How To Cure GERD Permanently?

Overview

If you've been suffering from acid reflux, also known as gastroesophageal reflux disease or GERD, which has been affecting your quality of life, the good news is that it can be permanently cured. Unfortunately, it does not heal on its own and requires treatment. Depending on the severity and intensity of your illness, a permanent GERD cure is possible through lifestyle changes, drugs, surgery, or a combination of all of these.

About GERD

Heartburn, a defining symptom of gastroesophageal reflux disease (GERD), is also a common name for the ailment. It is a chronic disorder defined by the regurgitation of stomach acid into the oesophagal food pipe.1 The unilateral stomach valve malfunctions, causing the stomach's acidic contents to backflow and is characterised by a painful burning sensation brought on by the irritation and inflammation of the oesophagal lining. 

It should also be highlighted that a single episode of heartburn or acid reflux does not indicate that you have gastroesophageal reflux disease; instead, a pattern of symptoms with related causal and risk factors is required for diagnosis. It adversely affects an affected individual's quality of life and significantly raises their morbidity risk.2

Causes

A variety of risk factors predispose an individual to develop GERD symptoms, including unhealthy food and lifestyle practices such as:

  • Increased consumption of carbonated beverages such as cola drinks and caffeinated liquids such as tea and coffee
  • Spicy foods
  • Excess intake of fried, fatty and heavy food items
  • Excessive weight 
  • Smoking cigarettes
  • Emotional stress and anxiety
  • Hormonal imbalances and pregnancy 
  • Pain relief medication like aspirin and ibuprofen 
  • Advancing age 
  • Genetic factors3
  • Conditions like hiatus hernia and malfunctioning lower oesophagal sphincter 

When food passes through the oesophagus, it reaches the stomach through a one-way opening regulated by a set of muscles called the lower oesophagal sphincter, which rests on the bottom end of the oesophagus. Under normal conditions, it merely opens to enable food into the stomach. When an individual has multiple risk factors for the development of gastroesophageal reflux disease, the lower oesophagal sphincter weakens and malfunctions, enabling food and acid from the stomach to enter the food pipe. The symptoms of GERD are caused when food rushes back into the oesophagus mixed with acid and bile.4

Symptoms 

Some of the common symptoms of gastroesophageal reflux disease are:5

  • A burning sensation in the chest that intensifies after meals and while lying down, particularly at night
  • Pain in the chest that is not caused by a cardiac event
  • Regurgitation of acid, resulting in a sour and unpleasant taste
  • Perpetually feeling sick 
  • Nausea 
  • Difficulty and pain in swallowing
  • Bad breath 
  • Hiccups 
  • Worsening chronic cough
  • Respiratory signs 

It should also be noted that while the triggers for each individual may differ, the symptoms are generally the same. The related symptoms worsen with postural changes, notably while bending or lying down, and they also worsen after eating.

Complications

Even though gastroesophageal reflux disease is a common disorder, many people are unaware that if left untreated for an extended period, it can result in serious adverse effects, including fatality. The oesophagal complications include esophagitis, oesophagal constriction, and precancerous alterations like Barrett’s oesophagus.7 Untreated GERD also has extraesophageal complications, including respiratory problems like asthma, congestion, and laryngitis.8

Treatments For GERD

GERD treatment can permanently cure this nasty condition and help to restore your quality of life. Treatments range from over-the-counter medications to surgery.

Lifestyle And Dietary Changes

Since most of the risk factors and triggers for gastroesophageal reflux disease are associated with lifestyle and dietary practices, a few modifications can go a long way toward treating GERD symptoms.

Weight/BMI

A higher BMI and weight suggest that a person has a larger fat reserve, which is frequently concentrated in the abdominal region. As a result of the increased abdominal pressure and stomach squeezing caused by the excess fat reserves around your abdomen and belly, the acid content of the stomach tends to backflow. So, decreasing weight and maintaining a healthy BMI can significantly assist in easing GERD symptoms.9

Reduce Caffeine, Alcohol, and Acidic Foods

Carbonated, caffeinated, and alcoholic beverages such as tea, coffee, soft drinks, and alcohol, as well as acidic foods such as citrus, lemon juice, tomato sauces, and vinegar, are known triggers that irritate the gastric lining, causing symptoms of gastroesophageal reflux to worsen and the frequency of episodes to increase. Such foods and beverages should be avoided.

