Gastroesophageal Reflux Disease (GERD)

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Signs and Symptoms - What are the symptoms of GERD?

Persistent heartburn

A burning sensation in the chest, especially after meals or when lying down, is a hallmark symptom of GERD. This discomfort often worsens at night or when bending over.

Acid reflux or sour taste in the mouth

Many individuals experience a bitter or sour taste, especially when stomach acid backs up into the throat or mouth. This can leave an unpleasant aftertaste and irritation.

Chest pain or discomfort

GERD can cause chest pain that may mimic heart-related pain. This discomfort is usually due to acid irritating the esophagus and is often felt after eating or while lying down.

Difficulty swallowing (dysphagia)

Some people with GERD find it hard to swallow food or feel like it’s stuck in the throat. This occurs due to inflammation or narrowing of the esophagus.

Chronic cough or sore throat

Irritation from acid reflux can lead to a persistent cough or a sore throat that doesn’t go away. These symptoms are particularly noticeable in the morning.

Hoarseness or voice changes

Frequent acid exposure can irritate the vocal cords, causing hoarseness, a raspy voice, or other changes in vocal quality, especially after waking up.

Bloating or belching

GERD often leads to a feeling of fullness, bloating, or frequent burping due to excess gas produced by the digestive system.

Regurgitation of food or sour liquid

Some individuals may experience regurgitation, where partially digested food or acidic fluid comes back up into the throat or mouth without vomiting.

Diagnosis / Investigations

Accurate diagnosis of GERD at Royal Care Hospital is made using a combination of clinical assessment and advanced diagnostic tools:

Upper GI Endoscopy

An upper gastrointestinal (GI) endoscopy is often the first step in diagnosing GERD. This procedure involves inserting a thin, flexible tube with a camera through the mouth to visually examine the esophagus, stomach, and upper part of the small intestine. It helps detect signs of inflammation, ulcers, or other abnormalities caused by acid reflux.

Esophageal pH Monitoring

Esophageal pH monitoring is a key test to measure acid exposure in the esophagus over a 24-hour period. A small probe is placed into the esophagus to record acid levels and correlate them with symptoms, providing accurate data to confirm GERD in cases where diagnosis is uncertain.

Manometry

Esophageal manometry assesses the strength and coordination of muscles in the esophagus. A thin tube with sensors is inserted through the nose into the esophagus to measure pressure and muscle contractions. This test is especially useful before surgery or when motility disorders are suspected.

Barium Swallow X-rays

In a barium swallow test, the patient drinks a contrast liquid (barium), and a series of X-rays are taken to track its movement through the esophagus and stomach. This test can reveal structural abnormalities such as hiatal hernias or narrowing of the esophagus that may contribute to GERD.

H. pylori Testing

Though not a direct test for GERD, evaluating for Helicobacter pylori infection is important as it is associated with peptic ulcers, which can cause symptoms similar to acid reflux. Tests may include breath, stool, or biopsy-based methods during endoscopy to check for this bacterium.

Types of GERD

GERD can be categorized based on the severity and cause:

Non-Erosive Reflux Disease (NERD): Symptoms without esophageal lining damage
Erosive Esophagitis: Visible inflammation or ulceration in the esophagus
Barrett's Esophagus: A precancerous condition caused by prolonged acid exposure

Causes

GERD may result from a combination of lifestyle, anatomical, and physiological factors:

Weak lower esophageal sphincter (LES)
Obesity or pregnancy
Smoking or alcohol consumption
Eating large meals or lying down soon after eating
Hiatal hernia
Certain medications

Surgical Conditions

In cases where GERD does not respond to medications or lifestyle changes, surgical intervention may be considered:

Laparoscopic Nissen Fundoplication: This minimally invasive procedure involves wrapping the upper part of the stomach (the fundus) around the lower esophagus. This reinforces the lower esophageal sphincter (LES), reducing reflux and promoting healing. The laparoscopic approach ensures faster recovery, less pain, and minimal scarring.

LINX Device Implantation: The LINX system involves placing a small ring of magnetic beads around the LES. These beads allow food to pass through while preventing acid from flowing back up. This advanced, reversible treatment is ideal for patients who prefer a less invasive surgical option and wish to preserve normal physiology.

Treatments & Procedures

At Royal Care Hospital, GERD management is personalized and comprehensive, addressing both symptoms and root causes through a multidisciplinary approach.

Endoscopic Treatments Minimally Invasive Surgical Options Lifestyle Modifications Medications Nutritional Counseling & Long-Term Monitoring

Endoscopic Treatments

Innovative non-surgical options like radiofrequency therapy (Stretta procedure) strengthen the LES and reduce symptoms in patients who are not ideal surgical candidates.

Minimally Invasive Surgical Options

For advanced cases, Royal Care offers laparoscopic surgeries including Nissen fundoplication and LINX device implantation, ensuring less downtime and quicker recovery.

Lifestyle Modifications

Patients receive guidance on weight management, dietary adjustments, meal timing, and strategies to avoid reflux triggers such as spicy or fatty foods, caffeine, and alcohol.

Medications

Depending on the severity of symptoms, patients are prescribed antacids, H2 receptor blockers, or proton pump inhibitors (PPIs) to control stomach acid production and promote esophageal healing.

Nutritional Counseling & Long-Term Monitoring

Dieticians and gastroenterologists collaborate to provide tailored dietary advice and ongoing monitoring, ensuring sustained relief and prevention of recurrence.

Prevention and Awareness

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Medical Gastroenterology team

Frequently Asked Questions

1. What is GERD?

GERD is a chronic digestive condition caused by the backflow of stomach acid into the esophagus.

2. What are the symptoms of acid reflux disease?

Acid reflux disease, also known as Gastroesophageal Reflux Disease (GERD), occurs when stomach acid frequently flows back into the esophagus. This backwash (reflux) can irritate the lining of the esophagus.Common symptoms include heart burn, regurgitation, difficulty swallowing,sore throat or

3. How is GERD treated?

Treatment options include medications, lifestyle changes, and surgical procedures for severe cases.

4. Can GERD lead to complications?

Yes, untreated GERD can lead to esophagitis, Barrett’s Esophagus, and even esophageal cancer.

5. Are GERD and peptic ulcers related?

While distinct, both can be caused by excessive stomach acid and may co-exist in some patients.