Treatment for GERD is More Challenging than Gastritis, is That True?

In general, while many people experience symptoms similar to indigestion, treating GERD turns out to be more complex and requires special attention. Let’s take a deeper look into this condition, its symptoms, and why its treatment is more complicated than that of regular indigestion.

GERD stands for gastroesophageal reflux disease, which is a condition where stomach acid repeatedly rises into the esophagus. Normally, stomach acid should stay in the stomach to help digest food. However, in GERD sufferers, this process is disrupted due to a problem with the lower esophageal sphincter (LES). The LES is a muscle that serves as a valve to keep food and stomach acid from moving back into the esophagus after it’s been ingested. If this muscle is weak or doesn’t function properly, stomach acid can flow back into the esophagus, leading to a burning sensation or heartburn in the chest.

Unlike regular indigestion, which mainly concerns problems within the stomach, GERD directly involves a malfunction in the body’s mechanisms that prevent stomach acid from rising into the esophagus. This causes irritation to the walls of the esophagus and can develop into a more serious issue if not treated properly.

People with GERD can experience a variety of symptoms that interfere with daily activities. The most common symptom is heartburn or a burning sensation in the chest, which occurs due to acid reflux. Additionally, GERD sufferers may also experience chest pain, which is often mistaken for heart attack symptoms. This makes it crucial to seek medical consultation to avoid misinterpretation of the symptoms.

Other common symptoms of GERD include:

• Heartburn: A burning sensation in the chest, often occurring after meals or when lying down.
• Regurgitation: This is when stomach acid or food rises into the throat or mouth, often accompanied by a bitter or sour taste.
• Difficulty swallowing (dysphagia): A feeling of obstruction in the throat or difficulty swallowing food or liquids.
• Dry cough and throat irritation: Stomach acid rising into the throat can cause irritation, leading to chronic coughing.
• Shortness of breath: This can occur if stomach acid enters the airways, causing irritation in the air passages.
• Nausea: Some GERD sufferers report persistent nausea.

Although both GERD and indigestion are related to stomach acid, treating GERD is more challenging because this condition is chronic and tends to recur if not properly managed. GERD can persist for years, and its symptoms often return even after treatment.

One reason why GERD treatment is more difficult than treating regular indigestion is that it not only involves stomach problems but also dysfunction in the lower esophageal sphincter, which can lead to long-term complications. Additionally, untreated GERD can cause damage to the esophagus, potentially leading to esophageal cancer in some cases.

Another challenge in treating GERD is the possibility of its symptoms mimicking other diseases, such as heart disease or respiratory disorders, requiring further examination for an accurate diagnosis.

After understanding the causes and symptoms of GERD, it’s important to know the treatment options available. GERD treatment usually involves two main approaches: lifestyle changes and medication.

1. Lifestyle Changes. The first step in treating GERD is making lifestyle changes, as daily habits play a significant role in worsening symptoms. Some lifestyle changes that can help relieve GERD symptoms include:

• Avoiding trigger foods: Spicy, fatty foods, chocolate, coffee, and acidic foods can worsen GERD symptoms. Try to avoid these foods, especially before bedtime.

• Eating smaller, more frequent meals: Large meals can increase pressure on the stomach and the esophageal sphincter, potentially causing acid reflux. It’s best to eat smaller portions 4–5 times a day.

• Avoid lying down after eating: It’s recommended to wait at least 2–3 hours after eating before lying down to allow the food to be properly digested.

• Losing weight: GERD sufferers who are overweight should try to lose weight, as obesity increases pressure on the stomach and affects the esophageal sphincter.

• Quit smoking and limit alcohol intake: Smoking and alcohol can weaken the esophageal sphincter and worsen GERD symptoms.

2. Medications. If lifestyle changes alone are not enough to manage GERD symptoms, doctors will usually prescribe medications to reduce stomach acid production or address other digestive issues. Common medications for GERD include:

• Antacids: These neutralize stomach acid and can provide relief for mild GERD.

• H2 receptor antagonists: These reduce stomach acid production by blocking histamine receptors that stimulate acid production.

• Proton Pump Inhibitors (PPIs): PPIs are stronger medications that block acid production and are used for more severe GERD. They also help heal esophageal damage caused by stomach acid exposure.

• Prokinetic agents: These improve digestive motility by stimulating muscle contractions in the intestines, helping food move more smoothly and preventing acid reflux into the esophagus.

When undergoing GERD treatment, it’s essential to be mindful of the types of food consumed, as certain foods can worsen acid reflux symptoms. Generally, foods high in fat can increase the risk of acid reflux. Here’s a list of foods to avoid:

• Fried and fatty foods: Foods like fried potatoes and onion rings contain high levels of fat, which can slow digestion and cause stomach acid to rise into the esophagus.
• Full-fat dairy products: Products like butter, whole milk, regular cheese, and sour cream contain saturated fats that can trigger reflux. Opt for low-fat dairy or plant-based alternatives.
• Fatty meats: Fatty cuts of meat, such as beef, pork, or lamb, should be avoided. The fat in these meats increases stomach acid production.
• Animal fats and processed meats: Fats from bacon, ham, and other processed meats contain high levels of fat and sodium that can worsen GERD.
• Fried desserts and snacks: Chocolate, ice cream, and chips that are fried and high in fat can worsen acid reflux symptoms like heartburn.
• Creamy sauces and gravies: Creamy sauces, gravy, and thick salad dressings often contain high levels of fat and additives that can trigger reflux. Opt for lighter sauces or make your own using natural ingredients.

In addition to fatty foods, other foods and beverages that can trigger GERD symptoms include:

• Alcohol and caffeine: Both of these can weaken the lower esophageal sphincter, which helps prevent stomach acid from rising. Limit or avoid alcohol and caffeinated drinks.
• Carbonated drinks: Soda and other carbonated beverages can increase pressure in the stomach, causing acid reflux into the esophagus. These drinks can also cause bloating.
• Tomatoes and citrus fruits: Tomatoes and citrus fruits like limes, lemons, and grapefruits contain high levels of acid, which can worsen GERD symptoms. Despite being high in vitamin C, the acid in these fruits can irritate the stomach.
• Mint leaves: Mint, whether in fresh leaf form or as peppermint oil, can cause relaxation of the esophageal sphincter, worsening acid reflux symptoms.
• Garlic and onions: Both garlic and onions can cause inflammation and worsen GERD symptoms for some people. They can also lead to increased gas production and bloating.
• Spicy foods: Spicy foods containing chili peppers and sharp spices can stimulate excessive stomach acid production, increasing the risk of acid reflux.

One key aspect in managing GERD successfully is listening to your body. What may have a negative effect on others might not affect you in the same way, and vice versa. You can create a food journal to help track and monitor which foods are "safe" and which should be avoided to reduce GERD flare-ups.

GERD requires more attention in its treatment compared to regular indigestion. Due to its chronic nature and tendency to recur, GERD treatment must be comprehensive, involving healthy lifestyle changes and appropriate medication. Medical consultation is essential to obtain an accurate diagnosis and select the right treatment plan.

If you experience any of the symptoms mentioned above, don't hesitate to consult with a gastroenterology specialist. At IHH Healthcare Malaysia, we offer comprehensive, professional medical care to help you manage and treat GERD according to your individual needs. Don’t let this health issue disrupt your quality of life—take action now for better care and satisfying results.