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Gastroesophageal reflux disease (GERD): Symptoms, Causes, Treatment

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2020-01-28
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Gastroesophageal reflux disease (GERD): Symptoms, Causes, Treatment

by Dhani Anggara, MD

GERD

 

Gastroesophageal reflux disease (GERD) is a long-term condition where acid from the stomach comes up into the esophagus.

GERD symptoms

Acid reflux can cause an uncomfortable burning feeling in your chest, which can radiate up toward your neck. This feeling is often known as heartburn.

If you have acid reflux, you might develop a sour or bitter taste at the back of your mouth. It might also cause you to regurgitate food or liquid from your stomach into your mouth.

In some cases, GERD can cause difficulty swallowing. It can sometimes lead to breathing problems, like a chronic cough or asthma.

 

Prevention

  • Other lifestyle and behavior changes can help relieve GERD include:
  • Eat moderate amounts of food and avoid overeating.
  • Stop eating 2 to 3 hours before sleeping.
  • Quit or avoid smoking.
  • If a person is overweight, losing weight can help prevent symptoms.
  • Do not wear clothing that is tight around the abdomen.
  • Sleep at a slight angle with the head slightly elevated.

 

 

Treatment

Your doctor is likely to recommend that you first try lifestyle modifications and over-the-counter medications. If you don't experience relief within a few weeks, your doctor might recommend prescription medication or surgery.

Over-the-counter medications

The options include:

  1. Antacids that neutralize stomach acid. Antacids, such as Mylanta, Rolaids and Tums, may provide quick relief. But antacids alone won't heal an inflamed esophagus damaged by stomach acid. Overuse of some antacids can cause side effects, such as diarrhea or sometimes kidney problems.
  2. Medications to reduce acid production. These medications — known as H-2-receptor blockers — include cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR) and ranitidine. H-2-receptor blockers don't act as quickly as antacids, but they provide longer relief and may decrease acid production from the stomach for up to 12 hours. Stronger versions are available by prescription.
  3. Medications that block acid production and heal the esophagus. These medications — known as proton pump inhibitors — are stronger acid blockers than H-2-receptor blockers and allow time for damaged esophageal tissue to heal. Over-the-counter proton pump inhibitors include lansoprazole (Prevacid 24 HR) and omeprazole (Prilosec OTC, Zegerid OTC).

 

Prescription medications

Prescription-strength treatments for GERD include:

  1. Prescription-strength H-2-receptor blockers. These include prescription-strength famotidine (Pepcid), nizatidine and ranitidine. These medications are generally well-tolerated but long-term use may be associated with a slight increase in risk of vitamin B-12 deficiency and bone fractures.
  2. Prescription-strength proton pump inhibitors. These include esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec, Zegerid), pantoprazole (Protonix), rabeprazole (Aciphex) and dexlansoprazole (Dexilant). Although generally well-tolerated, these medications might cause diarrhea, headache, nausea and vitamin B-12 deficiency. Chronic use might increase the risk of hip fracture.
  3. Medication to strengthen the lower esophageal sphincter. Baclofen may ease GERD by decreasing the frequency of relaxations of the lower esophageal sphincter. Side effects might include fatigue or nausea.

 

Source:

  1. https://www.mayoclinic.org/diseases-conditions/gerd
  2. https://www.medicalnewstoday.com/articles
  3. https://www.healthline.com/health/gerd

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