What Does It Mean?
When a person says that he/ she feel like something is stuck in the throat or feeling like burping all the time, they typically point towards a clinical condition called Gastro Esophageal Reflux Disease or GERD. Gastro Esophageal Reflux or plain burping is a normal physiological process which usually after meals without harming the esophageal mucosa.
Gastro Esophageal Reflux Disease (GERD) causes frequent burping with regurgitation of gastric contents and prolonged exposure of esophagus to gastric contents which leads to signs and symptoms and tends to hamper a person’s daily routine.
GERD is a chronic, relapsing clinical condition which characterized by involuntary reflux of acid or gastric contents into the esophagus and throat.
Signs and Symptoms of GERD:
The signs and symptoms of GERD can be divided into esophageal and extra-esophageal. The below mentioned set of signs and symptoms will help you understand how it would feel like to have Gastro Esophageal Reflux Disease.
|Esophageal Symptoms||Extra-esophageal Symptoms|
Extra-esophageal symptoms of a cough and sore throat are often called “Acid Laryngitis”.
Complications of Gastro-esophageal Reflux Disease are:
- Reflux Esophagitis – Inflammation or redness and even ulceration bleeding and stricture formation may occur.
- Barrett’s Esophagus – This is a pre-malignant condition. Where the inner lining of the esophagus is replaced by a different one. This condition is called “Columnar Lined Esophagus”.
- Anemia – From long standing cases of reflux esophagitis where ulceration and bleeding may have happened.
- Esophageal Stricture – This is a non-malignant condition. As a process of healing, scar formation replaces the normal mucosa of esophagus. Recurrent scarring causes narrowing of the esophagus.
- Gastric volvulus – This is a major complication of persons having acid-reflux symptoms because of a hiatus hernia.
GERD is one of the most common clinical conditions affecting people in the European countries and USA; whereas a recent study conducted to analyze the prevalence of GERD in India showed the following:
- GERD affects about 30% of the entire population.
- High prevalence of GERD in southern states of India – about 22%.
- Symptoms of GERD were found to be increasing with age.
- Obesity increased the risk of having the acid reflux disease.
- Low prevalence was found in individuals with higher level of education, yet, there was a higher prevalence in urban areas as compared to the rural community.
- Chewing pan masala has shown to have a positive association with acid reflux disease. Presence of tobacco is assumed to be the cause.
This acid reflux disease can potentially hamper the quality of life. It is also associated with a high rate of morbidity and mortality. It is also associated with increased risk of developing esophageal cancer.
Why Does It Happen?
Normally, the esophagus is 18-25 cm long. It is guarded at its beginning and end by upper and lower esophageal sphincters which relax when food passes and again recoil when the food enters stomach. This peristaltic motion helps to clear the food contents from the esophagus.
The esophagus undergoes rhythmic contraction and relaxation in order to carry food into the stomach. Saliva on the other hand is alkaline in nature and neutralizes gastric acid.
Causes of Feels Like Something Stuck in Throat and Burping
The following causes are responsible for making you burp and feel like something is stuck in your throat:
- Gastro Esophageal Reflux Disease happens when the lower esophageal sphincter is unable to close once food enters the stomach – seen in about 75% of patients with GERD.
- Weak or uncoordinated contraction and relaxation of esophagus causing poor esophageal clearance.
- Poor salivation or decreased production of saliva can increase irritation of esophagus.
- Hyperacidity – Excessive production of gastric acid or reflux of bile from the duodenum into the stomach. Hyperacidity increases the severity of heart burn.
- Impaired or delayed gastric emptying itself is a potent cause for acid-reflux disease – responsible for 20% cases of GERD.
- Certain drugs and medications especially calcium channel blockers.
- Increased abdominal pressure as in obesity and pregnancy.
- Hiatus hernia – Protrusion of the stomach into the chest through the diaphragm. Occurs in about 50% of the population above the age of 50 years.
How Do Medical Tests Help?
Blood investigations do not help much in the identification of GERD. Other specific tests which may pin-point towards a diagnosis of acid-reflux disease are:
- Endoscopy is the first choice of investigation to diagnose GERD.
- Endoscopic examination helps to rule out other upper gastro-intestinal conditions which may be causing acid-reflux, heart burn and regurgitation.
- Endoscopy also helps to identify any complications which may be present in long-standing and untreated or self-treated cases of GERD.
- 24-hour intra-luminal monitoring of pH of the esophagus is done if the diagnosis is still unclear and if endoscopy turns out to be normal.
- Intra-luminal pH is constantly recorded while the patient is carrying out his/ her day-to-day activities. A pH of less than 4 for more than 6-7% of study time indicates acid-reflux disease.
Management does not simply mean taking a course of medicines. Behavioural changes and lifestyle modifications are as important as medicines.
- Avoid lying down immediately after meals – at least 3-4 hours after meals.
- Eat several small meals in a day instead of taking three full heavy meals. Smaller portions of food can be digested more easily.
- Avoid wearing tight clothing around the waist to reduce strain-induced acid reflux.
- Avoid certain food which can irritate the esophagus – citric juices, aerated drinks, spicy and fatty food, chocolates, excess of tea or coffee and avoid taking meals later in the evening or at night
- As we have seen obesity and overweight is directly associated with GERD. Therefore, losing some weight shows significant relief from symptoms.
- Avoid smoking, alcohol and usage of drugs, if any.
- Avoid certain medications which irritate the lower esophageal sphincter and the esophagus – calcium channel blockers, nitrates, narcotics and sedatives, ferrous suphates and NSAIDs.
- Massage upper portion of your abdomen in a downward direction while lying down for at lest five minutes in the morning and at night. This improves blood circulation and strengthens the hiatus.
Top 10 Home Remedies for Managing Acid-Reflux Disease
- Yoga will help you strengthen your stomach and diaphragm muscles to prevent hiatus or stop hiatus from progressing. The poses need to be learnt and practised in presence of a qualified yoga trainer.
- Half a teaspoon of baking soda in a glass of water works as a natural antacid and provides instant relief from heartburn symptoms.
- Two spoons of apple cider vinegar in a glass of warm water about 30 minutes before meals reduce heartburn symptoms because of its alkaline nature.
- Cinnamon is a commonly used spice and a house-hold remedy to soothe the stomach. It can be had as a tea or simply chewed. Cinnamon is a natural antacid and aids in digesting food especially after meals.
- Chamomile tea along with some honey relaxes muscles of the stomach and reduces heartburn.
- Bananas reduce regurgitation and acid reflux.
- Mustard is a natural antacid and it neutralizes the acid reflux.
- Chewing gum after a meal is known to increase the secretion of saliva which helps in neutralizing the acid and faster digestion of food. Chewing gum containing bicarbonate is more effective.
- Lemon is a natural source of vitamin C which is essential for maintaining the integrity of tissues and enables healing. Lemon juice is more potent than apple cider vinegar to reduce heartburn and regurgitation.
- Two spoons of Aloe Vera gel to be made into juice with a glass of water before meals reduce regurgitation.
Apart from these home remedies, it is imperative to have plenty of water and exercise regularly. These two measures work as wonderful remedies to manage most of the illnesses, not a just acid-reflux disease. Most of the patients do not seek medical help for a long period of time and resort to home remedies or often self-treat using over-the-counter medications.
It is essential to seek professional medical help if you have been experiencing a feeling of something stuck inside your throat for a long period of time or if the symptoms remain the same or increase in intensity in spite of trying to manage your condition using home remedies and lifestyle modifications.
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