GERD or Gastroesophageal reflux disease, a medical condition where contents of the stomach, primarily acids, flow back to the esophagus. This action is called Reflux and it occurs if the muscles found at the juncture of the esophagus and the stomach fail to function effectively. Thus this condition is also called acid reflux.
This muscle is called, Lower Esophageal Sphincter (LES) whose function is to control the reflux of material from the stomach back to the esophagus. The stomach produces hydrochloric acid that is used to breakdown food particles during the digestion process. The stomach has a mucous lining that protects the stomach from getting damaged by the acids, which the esophagus doesn’t. When the acid successfully refluxes back into the esophagus, a burning pain is felt close to the heart, thus this symptom is called heart burn. In truth, this condition has nothing to do with the heart.
Suppressing acid reflux is the main focus in nearly all cures for heartburn. The treatment applied is aimed at reducing the acids and strengthening the muscles in the esophagus, intestines and stomach, with particular emphasis on the esophageal sphincter.
Many cases of acid reflux are results of the type of diet one maintains. Spicy food eaten on a continuous basis, for example can lead to this condition. Most cases of acid reflux can be treated through a lifestyle change involving diet or through over the counter drugs such as antacids.
For those people who suffer moderate to severe cases of acid reflux can be treated using a variety of stronger medication. There have been debates on the process for treating such cases using a two step methodology. The two sides to the debate are whether using a Step Up or Step Down method is more effective over the other.
A step up approach is to use a less potent drug such as H2 blockers. These drugs are aimed at reducing the secretion of gastric acids by cells in the stomach. Most H2 blockers are non prescriptive and can be purchased over the counter. If the drug is not effective, a step up to a more powerful drug such as proton pump inhibitors can be prescribed.
The step down methodology is to start treatment using the stronger proton pump inhibitor. If no symptoms recur over a period of two to three months, the medication is brought down to a less potent H2 blocker. If no symptoms recur then the drug is completely stopped.
Either way, when there is no relief from GERD despite above efforts, it is imperative that one consult with a gastroenterologist who may conduct further studies including an endoscopy. It is highly possible that the source of the reflux is not caused by gastric acids; rather it may be another type of condition caused by other material such as bile. It is also a way to make sure that the right type of medicine specific to your condition is used.
