Gastroesophageal Reflux Disease - GERD

What is Gastroesophageal reflux disease (GERD)?
GERD is a chronic disease of the digestive system characterized by the flow of reflux into the esophagus. Reflux contains stomach acids, food and fluids and is the most common cause of vomiting among mammals and apnea among babies.

Reflux is caused by the dysfunction of the lower esophageal sphincter. This sphincter normally opens when food is being passed into the stomach and closes to prevent food from coming back up. When the sphincter malfunctions, it opens up too frequently and the stomach acids travel into the esophagus, accompanied by a burning sensation and vomiting.

Symptoms include vomiting, weight loss, discomfort, refusal to eat and apnea.

In order to diagnose the condition, doctors perform a number of tests. These tests include x-rays of the stomach and small intestine and a pH Metria which determines the level of acid in the esophagus. A tube is inserted through the nose into the esophagus which allows the doctor to measure the pH level in the esophagus for a consecutive 24 hours.

Treatment of GERD
Most cases of GERD heal themselves, however there are some medical treatment methods available.

Traditional Treatment – Non-Surgical
This treatment method has two components: diet and medication. A proper diet can help control reflux. This diet includes portion control, starch-based formula (deactivates the pH level), careful monitoring of the baby’s position and avoiding tight clothing and diapers. Medications are prescribed based on the doctor’s recommendation. The most common medications include Zantac (lowers the amount of acid release), Gaviscon (administered after a meal and prevents food coming back through the esophagus) and Prepulsid (given 20 minutes prior to a meal, increases intestinal activity to prevent reflux).

Surgical Treatment for GERD
This treatment method is only used in severe cases of reflux, where traditional treatment has been proven to be ineffective. The surgery is called a Nissen Fundoplication. An artificial sleeve is created by wrapping the upper of part of the stomach around the lower sphincter to prevent reflux.