3 Mount Elizabeth, #14-15, Mount Elizabeth Medical Centre, Singapore 228510

Gastroesophageal Reflux Disease (GERD)

GERD

What is gastroesophageal reflux disease?

Gastroesophageal reflux disease (GERD) is a common condition characterised by persistent episodes of acid reflux that risk irritating the lining of the oesophagus. Acid reflux refers to stomach acid repeatedly moving up into the oesophagus, affecting approximately 20% of the population of Singapore. Although acid reflux is common in Singapore, acid reflux that occurs at least twice a week, or lasts for several weeks leads to chronic acid reflux, which in turn causes GERD.

It is possible to develop GERD at any age. However, the prevalence of GERD is higher among those who are in their 20s. Additionally, the likelihood of reflux increases as you age, especially after the age of 40. In fact, babies who are born prematurely, or are born with a congenital disease that affects their oesophagus are more likely to develop GERD.

What causes gastroesophageal reflux disease?

Acid reflux Singapore.
If you have experienced sudden heartburns, especially after a meal, then chances are you have acid reflux.

The mouth, and the stomach are connected by the oesophagus. At the end of the oesophagus, where the stomach connects, there is a valve called the lower oesophagus sphincter (LES). The LES is a circular muscle that only opens when you swallow, burp, or have hiccups. It closes again to prevent the stomach acid from coming back up again. Acid reflux occurs when the LES weakens, or when it relaxes, such as after a heavy meal. While the LES usually relaxes temporarily, GERD happens when the LEX is weakened.

If you have any questions regarding acid reflux, or GERD, then do get in touch with us today to have them answered.

Who is at risk of getting gastroesophageal reflux disease in Singapore?

You are more likely to be diagnosed with GERD if you have the following risk factors:

  • Congenital defects: birth defects such as oesophageal atresia, and hernias can weaken your LES.
  • Connective tissue diseases: connective tissue diseases like scleroderma can weaken the oesophagus muscles.
  • Hiatal hernia: a hiatal hernia refers to stomach contents that are being pushed through a hole in the diaphragm, which eventually compresses both the oesophagus, and the diaphragm, and trapping acid. As a result, the LES gradually loses its muscular support.
  • Medications: you are more likely to develop GERD if you are under certain medications such as Antidepressants, Benzodiazepines, Calcium channel blockers, Nonsteroidal anti-inflammatory drugs (NSAIDs), Theophylline, and Hormone therapy (HT) medications.
  • Obesity: the added pressure, and volume in the abdomen can weaken the LES. Additionally, obesity has also been known to increase the likelihood of developing hiatal hernia.
  • Pregnancy: similar to how obesity affects the LES, the pressure, and volume in the abdomen, coupled with pregnancy hormones, can temporarily relax the LES.
  • Smoking: whether you are a smoker, or are exposed to second-hand smoke, tobacco is known to relax the LES. It also induces chronic coughing, which further weakens the LES, and contributes to developing hiatal hernia.

What are the symptoms of gastroesophageal reflux disease?

You may have GERD if you have experienced the following symptoms:

Meanwhile, it is normal for babies to regurgitate (spit ups). However, it warrants a trip to the doctor if they show any of the following symptoms:

  • Bad breath.
  • Difficulty sleeping.
  • Excessive fussiness.
  • Refusing to feed.
  • Persistent vomiting episodes.
  • Wheezing.

Have you been experiencing symptoms of GERD? Then do not wait any longer! By scheduling an appointment with Dr. Ronnie, you will be able to have your symptoms examined, and receive proper treatment.

How is GERD diagnosed in Singapore?

A gastroenterologist will opt to perform one of the following diagnostic procedures to confirm a GERD diagnosis, or to determine if there are any complications. These diagnostic procedures include the following:

  • Esophagram: an esophagram is a type of X-ray that involves you swallowing a chalky liquid (barium) to facilitate fluoroscopy, and taking pictures of the oesophagus as you swallow.
  • Esophageal manometry: an esophageal manometry uses pressure sensors that are planted in a nasogastric tube to measure the muscle activities in the oesophagus, and determine if the LES is functioning properly.
  • Esophageal pH test: an esophageal pH test measures the acid content in the oesophagus.
  • Upper endoscopy: an upper endoscopy involves inserting an endoscope through the mouth to have a closer look at the inside of the oesophagus.
GERD Singapore
GERD happens when the lower oesophagus sphincter (LES) becomes weak, or relaxes to frequent that it is easier for stomach acid to travel back up the oesophagus.

How is GERD treated in Singapore?

Our doctors will usually encourage patients to make some lifestyle changes to manage their acid reflux, such as:

  • Eating in smaller, but frequent quantities.
  • Losing some weight.
  • Reducing alcohol intake.
  • Quitting smoking.

While lifestyle changes can drastically reduce the number of acid reflux occurrences, our doctors may also prescribe some medications to reduce stomach acid. These medications can include:

  • Antacids: to neutralise your stomach acid, so that it is less damaging to the oesophagus.
  • Alginates: to help create a barrier between the stomach acid, and the oesophagus as the contents of the alginates float on top of the stomach acid.
  • Baclofen: to reduce muscle spasms, and reduce the frequency of LES relaxation, thereby reducing the occurrence of acid reflux.
  • Histamine receptor antagonists (H2 blockers): to reduce stomach acid by blocking histamine from producing it.
  • Proton pump inhibitors (PPIs): to promote healing as they block stomach acids, and reduce acid reflux.

If your condition does not improve with medication, then you might have to undergo surgery. Some of the common surgical procedures to treat GERD are:

  • Fundoplication: the procedure is performed laparoscopically by a surgeon, who tightens the muscular structure that supports the LES, and prevents acid reflux. This is made possible as the top of the stomach is wrapped around the LES.
  • LINX device: a LINX device is a ring of tiny magnetic beads that is used to keep the juncture between the oesophagus, and the stomach closed during reflux. Fortunately, the magnetic beads do not affect magnetic resonance imaging (MRI), or airport security.
Acid reflux Singapore
Proton pump inhibitors (PPIs) have been used to treat GERD as it helps to block stomach acids, and prevent acid reflux.

Frequently Asked Questions

Some of the possible complications of GERD include gastrointestinal (GI) bleeding, strictures, ulcerations, erosive oesophagitis, and Barret’s oesophagus.

Yes, it is possible to permanently cure GERD. However, it might take some time, and may require several trials, and errors to find a treatment plan that suits you.

To prevent GERD at home, you can consider:

  • Elevating your head when you go to bed.
  • Eat slowly, and in smaller portions, but more frequently.
  • Maintain a healthy weight.
  • Stop smoking.

Yes, some foods can cause acid reflux. These foods include:

  • Certain beverages, like alcohol, coffee, carbonated beverages, and tea.
  • Certain fruits, and vegetables, like pineapple, citrus fruits, tomatoes, garlic, and onions.
  • High fat foods such as french fries, onion rings, ice cream, cheese, butter, and whole milk.
  • Spicy food.

Location

Colorectal Care Specialists (CRCS)

3 Mount Elizabeth, #14-15, Mount Elizabeth Medical Centre, Singapore 228510

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