Gastro-Esophageal Reflux Disease (GERD) is extremely common disorder and is primarily treated with changes in lifestyle as well as acid suppression. Changes in life style like diet modification, elevation of head end of bed and cessation of smoking are important. GERD is the condition where degree of exposure of esophageal mucosa to gastric contents is greater than normal. It typically occurs after eating.

We of course all know how the GERD presents itself in the form of heartburn and pain. However, that is oversimplification and there are lots of other ways GERD can present e.g. Hoarseness, chronic cough, asthma, laryngitis, recurrent pneumonia and ENT infections, nocturnal choking, sleep apnea, loss of dental enamel, bad breath and globus sensation. Acid reflux has been implicated in sudden infant death syndrome. Sometimes GERD can cause serious complications. Inflammation of the esophagus from stomach acid causes bleeding or ulcers. In addition, scars from tissue damage can narrow the esophagus and make swallowing difficult. Some people develop Barrett’s esophagus, where cells in the esophageal lining take on an abnormal shape and color, which over time can lead to cancer. Many pulmonologists routinely try acid suppression in cases of atypical asthma.

It is well documented that certain foods promote or worsen symptoms of acid reflux. Citrus, tomato and coffee directly irritate the mucosa. Other foods to avoid include garlic, onions, fatty foods, spicy foods, mint, caffeinated drinks, peppermint, alcohol and chocolate. Overeating as well as going to bed within 2-3 hours of supper should be avoided since gastric distention promotes reflux. Weight gain, and smoking have also been implicated in the pathogenesis of Gastro-Esophageal Reflux Disease and thus should be avoided. Reflux symptoms may be reduced simply by elevating the head end of the bed or by using a wedge under upper body. The esophageal acid exposure time is reduced by gravity.