Understanding Gastroesophageal Reflux Disease (GERD) and its Causes: Patient Education

QUESTION

A 44-year-old morbidly obese female comes to the clinic complaining of  “burning in my chest and a funny taste in my mouth”. The symptoms have been present for years but patient states she had been treating the symptoms with antacid tablets which helped until the last 4 or 5 weeks. She never saw a healthcare provider for that. She says the symptoms get worse at night when she is lying down and has had to sleep with 2 pillows. She says she has started coughing at night which has been interfering with her sleep. She denies palpitations, shortness of breath, or nausea.

PMH-HTN, venous stasis ulcers, irritable bowel syndrome, osteoarthritis of knees, morbid obesity (BMI 48 kg/m²)

FH:non contributary

Medications: Lisinopril 10 mg po qd, Bentyl 10 mg po, ibuprofen 800 mg po q 6 hr prn

SH: 20 PPY of smoking, ETOH rarely, denies vaping

Diagnoses: Gastroesophageal reflux disease (GERD).

Question:

1.     If the client asks what causes GERD how would you explain this as a provider? 

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ANSWER

Understanding Gastroesophageal Reflux Disease (GERD) and its Causes: Patient Education

Introduction

Gastroesophageal Reflux Disease (GERD) is a common condition that affects the digestive system, leading to uncomfortable symptoms in individuals. As a healthcare provider, explaining the causes of GERD to patients is crucial for their understanding and empowerment in managing the condition effectively. This essay outlines a comprehensive explanation of the causes of GERD, offering insights into the factors contributing to its development.

Causes of GERD

GERD is primarily caused by the malfunction of a muscular valve called the lower esophageal sphincter (LES), which separates the esophagus from the stomach. The LES is responsible for preventing stomach contents, including stomach acid, from flowing back into the esophagus. When the LES weakens or relaxes inappropriately, stomach acid can leak into the esophagus, leading to the characteristic symptoms of GERD.

Several factors contribute to the weakening or relaxation of the LES, including

Obesity: Excess body weight, such as in your case of morbid obesity (BMI 48 kg/m2), can exert pressure on the stomach and LES, increasing the risk of reflux.
Hiatal Hernia: A hiatal hernia occurs when a portion of the stomach bulges through the diaphragm, allowing acid to flow back into the esophagus.
Certain Foods and Lifestyle Habits: Consuming large meals, acidic or spicy foods, caffeine, alcohol, and smoking can relax the LES and trigger reflux.
Positional Factors: Lying down or bending over after eating, as well as sleeping with multiple pillows, can increase the likelihood of acid reflux.

Impact of GERD

GERD can result in various symptoms, such as the burning sensation in the chest and the unpleasant taste you’ve described. Additionally, acid reflux can lead to complications, including inflammation of the esophagus (esophagitis), respiratory issues like coughing at night, and disruption of sleep due to discomfort. It’s essential to address GERD promptly to prevent these complications from affecting your overall well-being.

Conclusion

Gastroesophageal Reflux Disease (GERD) is primarily caused by the weakening or relaxation of the lower esophageal sphincter (LES), allowing stomach acid to flow back into the esophagus. Factors such as obesity, hiatal hernia, dietary choices, and certain lifestyle habits contribute to this malfunction. Understanding these causes empowers individuals to make informed decisions about their lifestyle and dietary choices, promoting better management of GERD and reducing the impact of its symptoms and potential complications. As a provider, my goal is to support you in managing GERD effectively through a holistic approach that addresses both the underlying causes and symptom relief.