Gastroesophageal Reflux disease, or GERD, is a fairly common digestive disorder that occurs when stomach acid and sometimes bile, refluxes or flows back into the esophagus and mouth. Basically, there is a “one-way valve” between the esophagus and stomach that allows food to enter the stomach but prevents it from refluxing back into the Esophagus. This valve is called the lower esophageal sphincter (LES) which is a band of muscles that contract and relax to form a protective barrier. When the LES becomes weak or does not close properly, acid reflux can occur.
Some people may experience all the GERD symptoms while others notice only one or two. Similarly, the severity level may be different, depending on the person; but it is important that you do not ignore any signs even if you think they may not be significant. If you are suffering relentlessly from any of the symptoms listed below, contact Digestive Care Physicians in north Atlanta to get tested for GERD. Dr. Ranvir Singh, Dr. Stephen Rashbaum, Dr. Nitin Parikh, and Dr. Long B. Nguyen, will perform an imaging test to evaluate the condition of your esophagus for signs of acid reflux. If GERD is responsible for your symptoms, you will be presented with a range of available treatment options.
- Difficulty swallowing (dysphagia)
- Dry cough
- Hoarseness and sore throat
- Acid reflux
- Lump in the throat
- Chest pain
- Erosion of teeth and gums
- Difficulty breathing
Testing for GERD
The symptoms of GERD and Acid Reflux are similar but you can view GERD as the second phase of acid reflux. To properly diagnose and treat your GERD symptoms, board certified physicians Dr. Ranvir Singh, Dr. Stephen Rashbaum, Dr. Nitin Parikh, Dr. Long B. Nguyen, and providers Tammi D’Elena, PA-C; and Vanessa T. Dang, MSN, APRN; may require non-surgical testing. The most common procedures performed to diagnose GERD are
GERD Treatment Options
Over The Counter: Most often, GERD can be managed with lifestyle changes and over the counter medications. However, it is important to know that these treatments only offer temporary relief and do not provide any healing elements.
- Antacids: After diet changes, antacids are usually the first course of action because they provide quick relief of symptoms. These include products such as Maalox, Mylanta, Rolaids, and Tums.
- H2 Receptor Blockers: These do not act as quickly as antacids but they do provide longer relief. Popular H2 receptor blockers include Pepcid AC and Zantac.
- Proton Pump Inhibitors: These drugs are designed to prevent acid production and release in the stomach and intestines, thereby reducing the risk of acid reflux and esophageal damage. Common examples are Prevacid 24 and Prilosec OTC.
Prescription Medications: Sometimes, over-the-counter treatments are not strong enough to provide relief in more severe cases, so your doctor may recommend Acid Reflux prescription medications.
- Prescription Strength H2 Receptor Blockers: These include drugs such as Tagamet, Pepcid, Axid, and Zantac.
- Prescription Strength Proton Pump Inhibitors: Common examples are Nexium, Prevacid, Prilosec, Protonix, Aciphex, and Dexilant. When taking proton pump inhibitors at the prescription level, your doctor may recommend a calcium supplement because these medications can cause a loss of bone mass.
- Prokinetic Agents: These treatments are used to strengthen the lower Esophageal Sphincter and are also given to patients with slow gastric emptying since they speed up digestion so acid does not stay in the stomach for any longer than necessary. These drugs can cause significant side effects such as fatigue, depression, and anxiety and may also interfere with the effectiveness of other medications.
Surgical Procedures: In cases of severe GERD symptoms, a healthy GERD diet is not enough and surgery is sometimes necessary. Most doctors will not perform surgery until all other options have been exhausted and it has become obvious that lifestyle changes in terms of, among other things a GERD diet and medications are not effective.
- Nissan Fundoplication: This procedure reinforces or tightens the lower Esophageal Sphincter by wrapping the top of the stomach around the lower Esophagus.
- Stretta Procedure: In this procedure, Esophageal tissue is actually heated and damaged to form scar tissue which helps to strengthen the muscles.
GERD Dietary Guidelines
The following list is comprised of foods that are typically known to be ‘safe’ or to ‘trigger’ symptoms.
|Food Groups||Food to Avoid||Foods to Add to Your Diet|
|FRUITS||Oranges and orange juice, lemons and lemonade, grapefruit and grapefruit juice, tomato and tomato juice, cranberries and cranberry juice||Apples (fresh and dried), apple juice, bananas, pears, peaches, melons, strawberries, grapes|
|VEGETABLES||Raw onions, peppers, radishes, french fries, mashed potatoes||Baked potato, broccoli, cabbage, carrots, green beans, peas, asparagus, lettuce, sweet potatoes|
|MEAT||Fatty ground beef, marbled sirloin, chicken nuggets, buffalo wings, fried meat||Extra lean ground beef, steak (London Broil), skinless chicken breast, egg whites or substitute, fish (with no added fat), white turkey meat|
|DAIRY||Whole milk, chocolate milk, ice cream, high fat cream cheese or sour cream||Feta or goat cheese, fat-free cream cheese, fat-free sour cream, low-fat soy cheese|
|GRAINS||High-fat grain products (cheese bread or products made with whole milk)||Cereal (bran or oatmeal), corn bread, graham crackers, pretzels, rice (brown or white), rice cakes, millet, quinoa|
|BEVERAGES||Caffeinated beverages, whole milk, alcohol, carbonated beverages||Water, herbal teas, non-citrus drinks, skimmed milk|
|FATS/OILS/CONDIMENTS||Strong mustard, chili sauces, creamy salad dressing, black pepper, vinegar, curries, pickles, mint||Low-fat salad dressing, herbs ( basil, thyme, sage, oregano), hummus, mild sauces|
Board-Certified physicians Dr. Ranvir Singh, Dr. Stephen Rashbaum, Dr. Nitin J. Parikh, Dr. Long B. Nguyen, Dr. Ruth Montalvo, and providers Tammi D’Elena, PA-C and Vanessa T. Bridgeman, MSN, APRN, FNP-BC; care for patients in the North Atlanta, GA; area including Johns Creek, GA, Cumming, GA, Lawrenceville, GA, Alpharetta, GA, and Dawsonville, GA. The in-house endoscopy suite at Digestive Care Physicians is a certified facility which has achieved the highest level of accreditation by the Association for Ambulatory Health Care (AAAHC). If you suffer from gastrointestinal problems, abdominal pain, or need a colorectal cancer screening, contact us at (770) 227-2222 to schedule an appointment.