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Table of Contents

Gastroesophageal Reflux Disease (GERD)

 

What are GERD and acid reflux?

This is a very common question. When the contents of the stomach move back into the esophagus, the action is called acid regurgitation or reflux. This condition is commonly called gastroesophageal reflux disease (GERD). If GERD is left untreated, it can cause serious health issues. 

 

Common symptoms associated with GERD

 

One of the most common symptoms of GERD is acid reflux. A feeling of uncomfortable burning in the chest which may also migrate to the throat and neck is called acid reflux. Acid reflux can cause a sour or bitter taste in the mouth. It can also cause regurgitation of stomach contents in your mouth.

Other symptoms of GERD are:

  • Nausea

  • Bad breath

  • Hoarse voice

  • Chest pain

  • Pain and difficulty in swallowing

  • Chronic cough

 

Diagnosis of GERD

 

A doctor conducts a physical exam and asks about the symptoms you are suffering from. Certain tests may also be suggested to you, including:

 

Diagnosis of Gastroesophageal Reflux Disease

Test

Procedure

Ambulatory 24-hour pH probe

In this test, a small tube is inserted through your nose to the esophagus. The pH receptor at the tip of this tube measures the acid exposure of the esophagus. An individual wears this tube for 24-hours. 

Esophageal pH monitoring

In this procedure, a monitor is inserted in your esophagus to check how acid is regulated in your body for a period of a few days.

Upper endoscopy

In an upper endoscopy, a flexible tube with a tiny camera is inserted into the esophagus to examine it, and also a tissue sample is collected, if needed for biopsy. 

Esophogram

In this procedure, you will have to drink barium solution. After that x-ray imaging is done to examine your upper digestive tract. 

Esophageal manometry

In this procedure, the strength of your esophageal muscles is measured by inserting a flexible tube into your esophagus, through the nose. 

 

Treatment options for GERD

Lifestyle Modification

Lifestyle modification is the key to relieving the symptoms of GERD.

Your doctor may encourage you to make certain lifestyle changes, including: 
 

  • Weight management

  • Avoid heavy meals, especially in the evening

  • Elevate head during sleep

  • Don’t lie down just after eating, wait for a few hours

  • If you smoke, quit it

Medication

Your doctor may suggest some over-the-counter medicines to overcome the symptoms. However, every medicine has some side effects. So, don’t take any medicine without consulting with your doctor. He/she will suggest medicines best suitable for you. 
 

Antacids: This is used occasionally for mild symptoms of acid reflux and GERD. If you take antacids regularly, you may need stronger medication. 
 

H2 receptor blockers: H2 blockers like Pepcid AC, lower the number of acids produced by the stomach. However, a type of H2 blocker, ranitidine was recently recalled by FDA due to the presence of carcinogen N-nitrosodimethylamine (NDMA).
 

Proton pump inhibitors (PPIs): PPIs also decrease the amount of acids produced by the stomach, but they work better than H2 receptors. They are also known to heal the lining of the esophagus damaged due to GERD.

 
Surgery 

In most cases of GERD, lifestyle modification and medication is enough to relieve the symptoms. But in some cases, surgery is needed. When you develop complications of GERD, your doctor may recommend surgery. There are multiple surgeries for the treatment of GERD, including fundoplication and bariatric surgery. 

 

Home remedies

Some individuals prefer home remedies for the treatment of heartburn and acid reflux. It is ok when the symptoms are occasional. But if you are diagnosed with GERD, self-diagnosis, and self-medication may cause serious health issues. Some remedies which may harm you in place of providing relief: 

Remedies

Effect

Milk

Milk is alkaline, so will provide relief initially, but once the milk is digested, the fat and protein present in it may worsen the symptoms of heartburn. Low-fat milk may be easily tolerated by a few people. 

Baking soda and water solution

Although baking soda is safe when consumed in small amounts, it is alkaline and can neutralize acidity. Baking soda is high in sodium, so too much consumption can cause side effects. 

