My City Wellness Winter 2022

In normal digestion, the natural sphincter (ring of muscle) be- tween the esophagus and stomach (LES) opens to allow food into your stomach. en, it closes to stop food and acidic stomach juices from owing back into your esophagus. Gastroesophageal re- ux happens when the LES is weak or relaxes when it shouldn’t, allowing the stomach’s con- re ux can eventually cause damage and scarring of the esophageal tissue. Many factors con- tribute to causing GERD. e most com- mon causes include being overweight, consumption of large meals, and eating too close to bedtime. Con- suming certain foods such as tomato prod- ucts, fatty or fried food and co ee or alcohol can contribute. ere are some anatomical causes such as a hiatal hernia (when the stomach migrates up toward the chest) that can be strongly associated with GERD. The most common symp- tom of GERD is heartburn (acid indigestion). It usually feels like a burning chest pain that starts be- hind your breastbone and moves upward to your neck and throat. Many people say it feels like food is coming up into their mouth, leaving an acidic or bitter taste. The discomfort can last as long as two hours. It’s often worse after eating; lying down or bending over can also result in heartburn. Many people feel better if they tents to ow up into the esophagus. Chronic acid

stand upright or take an antacid that clears acid out of the esopha- gus. Some people with long-term GERD can develop more advanced symptoms such as lingering cough, asthma, and even pneumonia. Treatment for GERD is aimed at reducing the amount of re ux or lessening damage to the lining of the esophagus from re uxed mate- rials. Common treatment medi- cations include antacids (TUMS), H2 Blockers( Pepcid®, Tagamet®) and Proton Pump Inhibitors (Pri- losec OTC®, Protonix®, Prevacid®). ese drugs can help neutralize acid in the esophagus and stomach and stop heartburn symptoms. In addition to medications, there are several lifestyle changes that can be made to help lessen symptoms of GERD. ey include: avoiding foods that can relax the LES such as ca eine, alcoholic beverages and citrus fruits; eating small- er portions, and avoiding meals three hours prior to laying down. Avoiding smoking and focusing on keeping a normal weight are also important to prevention of GERD. For patients with severe GERD that persists, there are diagnostic

tests to determine the cause. Most commonly, an upper endoscopy will be performed during which a thin scope with a light and camera at its tip are used to look inside the upper digestive system – the esophagus, stomach, and the rst part of the small intestine, called the duode- num. Sometimes an upper gastro- intestinal (UGI) x-ray series or even more advanced studies such as pH testing or esophageal manometry may be required for diagnosis. For most people, GERD can be controlled with medications and lifestyle changes; but a select few, possibly those who also have a large hiatal hernia, will develop severe damage and symptoms and may be candidates for surgery. The most common is a laparo- scopic fundoplication, which is a minimally-invasive procedure to restore proper function of the lower esophageal sphincter. Gastroesophageal reflux dis- ease is very common, affecting almost 60 million people. e most common causes are behavioral and therefore, focused lifestyle choices can help the majority of su erers to resolve or control the symptoms. ®

The most common causes of GERD are behavioral and therefore, focused lifestyle choices can help the majority of sufferers to resolve or control the symptoms.

About the Author Michael Kia, DO, FACOS, FACS is a board certified general surgeon with fellowship training in minimally invasive and robotic surgery and complet- ed his fellowship in advanced laparoscopic and robotic surgery at the world-renowned University of Texas in Houston. He received his B.S. from the University of Michigan, his medical degree from Touro University in San Francisco, and performed his residency in general surgery through Michi- gan State University. Dr. Kia is an Associate Clinical Professor of Surgery at MSU and a Fellow of the American College of Osteopathic Surgeons.

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