GERD Symptoms, Causes, and Complications
Signs & Symptoms of GERD
The signs and symptoms of GERD vary significantly from case to case. For example, patients who eat certain foods, such as those that are heavily spiced, may experience worsened discomfort than a patient who avoids those foods, even if the severity of their GERD is the same.
The telltale sign of GERD is chronic pain and discomfort in the chest area often referred to as heartburn or acid reflux. Other symptoms and signs can include:
- A persistent and dry cough
- Persistent sore throat
- Wheezing with or without the presence of asthma
- The occurrence and recurrence of pneumonia
- Significant pain or discomfort in the upper or lower chest area
- Bad breath
- Discoloration or erosion of teeth as a result of persistent contact with acid
- Problems swallowing including pain
- Nausea or vomiting
- Acidic taste in the mouth
- Difficulty sleeping
In severe cases, heartburn may feel like a heart attack because of the pressure and discomfort that is often felt in the chest. Remember that you should contact 911 immediately if you find yourself in what you believe to be an emergency medical situation.
Causes of GERD
Despite the prevalence of the disease, the root causes of GERD are not fully understood. In other words, we don’t yet know why the LES fails in some people, but doesn’t in others. Despite this ambiguity however, we do know that there are various conditions and lifestyles that can increase the risk of developing GERD. Some of these can be managed through lifestyle changes and others require greater intervention:
- Hiatal hernia, or a hernia that forms in when the stomach pushes up through the hiatus of the diaphragm and into the chest cavity. While the link between hiatal hernia and GERD has not been fully explored, there is definitely a link of some sort. If the hiatal hernia is strangulated (blood flow to the protruding stomach is restricted) surgery is indicated
- Dietary choices may also affect GERD. Spicy and acidic foods can increase the chance of reflux along with caffeinated drinks, dairy and sweets. Learn more about the foods to avoid
- Pressure on the abdomen from coughing, obesity and pregnancy can contribute to chronic reflux
- Smoking can cause GERD. It is important to note that even inhaling second hand smoke can be detrimental
- Various medications have side-effects that can include acid reflux. Check with your doctor before starting a new medication
The causes of GERD are varied and your physician will begin with a complete medical history. Upon understanding lifestyle choices and conditions you may have, the appropriate course of treatment can be started. You can also learn more about the signs and symptoms of GERD. For severe GERD or GERD that doesn’t respond to preliminary treatment, reflux surgery may be an appropriate solution.
As increased abdominal pressure is known to contribute to reflux, weight loss is often recommended to aid in decreasing the occurrence and severity of GERD. For some patients who have a higher BMI, or body mass index, bariatric surgery may be utilized for both weight loss and GERD treatment. If you are not familiar with your BMI, we encourage you to check your BMI and find out if you would qualify for weight loss surgery.
Complications Associated With GERD
The stomach and esophagus are anatomically separated because of an important but corrosive bodily fluid – stomach acid. While the lining of the stomach is perfectly suited to handle an acidic environment, the esophagus is not. GastroEsophageal Reflux Disease or GERD creates a continuous attack of acid on the esophagus, which in turn can cause inflammation and significant complications. Firstly, we should explore the discomfort the patient will feel as a result of chronic acid reflux. This may include chest pain, nausea, a burning sensation in the chest, bad breath, discolored teeth and a host of other life and lifestyle altering conditions.
While none of these conditions are in and of themselves life-threatening, they signal the possibility of longer-term adverse issues. These complications can include:
- Esophageal stricture, or the narrowing of the esophagus, which is a common condition associated with untreated GastroEsophageal Reflux Disease. Stomach acid causes damage to the esophageal lining and as a result, scar tissue begins to form. This scar tissue begins to build, often causing difficulty swallowing, especially in severe cases
- Because of the acidic contents of the stomach, the sensitive lining of the esophagus can eventually succumb and form an open wound. This is called an esophageal ulcer and is often very painful. Bleeding can occur, but the most common complaint is pain and difficulty swallowing
- Barrett’s esophagus, a condition whereby the cellular lining of the esophagus begins to change, increases the risk of esophageal cancer. A regular endoscopy (where a small camera is passed through the esophagus) will be necessary to monitor the progression of the esophageal cells and monitor for malignancy
Most patients who have advanced symptoms associated with GERD may not have had substantial relief from conventional treatments such as lifestyle change or over-the-counter and prescription medications. They usually suffer through their condition hoping that it resolves itself, but it rarely does. These patients should consider a minimally invasive endoscopic procedure such as TIF, Transoral Incisionless Fundoplication, for the long-term improvement or resolution of their symptoms.