UNDERSTANDING GERD: FROM REFLUX TO ESOPHAGIAL CANCER

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Failure to understand a disease has consequences to patient. In the 21st century, knowledge about lifestyle related disorder with day by day increasing incidences is a must to have in order to continue having better living. For patients with Acid reflux disease, the naïve and false belief that all facets of the disease occurs in everyone and seldom require treatment is suicidal in itself. And hence let us know a little more about GERD and its long term adverse effects.

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GERD also known as Gastro esophagial reflux disease/ Acid reflux disease is a digestive disorder whereby contents of stomach (acidic) comes back up to esophagus ( food pipe) owing to disarray in the lower esophagial sphincter mechanism. The common symptoms of GERD are Heart burn, chest pain, regurgitation, difficulty in swallowing. Atypical symptoms related to severity of the disease are coarse or chronic cough, throat pain, hoarseness of voice, dental infections, ear infection etc.

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GERD occurs because of either a functional or mechanical problem of our lower esophagial sphincter mechanism which prevents reflux into esophagus. Transient relaxation of this sphincter can be due to certain foods like coffee, chocolate, meals which are high on fat content, alcohol, certain medications and can be due to hormonal factors like progesterone. What is more important is to understand that the refluxate not only contains gastric/ stomach acidic juices but also upper small bowel/ duodenal biliary contents.

Mature man has acid reflux
Mature man has acid reflux

Prolonged or neglected reflux of duodenal and gastric contents to esophagus causes metaplasia- alteration in epithelial lining of esophagus leading to cancerous changes. The condition is called Barrets Esophagus and is precursor of esophagial carcinoma.

Gastroesophagial reflux disease ( GERD) is the classical good news- bad news story. Having discussed the bad part of it, the good news is about the availability of effective acid suppressive drugs and the effective surgical treatment done laparoscopically has improved the quality of life of patients. The medications have successfully reduces the incidences of erosive esophagitis, serious ulcers and strictures and have controlled pain arising from reflux. The detection, diagnosis and management of patients with Barret’s esophagus has plateaued the incidences of esophagial cancer cases. The surgical methods ( Fundoplication) done by suitable hands and with the advent of laparoscopy has further withheld the insult.

So in order to live a healthier life, awareness about GERD its pathophysiology, its long term effects and complications and treatment will help people suffering from GERD to have better life. All one need to have is to see a clinician and undergo Upper GI endoscopy once diagnosed or found to suffering from its problems.

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