Gastroesophageal reflux disease, also known as GERD, occurs when the lower esophageal sphincter becomes weak. This muscle is located between the esophagus and the stomach and normally helps prevent stomach contents from moving upward.
When the lower esophageal sphincter does not close properly, stomach acid can flow back into the esophagus and may reach the throat. This can cause irritation, discomfort, and repeated reflux symptoms.
Symptoms of GERD
Common symptoms of gastroesophageal reflux disease may include:
- A burning sensation in the chest, commonly known as heartburn
- Difficulty swallowing
- Dry cough
- Sore throat
- Hoarseness of voice
- A sour or acidic taste in the mouth
- Vomiting
- A feeling of a lump in the throat
Diagnosis of GERD
GERD can be confirmed through medical evaluation and diagnostic tests that assess the esophagus, acid reflux, and esophageal muscle function.
Upper Gastrointestinal Endoscopy
Upper gastrointestinal endoscopy allows the doctor to examine the esophagus, stomach, and the area around the lower esophageal sphincter.
It helps detect inflammation, irritation, ulcers, narrowing, or other changes caused by acid reflux.
Esophageal pH and Motility Testing
Esophageal pH testing measures the amount of acid reflux reaching the esophagus.
Esophageal motility testing evaluates the movement and function of the esophagus and the lower esophageal sphincter.
These tests help confirm the diagnosis and determine the most suitable treatment plan.
Treatment Options
Treatment of GERD depends on the severity of symptoms, test results, and the patient’s overall condition.
Treatment options may include:
- Medical treatment
- Endoscopic treatment through the mouth
- Surgical treatment
Medical Treatment
Medical treatment may include medications that reduce stomach acid, relieve symptoms, and help heal irritation in the esophagus.
Lifestyle and dietary changes may also be recommended to reduce reflux episodes and improve treatment results.
Endoscopic Treatment for GERD
GERD can be treated using non-surgical endoscopic techniques performed through the mouth. These techniques aim to narrow or strengthen the lower esophageal sphincter area, helping reduce the backflow of stomach acid into the esophagus.
Endoscopic treatment may be suitable for selected patients depending on their symptoms, endoscopy findings, and pH and motility test results.
ARMA, ARMS, and ARBAAM Techniques
Some endoscopic techniques treat the mucosal lining in the upper part of the stomach near the lower esophageal sphincter.
These techniques may include:
- ARMA, which uses ablation
- ARMS, which uses mucosal resection
- ARBAAM, which uses band ligation
The aim of these procedures is to create controlled narrowing at the cardia area, which helps reduce reflux and limit the upward movement of stomach acid.
GERD-X Technique
GERD-X is another non-surgical endoscopic technique used to treat gastroesophageal reflux disease.
During this procedure, non-surgical stitches are placed endoscopically to narrow the cardia opening and improve the function of the lower esophageal sphincter.
This helps reduce reflux and improve symptoms in suitable patients.
Surgical Treatment
Surgical treatment may be considered in certain cases, especially when symptoms are severe, medications are not effective, or the patient is not suitable for endoscopic treatment.
Choosing the Right Treatment
The most suitable treatment depends on the patient’s symptoms, endoscopy findings, esophageal pH and motility test results, and overall health condition.
A proper medical evaluation is necessary to determine whether medical treatment, endoscopic treatment, or surgery is the best option.
