Understanding GERD: What It Is and Why It Happens
Gastroesophageal reflux disease is a common digestion disorder in which stomach acid flows up into the esophagus. It's called reflux, and it can irritate the lining of the esophagus, causing burning sensations in the chest. Though many experience heartburn at some time, GERD is a chronic condition that affects the quality of life for millions.
An understanding of GERD therefore would require an appreciation of the physiology of the digestive system. The esophagus is merely a muscular tube connecting the mouth to the stomach; the junction between the esophagus and the stomach carries a circular muscle called the lower esophageal sphincter (LES), which basically acts as a gatekeeper for being in position to prevent stomach contents from flowing back into the esophagus.
However, in such people suffering from gastroesophageal reflux disease, the LES may relax abnormally or not completely tighten to allow stomach acid to come up. Some causes of GERD include the following:
- Weakened LES: Over time, the LES may become weakened, making it more susceptible to relaxation.
- Hiatal hernia: This is the condition whereby a part of the stomach bulges through the diaphragm, which separates the chest and abdominal cavities, into the chest. It might press against the lower esophagus sphincter and increase the likelihood of reflux.
- Delayed stomach emptying: If food resides in the stomach for the longest period, the concentration of acid can be high hence increasing the likelihood of reflux.
- Medications: Some antihistamines, calcium channel blockers, and aspirin are some of the medications relaxing the LES.
- Lifestyle: Obesity, smoking, and drinking alcohol or caffeine often make GERD symptoms worse.
The Science Behind GERD: What is Happening to Your Body
Stomach acid flows back up into the esophagus, causing irritation of the delicate mucosa lining. This irritation can cause a wide variety of symptoms - from heartburn, a burning sensation in the chest that worsens with lying down or bending over, to acid reflux and a sour or bitter taste in the mouth.
- Chest pain: It resembles several variants of a heart attack, but could be distinguished by their nature.
- Dysphagia: Irreversible inflammation and swelling by acid reflux in the esophagus.
- Chronic cough: GERD can cause chronic coughing
- Asthma: In some people, GERD causes asthma or worsen asthma.
Untreated GERD can have serious complications over time, like the following:
- Esophagitis: An inflammation of the esophagus.
- Esophageal stricture: The narrowing of the esophagus caused by scar tissue.
- Barrett's esophagus: A condition in which the lining of the esophagus changes. This can sometimes become a precursor to cancer.
- Asthma: GERD can trigger or exacerbate asthma symptoms in some individuals.
New Findings on GERD from Most Recent Study
There is an ongoing effort on the part of scientists to learn more about GERD and to find better treatments. The latest discoveries show:
- Role of Gut Microbiome: The relative number of favorable bacteria in the gut, its so-called microbiome, seems to affect the gastroesophageal reflux disease. Scientists assume that the type of bacteria participates in the development of acid production and inflammation.
- Neural Factors: It was recently discovered that the nervous system is involved in gastroesophageal reflux disease. Malfunctioning nerve signals can impact the LES and cause reflux.
- Genetic Predisposition: There may be genetic conditions to develop gastroesophageal reflux disease. Scientists are studying certain genes that have been identified as connected with this condition.
Future Treatments for GERD: Promising Directions
Current treatments are now able to manage symptoms of gastroesophageal reflux disease, but novel therapies are still being developed by scientists to provide a more permanent cure or to do away with the disease. Among these promising directions is the following:
- Targeted Drug Therapies: Many drugs are now being developed that target the pathophysiological cause of gastroesophageal reflux disease, and among these include drugs that fortify the LES or reduce the production of acid.
- Minimally Invasive Procedures: Advances in minimally invasive surgery have brought new hopes for patients who are suffering from severe gastroesophageal reflux disease. The aim is a restoration of normal function of the LES.
- Regenerative Medicine: Scientists have begun working with the hope of one day using stem cells to heal broken esophageal tissue so that GERD symptoms may be controlled.
GERD is a condition of
tremendous impact on quality of life, but recent treatments now are
available that can assist in the management of such symptoms. Moreover,
research continues to promise better and more long-lasting treatments in
the near future. In the lives of patients and healthcare providers,
knowledge of the science behind gastroesophageal reflux disease makes
for increasingly effective treatment and prevention plans.
If
patients with gastroesophageal reflux disease are informed about what is
happening to them, and are updated on current studies, they can regain
control over their lives with the help of healthcare professionals.
Sources
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK):https://www.niddk.nih.gov/
MAmerican Gastroenterological Association (AGA):https://gi.org/
Harvard Health Publishing:https://www.health.harvard.edu/
MedlinePlus:https://medlineplus.gov/