Avoid Large Fatty Foods

Large meals and fatty foods are more challenging to digest, so they tend to linger in the stomach for longer, causing the stomach sphincters to relax and increasing the production of stomach acid, which tends to backflow into the oesophagus. To avoid this, limit greasy, fried, and large meals and replace them with smaller and more frequent meals throughout the day.

Stop Smoking

Along with irritating the gastric lining, numerous cigarette substances weaken the lower oesophagal sphincter, contributing to acid reflux. To prevent the emergence of GERD symptoms, smoking should be avoided.

Don’t Lie Down After Eating

Positional alterations affect the symptoms of gastroesophageal reflux, especially if you lie down immediately after eating; the relaxed muscles on the stomach opening will facilitate backflow due to the lack of gravitational pull and resting position. To avoid acid reflux caused by lying down, elevate your head and lie on your left side rather than your back.

Avoid Stress

Stress is a known trigger for GERD and aggravates symptoms.10 It is important to practice distracting and calming exercises to keep tension and anxiety at bay.

Medications 

In many patients, over-the-counter and prescription drugs have considerably eased symptoms and cured gastroesophageal reflux. 

It is important to consult a doctor before beginning pharmaceutical therapy or seek guidance from a pharmacist. It is also important to know that while medication can help with mild to moderate acid reflux symptoms, prescription medications are required for more severe cases.

Antacids

Antacids are over-the-counter drugs that cure acid reflux symptoms by neutralising stomach acid and alleviating indigestion and heartburn symptoms. They often have a rapid onset and are available in various forms, including

  • Chewing gum
  • Tablets
  • Capsules
  • Liquid formulations

However, because they interact with other medications and are contraindicated during pregnancy, they should only be used with the approval of a primary care physician.

Histamine Blockers

Histamine blockers, also known as H2 blockers, work by blocking histamine receptors and lowering stomach acid production. When the stomach generates less acid, there is less likelihood of acid overflowing from the sphincter, preventing the onset of GERD symptoms.

Histamine or H2 blockers, unlike antacids, do not provide immediate relief but do provide long-term suppression of GERD symptoms. Depending on the severity of the gastroesophageal reflux, they are supplied both as over-the-counter and prescription medications. They should not be used for extended periods of time.

Proton Pump Inhibitors

Proton pump inhibitors, or PPIs, are also available over the counter in lower doses and by prescription for higher doses. They work in a similar manner to H2 inhibitors and reduce the secretion of stomach acids by blocking an enzyme necessary for acid secretion. Due to the side effects of PPIs, they are only recommended for a limited time under the supervision of a physician.

Prokinetic Agents

Prokinetic drugs work by reducing the occurrence of acid reflux. They achieve this by boosting stomach and gastroesophageal motility and strengthening the functional efficacy of the lower oesophagal sphincter, which reduces stomach acid regurgitation and increases gastric emptying, making them a great choice for GERD treatment and maintenance.

Endoscopic Therapy

Have your acid reflux episodes and associated symptoms persisted despite diligent adherence to lifestyle modification techniques and pharmacological therapy? Transoral incisionless fundoplication is a safe and less invasive endoscopic treatment that can treat GERD if you have moderate to severe GERD without a hiatal hernia.

Transoral Incisionless Fundoplication

The purpose of the transoral incisionless fundoplication is to restore the lower oesophagal sphincter so that it functions properly and prevents acid from entering the oesophagus. It is a minimally invasive procedure because there are no incisions, and the treatment is performed through an endoscope, which a gastroenterologist normally undertakes. It entails folding the tissues to create an antireflux barrier by folding the tissues on top of the stomach, known as the fundus, and securing them with a plastic fastener. The procedure is performed under general anaesthesia, is painless, and has a short recovery time.

