 hours.
However, if you experience heartburn several times per week for an extended period of time, you may have chronic GERD. GERD can progress to more serious problems if left untreated, but if correctly diagnosed and treated, it can be healed in less than a month, depending on the severity of the condition.
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