Ginger

Ginger is very commonly used to treat nausea. However, it is unclear how ginger helps with occasional heartburn. Several studies suggest that too much consumption of ginger may cause heartburn. 

Chewing gum

Saliva is slightly alkaline. Stimulating the secretion of saliva by chewing gum after consumption of a meal may help relieve the symptoms of GERD. However, more study is needed to draw any conclusion. 


Difference between heartburn and GERD

 

There is a difference between heartburn and GERD. Most people experience heartburn occasionally. Occasional heartburn is not a matter of concern. But if you experience heartburn more than twice a week, and also associated chest pain and chronic cough, you should consult your doctor. It might be GERD. 

Causes of GERD

 

There is no single cause of GERD. When a certain mechanism in your body doesn’t function properly, the chances of getting GERD increases. The lower esophageal sphincter (LES) is a circular band of muscles at the end of the esophagus. When you swallow, it opens. The rest of the time it is closed tightly. When this sphincter is not closed tightly or properly, acid reflux happens. This allows the passage of digestive juices and other contents of the stomach to the esophagus. 
 

Common causes which drive you towards GERD 

 

Hiatal hernia

In this case, a part of the stomach moves above the diaphragm. When the diaphragm is compromised, the chance of improper working of LES increases. 

Lying down soon after taking a meal

This can also create less pressure than the LES needs to function properly.

Frequent consumption of large meals

Consumption of large meals frequently results in distension of the upper part of the stomach. This distension causes improper functioning of LES.


Risk factors of GERD

 

There is no single reason for GERD. Several factors give rise to the improper functioning of LES, resulting in GERD. Certain lifestyle choices and health conditions may increase the chances of GERD, including: 
 

  • Obesity

  • Pregnancy

  • Smoking

  • Connective tissue disorder

  • Consumption of too much of certain medicines, including non-steroidal anti-inflammatory drugs, like aspirin, and ibuprofen.

  • Consumption of certain beverages, including soda, coffee, or alcohol

  • Consumption of too many fried foods

  • Consumption of large and frequent meals

  • Sleeping just after eating

  • Consumption of alcohol

  • While the connection between alcohol consumption and GERD is not clear, limiting or stopping alcohol completely has been linked with relief in GERD symptoms. 

 

Food that may trigger GERD

 

There are certain food items and beverages, which may aggravate the conditions of GERD. However, the food which triggers GERD is very personal and differs from person to person, there is a list of certain food items which are more triggering than others, including:
 

  • Fried foods

  • Citrus fruits and their juices

  • Soda 

  • Coffee

  • Mint

  • Tomato and its sauces

  • Onion

 

GERD associated with other conditions

 

Certain conditions aggravate the symptoms of GERD, including anxiety, pregnancy, asthma, and IBS. 

Disease conditions

Impact

IBS

IBS is a disease affecting your large intestine. It causes bloating, diarrhea, constipation, and stomach pain. According to a study, GERD is more common in people having IBS, when compared with the general population. If you have symptoms of both IBS and GERD, consult your doctor. He/she will prescribe some medications in addition to guidance for lifestyle modifications.

Pregnancy

Pregnancy increases the chances of acid reflux. If you have GERD before getting pregnant, pregnancy may worsen the condition. This is caused due to hormonal changes and increased pressure placed on the stomach due to a growing fetus. Both increase the chance of stomach contents entering the esophagus. The major concern is that every medicine is not safe during pregnancy. Must consult your doctor before taking any medicine.

Anxiety

According to a study, anxiety and heartburn are interconnected. When one increases, the symptoms of the other also get worse. Consult your doctor for lifestyle modification and medication. 

Asthma

A study has reported that asthma and GERD often occur together. However, more study is needed to understand the relationship between GERD and asthma. GERD may worsen the conditions of asthma and the medication used for asthma may increase the risk for GERD. If you have asthma and GERD, try to manage both conditions with the help of a doctor.

