Is it GERD? How to recognise the warning signs


By Shanika Abdullatib

MELAKA: Gastroesophageal reflux disease, commonly referred to as GERD or acid reflux is a digestive disorder often confused with symptoms arising from other common diseases, such as gallstone and gastritis — making it commonly unrecognised or even misdiagnosed.

As such, Pantai Hospital Ayer Keroh Consultant General Surgeon, Dr C. Rajkumar Vinayak said it is important to know the symptoms of GERD because it is generally a treatable disease that can result in serious complications if not treated properly.

“When you are unable to control the acid reflux, it leads to the aerosol formation which damages the mucosa of multiple organs as we breathe. Therefore, patients often visit multiple doctors before seeing a surgeon and undergo proper endoscopy and specialised assessment,” he told Bernama.

Dr Rajkumar said that it is more confusing in this situation because most GERD patients respond to normal gastric medications initially.

“However, medication unlike in peptic ulcer disease cannot rectify the hiatus hernia defect which will ultimately require some form of surgical intervention to rectify it,” he said.

Dr Rajkumar said the 24-hour pH monitoring and oesophageal manometry are the gold standard investigations to objectively assess GERD — a new service at Pantai Hospital Ayer Keroh.

He said these specialised tests measure GERD and other oesophageal problems accurately and are important for planning surgical management.

“These are essential for the evaluation of GERD since it is often misdiagnosed as gastritis or peptic ulcer diseases,” he said.

Elaborating, he said the tests involve the placement of a catheter and a wireless capsule device.

“A catheter (about the size of a smartphone power cord) will be placed through the nasal passage and then swallowed into the oesophagus. As the patient keeps swallowing, it generates vital data on the oesophagus and the pressure in the sphincter mechanism. This process takes about 15 to 20 minutes and the wire is then removed.

“The second component of the tests involve the placement of a wireless capsule device (about the size of a small thin pen drive) in the oesophagus by endoscopy under sedation. Once awake, the patient can consume food and go home with a recording device the size of a small handphone which collects data from the wireless device in the oesophagus,” he said.

Today, advanced technology makes the assessment more patient-friendly, unlike the older technology which requires wires dangling from the patient’s nose for one or two days.

“The true value of these tests is in its ability to predict suitability, type of surgery to be performed and surgical outcome as not all patients require surgical intervention,” he said as he reiterates that 24 hours PH study and manometry are the best way to assess once the patient is symptomatic.

In brief, Dr Rajkumar said lifestyle modifications are always the best ways to control the problem.

“I would say having a good dietary habit is the key. Stop smoking, avoiding tight clothing and sleeping with head-of-bed elevation will also help,” he said. – Bernama