Acid Reflux and GERD: Causes, Symptoms & Surgical Solutions

Acid reflux is a common digestive condition that can disrupt your daily life, especially when it becomes chronic. When acid reflux occurs frequently and severely, it may lead to a more serious condition called GERD (Gastroesophageal Reflux Disease). Understanding the causes, symptoms, and available treatments—including surgical options—can help patients manage the condition effectively and improve their quality of life.

What is Acid Reflux?

Acid reflux occurs when stomach acid flows back into the esophagus—the tube connecting your mouth and stomach. This backward flow (reflux) can cause a burning sensation in your chest known as heartburn.

Understanding GERD (Gastroesophageal Reflux Disease)

GERD is a more severe and chronic form of acid reflux. When acid reflux happens more than twice a week or causes inflammation in the esophagus, it is diagnosed as GERD. This condition may lead to complications if not treated properly.

Common Causes of Acid Reflux and GERD

Several factors contribute to acid reflux and GERD, including:

1. Weak Lower Esophageal Sphincter (LES)

The LES is a muscular ring that closes off the stomach from the esophagus. If it becomes weak or relaxes inappropriately, acid can flow back up.

2. Hiatal Hernia

This condition occurs when a portion of the stomach pushes through the diaphragm, disrupting the barrier that prevents reflux.

3. Obesity

Excess abdominal fat puts pressure on the stomach, forcing acid up into the esophagus.

4. Pregnancy

Hormonal changes and increased abdominal pressure during pregnancy can trigger reflux.

5. Certain Foods and Beverages

Spicy foods, caffeine, alcohol, citrus fruits, tomatoes, chocolate, and fatty foods are common triggers.

6. Smoking

Smoking weakens the LES and increases acid production.

7. Lying Down After Meals

This can make it easier for acid to flow back up the esophagus.

Symptoms of Acid Reflux and GERD

While symptoms may vary, the most common include:

• Burning sensation in the chest (heartburn)

• Regurgitation of food or sour liquid

• Difficulty swallowing (dysphagia)

• Chronic cough or sore throat

• Hoarseness or voice changes

• Feeling of a lump in the throat

• Bad breath

• Chest pain (can mimic heart issues)

When to See a Doctor

If you experience acid reflux symptoms more than twice a week or notice they’re interfering with your daily activities, consult a gastroenterologist. Ignoring GERD can lead to serious complications such as:

• Esophagitis (inflammation of the esophagus)

• Esophageal ulcers

• Strictures (narrowing of the esophagus)

• Barrett’s Esophagus (a precancerous condition)

• Esophageal cancer (in rare, untreated cases)

Diagnosis of Acid Reflux and GERD

Doctors may use various diagnostic tools, such as:

• Upper Endoscopy: To examine the esophagus and stomach lining.

• pH Monitoring: Measures acid levels in the esophagus.

• Esophageal Manometry: Tests the function of the esophageal muscles.

• Barium Swallow X-ray: Highlights abnormalities in the esophagus.

Non-Surgical Treatment Options

Initial treatment often includes lifestyle changes and medications:

Lifestyle Modifications

• Eat smaller meals

• Avoid trigger foods

• Lose weight if overweight

• Quit smoking

• Avoid lying down for 2–3 hours after meals

• Elevate the head of the bed

Medications

• Antacids: Neutralize stomach acid (e.g., Tums, Rolaids)

• H2 Blockers: Reduce acid production (e.g., Ranitidine, Famotidine)

• Proton Pump Inhibitors (PPIs): Stronger acid reducers (e.g., Omeprazole, Esomeprazole)

• Prokinetics: Help the stomach empty faster

When is Surgery Needed?

Surgery is considered for GERD patients who:

• Do not respond to medications

• Wish to avoid lifelong drug use

• Have complications like Barrett’s esophagus

• Have a large hiatal hernia

Surgical Solutions for GERD

1. Nissen Fundoplication

The most common surgical procedure for GERD. The surgeon wraps the top of the stomach (fundus) around the lower esophagus to strengthen the LES.

Benefits:

• Long-lasting symptom relief

• Eliminates need for medication

• Can repair hiatal hernia simultaneously

2. LINX Device

A ring of magnetic beads is placed around the LES to keep it closed but allow food to pass.

Benefits:

• Minimally invasive

• Preserves the body’s natural anatomy

3. Hiatal Hernia Repair

If a hernia is contributing to GERD, surgical repair may be required along with reflux surgery.

Post-Surgical Recovery and Expectations

Most patients recover quickly with minimally invasive procedures and report significant relief from symptoms. You may need to follow a soft diet for a few weeks and avoid strenuous activity initially.

Conclusion

Acid reflux and GERD can severely affect your lifestyle if left untreated. While medications and lifestyle changes work for many, surgical options provide hope for those with chronic or complicated GERD. Always consult with a qualified gastroenterologist or surgeon to determine the best treatment path for your condition.