 

Infants with GERD

 

It’s very common for babies to spit up food, but if your baby vomits very frequently, he/she might be suffering from GERD. 
 

Symptoms of GERD in infants
 

  • Recurring cough

  • Arching of back during or after feeding

  • Hiccups

  • Trouble in swallowing

  • Gagging or hiccups

  • Irritability during or after feeding

  • Refusal to eat

  • Weight loss

  • Difficulty in sleeping

 

Serious complications associated with GERD

 

Commonly, GERD doesn’t cause any serious health issues but can be fatal in some cases.

Serious complications of GERD:

Health issues

Symptoms

Barrett’s esophagus

It causes a permanent change in the walls of the esophagus.

Esophageal cancer

A small portion of individuals, suffering from Barrett’s esophagus develop esophageal cancer.

Esophagitis

It is an inflammation of your esophagus

Esophageal stricture

In this case, your esophagus narrows and tightens.

Other issues

It causes enamel erosion, gum disease, and other dental problems.

 

However, these complications are aroused due to untreated GERD. So, to avoid these complications, manage and treat the symptoms of your GERD with the help of your doctor. 

 

Nutritional guidelines for GERD

 

There are several treatments for GERD, but lifestyle modification, including 

While there are many medical treatments for GERD, changing your diet is one of the easiest and most affordable ways to manage symptoms. It can also help prevent acid reflux from happening in the first place. Although the symptoms of GERD are triggered by different food items in a different person, if you have GERD you must avoid these foods:

  1. Fried foods

  2. Spicy foods

  3. Soda

  4. Carbonated beverages

  5. Mint 

  6. Garlic

  7. Onions

Let’s discuss the food items that can be taken in moderation and that should be taken generously: 

 

Food category

To be taken into a limit

To be included

Beverages

Mint tea

Non-mint herbal teas
 

Citrus juices

Non-citrus juices
 

Tomato-based drinks

Non-fat milk
 

Regular coffee

Low-fat milk
 

Decaf coffee

  
 

Alcohol

  
 

Whole milk

  
 

Chocolate milk

  

Carbohydrates

Pasta in a creamy sauce

Plain pasta
 

Potato chips

Boiled potatoes
 

French fries

Waffles
 

Tortilla chips

Rice
 

Doughnuts

Pancakes
 

Croissants

Tortilla
   

Crackers
   

Low-fat muffins
 

Your queries (FAQ)

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Nothing, you need not to pay only consultation charge which you have to pay before the consultation. Please book an appointment from here.

 

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You can book an initial appointment from here.

 

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Before joining we need some blood and urine reports. So, if you are planning to join please do these tests and then consult with Dr. Pankaj Kumar. A detailed discussion will uncover many folds of your health problems which you should know for better management.

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Yes, you can definitely join without any tests report but customization is only possible with a proper clinical history, dietary history, and some basic blood and urine reports. Please book an appointment from here.

 

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You need to choose your plan as per your requirements or disease.

  1. Purchase the plan
  2. After a successful purchase, you will get forms in the dashboard
  3. You need to fill out the forms (profile form, photo and report upload, and enrolment form.
  4. If you are opting premium plan then please fill out the food choices form and submit
  5. After submission, we will schedule a call with Dr. Pankaj Kumar for a brief discussion and dietary history. 
  6. We usually deliver your diet plans after 3-4 days after all the formalities are over. This is the time when Dr. Pankaj Kumar customizes your diet plans.
  7. Diet plans are given in the dashboard. These diet plans are not advisable for others. 
  8. Usually, we assign a 7-10 days diet initially, and then according to response, we assign further plans.

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We have a team of doctors for online consultation. You can request online consultation here. You need to pay the doctor’s consultation fee in their account directly. 

 

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No, weight loss with any means (except a good balanced diet and exercise) creates problems in long run. These plans usually target muscle loss which is not recommended in our program. We preserve muscles and help to lose fat. For better understanding, you can do regular body composition analysis from any gym or you can buy this scale to analyze yourself.

