Do you suffer from GERD? Learn to identify AND FIX this possibly life-threatening condition!!

What is GERD?

Many of you may be wondering, it stands for Gastroesophageal Reflux Disease, it is a chronic ailment that consists in gastric reflux. Most people throughout their lives will suffer - from time to time - with signs and symptoms of gastric reflux, which is basically your gastric acid coming out of your stomach and into your esophagus. Usually gastric reflux does not occur often enough for it to cause damage to your esophagus. However in GERD, the frequency and quantity of the reflux are increased! leading to changes of your esophagus' outermost layer (epithelium) into whats denominated a "metaplasia".

Now, I'm not going to delve too deep into it, but these metaplasic changes may constitute whats known as Barret's Esophagus, a premalignant condition that has up to 10% probabilities (which is 350 times greater than that of people without Barret's esophagus) of evolving into a esophagogastric adenocarcinoma, a type of cancer with up to 85% mortality rates!

Let's find out if we are suffering from GERD! SYMPTOMS:

DISCLAIMER These symptoms will not always be present during GERD, but if they are, it means there is a high likelyhood of you suffering the disease.

The following symptoms are associated with a greatly increased risk of GERD if you have them more than 3 times per 2 weeks.

• Heartburn: Probably the most iconic symptom within GERD, consists in the burning sensation that's usually limited to your chest, but can go up up to your throat. Usually associated to big meals, during work-outs and while lying down (especially at night after having a late night meal!).
• Regurgitation: The effortless return of food or liquids towards your throat. May or may not be accompanied by
• Nausea.
• Water Brash: Excessive salivation, typical within esophageal afflictions and especially GERD.
• Coughing.
• Sensation of food getting stuck in your throat . Depending of severity, it can imply the inability to swallow solids or even liquids.
• Pain while swallowing.
• Globus sensation: Perception of having something "stuck" inside your throat when you haven't eaten anything.

Of special consideration are the first three symptoms listed, as when there are symptoms (considering there are asymptomatic GERD), it will most likely include those three. REMEMBER: You may only have one of the symptoms and it could STILL be GERD!

HOW TO FIX GERD?

The number 1 recommendation is always to look for help from a physician, however, GERD is a disease that can easily be addressed with just a few lifestyle changes:

• Avoid meals with: Lots of fatty contents, alcohol, peppermint, spearmint, coffee, tea, citric and other acidic fruits ( lemons, oranges, grapefruits, pineapples, etc), vinegar.
• Sleep sideways (On your left side): Positions your stomach so that its contents are farther from the sphyncter that leads to your esophagus.
• Elevate your head and torso while sleeping: Use a pillow that elevates your torso and head a bit, this will make it so that your stomach's contents will have to fight gravity before 'leaking' into your esophagus.
• Eat 2 hours prior sleeping: This will give your stomach time to empty itself from its contents so that it becomes less likely for there to be anything to reflux.
• Lose weight: Extra weight, especially abdominal fat, increases intra-abdominal pressures, which basically pushes your stomach and its contents upwards, making it more likely for there to be reflux.

Hopefully with this information, you will have an idea of what to do if you encounter these symptoms! Remember, to still go to the physician, but in the mean time, apply these measures to improve your symptoms put a halt at the development of a metaplasia!

Finally, I want to mention that as a medical student, my interest in this particular disease arose when I started Intermittent Fasting! I suddenly started having heartburn every other day, something I had rarely experienced before. Be extra weary of night-time reflux when undergoing I.F., as many people eat huge amounts of food before sleeping. The amount is usually so much, that even eating 2 to 3 hours before sleeping may not be enough, so plan your schedule with extra care, having night-time into consideration!

Rerences:

• K. (2015). Harrisons Principles of Internal Medicine, 19e. McGraw-Hill. Retrieved March 4th, 2018.
• Schwartz. (2015). Schwatz's Principles of Surgery, 10e. Mc Graw-Hill. Retrieved March 4th, 2018.
• 8 ways to quell the fire of heartburn (n.d) https://www.health.harvard.edu/staying-healthy/8-ways-to-quell-the-fire-of-heartburn
• Gastroesophageal reflux disease (n.d). Retrieved March 4th, 2018. https://en.wikipedia.org/wiki/Gastroesophageal_reflux_disease
• Esophageal cancer (n.d). Retrieved March 4th, 2018. https://en.wikipedia.org/wiki/Esophageal_cancer