Surgery

In severe cases of gastroesophageal reflux that are not relieved by medicinal therapy and lifestyle modifications and are also not suitable candidates for minimally invasive endoscopic treatment, the last resort for a permanent cure is surgery.

Fundoplication

Fundoplication, often known as keyhole surgery, is a type of laparoscopic surgery that involves making microscopic incisions in the skin. Except for the incision and suture placement, the surgery is substantially the same as transoral incisionless fundoplication and entails constriction of the lower oesophagal sphincter to prevent backflow and concomitant reflux. The tissues are wrapped around the lower oesophagal valve and sutured in place, resulting in orifice tightening and functional restoration.

It is carried out by a gastroenterology physician and surgeon. Given the size of the procedure, recovery time is prolonged and optimal care is required, particularly with nutrition and physical exertion in the first few weeks after surgery.

Summary

Gastroesophageal reflux disease (GERD) can be permanently treated with various therapeutic techniques such as lifestyle and dietary changes, drugs, minimally invasive therapy, and surgical procedures. The type of treatment recommended is determined by the severity of GERD as well as a variety of other factors, such as responsiveness to previous therapy.

References

  1. Clarrett DM, Hachem C. Gastroesophageal Reflux Disease (GERD). Missouri medicine [Internet]. 2018;115(3):214–8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140167/ 
  2. Revicki DA, Wood M, Maton PN, Sorensen S. The impact of gastroesophageal reflux disease on health-related quality of life. The American Journal of Medicine [Internet]. 1998 Mar 1 [cited 2020 Aug 21];104(3):252–8. Available from: https://pubmed.ncbi.nlm.nih.gov/9552088/
  3. Argyrou A, Legaki E, Koutserimpas C, Gazouli M, Papaconstantinou I, Gkiokas G, et al. Risk factors for gastroesophageal reflux disease and analysis of genetic contributors. World Journal of Clinical Cases [Internet]. 2018 Aug 16 [cited 2019 Mar 4];6(8):176–82. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6107529/#B29
  4. NHS Inform. Gastroesophageal reflux disease symptoms and conditions [Internet]. Nhsinform.scot. 2019. Available from: https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/gastro-oesophageal-reflux-disease-gord
  5. Galmiche J-P, Des Varannes SB. Symptoms and Disease Severity in Gastro-Oesophageal Reflux Disease. Scandinavian Journal of Gastroenterology. 1994 Jan;29(sup201):62–8.
  6. Kabadi A, Saadi M, Schey R, Parkman HP. Taste and Smell Disturbances in Patients with Gastroparesis and Gastroesophageal Reflux Disease. Journal of Neurogastroenterology and Motility. 2017 Jul 30;23(3):370–7.
  7.  Grossi L, Ciccaglione AF, Marzio L. Esophagitis and its causes: Who is “guilty” when acid is found “not guilty”?. World Journal of Gastroenterology. 2017;23(17):3011.
  8.  Molyneux ID, Morice AH. Airway reflux, cough and respiratory disease. Therapeutic Advances in Chronic Disease. 2011 May 10;2(4):237–48.
  9. Festi D, Scaioli E, Baldi F, Vestito A, Pasqui F, Biase ARD, et al. Body weight, lifestyle, dietary habits and gastroesophageal reflux disease. World Journal of Gastroenterology. 2009;15(14):1690.
  10. Bhatia V, Tandon RK. Stress and the gastrointestinal tract. Journal of Gastroenterology and Hepatology [Internet]. 2005 Mar;20(3):332–9. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/j.1440-1746.2004.03508.x

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Sidra Irfan

Bachelors of Dental Surgery, Dentistry, Lahore Medical & Dental College, Pakistan

Sidra is a general dentist who enjoys writing in general but particularly enjoys compiling health tech innovation and patient awareness material. She is an equal healthcare access advocate who is currently engaged in research and public health. She also works as a medical, health, and wellness SEO content writer.

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