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His lifestyle modification program is definitely superior and there are multiple reasons for joining his program; we are mentioning a few of them.

  1. His approach is very different. People like to discuss their problems in detail. Dr. Pankaj Kumar listens to everything then he connects their current problem with their lifestyle scientifically.
  2. He is a medical doctor who is having nutrition expertise which enables him to understand disease in a better way. You may rarely find a post-graduate doctor with expertise in nutrition. Watch the video “Why did Dr. Pankaj Kumar come into nutrition practice?” Dr. Pankaj Kumar is actively working for the betterment of his patients in a unique way for many years.
  3. His approach is individual-based. Every patient is different so their requirement is also different. 
  4. Full customization is another thing that enables patients to sustain a good lifestyle for a longer duration.
  5. The one-to-one approach gives a better motivation.
  6. Constant support and motivation via call or WhatsApp or recorded video and many more…

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If you are desperate to get results in just a few days then you are not in the right place. We advise people to watch this video to understand “why weight loss or any lifestyle modification results take time?”

Always remember, if you are getting results in just a few days then the probability of muscle loss is more. An ill person does not give any result. “Swasth sharir me swasth man ka niwas hota hai.” Most overweight or obese patients do have insulin resistance. Without healing insulin resistance you may not see any result. If your insulin is settling down, if insulin sensitivity is becoming better, you will certainly see positive results.  Weight loss is very difficult in certain diseases as these patients do not respond to diet and exercise programs. In these cases, pharmacotherapy may be required or in extreme cases, bariatric surgery is the only option. Weight loss is a very complicated process and it requires a lot of motivation as well as the right guidance.

These are the diseases/conditions where weight loss is very challenging. 

  1. Lack of motivation
  2. Psychiatric illnesses like stress, depression, anxiety, binge eating behavior
  3. Hormonal imbalances like post-menopausal condition
  4. polycystic ovarian disease (PCOD/PCOS)
  5. An endocrinal disorder like hypothyroid condition
  6. Chronic inflammation, however, is a dangerous health condition that can be caused by environmental or dietary factors such as prescription medications, smoking, air pollution, and certain foods, including sugar, wheat, and dairy. Chronic inflammation can lead to cellular damage, which in turn impairs normal functioning throughout the body. Alcohol (including beer and wine) is a refined carbohydrate, similar to sugar, candy, and white flour. Besides adding calories, alcohol may raise blood sugar and insulin levels, which can contribute to weight gain.
  7. Cushing’s syndrome Elevated levels of cortisol in the body for an extended period of time can also lead to Cushing’s Syndrome
  8. Syndrome X: Syndrome X or hyperinsulinemia, refers to a group of health conditions that seem to be related to insulin resistance.
  9. Certain medications:
  • Medications used to treat type 2 diabetes (such as sulfonylureas)
  • Antipsychotic or schizophrenia medications, including chlorpromazine, thioridazine, and olanzapine
  • Beta-blockers – medication prescribed for high blood pressure, and some heart diseases.
  • Antidepressants such as amitriptyline, imipramine, or trazodone
  • Hormone replacement therapy
  • Birth control pills
  • Corticosteroids are taken for conditions like asthma and lupus
  • Antiepileptics are taken to control seizures, especially valproic acid and carbamazepine

We do not give any guarantee as the results vary from patient to patient. We help to heal your body from the inside and you will definitely feel better. Results are not only observing weight change on the weighing scale rather you should focus on body composition change. It is usually observed by decreasing fat percentage and increasing muscle percentage. We always stressed to read our terms and condition carefully before joining. We do not initiate any refund if you do not get the results as we already informed you results vary from person to person. Read our refund policy here.

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For one monthly plan, we do not offer any refund. Customization is a time taking process and after delivering a diet refund is not possible rather we can further customize it as per your choice and body’s requirements. So before joining, make sure you will continue for the chosen duration. Read our refund policy here.

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