Diabetes and GERD often occur together. What is the link between these
two disorders?
Gastroesophageal reflux disease — or GERD, is a digestive disorder that results in stomach
acid frequently flowing back into the esophagus or the tube that connects your mouth and
stomach. This acid irritates the lining of your throat.
Diabetes and GERD: The Connection
GERD commonly occurs in people with diabetes. A study from 2015 looked at the rates of
GERD in people with diabetes. In that study, 42 percent of the participants, who were diagnosed
with type 2 diabetes, also had GERD. 1
There are many reasons for the higher rates of GERD in people with diabetes. One study from
2013 suggested that type 2 diabetes is a risk factor for diabetes. It is recommended that the
metabolic syndrome present in diabetes triggers GERD. 2
GERD Treatments and Diagnosis
The first step in getting treatment for GERD is to understand the symptoms. Here are some
signs of GERD: 3
Symptoms of GERD
Nausea or vomiting
A burning sensation in your chest that is worse after eating
Feeling like a lump is in your throat
Regurgitation of food
Trouble swallowing
Asthma symptoms
Disrupted sleep
Chronic cough
Many people experience the symptoms of acid reflux at times. However, if the above symptoms
occur more than once a week, it could indicate GERD.
Diagnosis of GERD
Physical examination – Your doctor will start with a physical exam and medical history.
Food diary – You may be asked to keep a food diary and a list of foods that trigger GERD. This can help your doctor figure out your triggers. It can also assist in diagnosis.
X-rays – A barium x-ray can help your doctor diagnose GERD. During this procedure, you will swallow a chalky liquid called barium. This coats the inside of your stomach, intestines, and throat. The liquid makes it easy for the doctor to see problems on an x-ray.
Endoscopy: A tiny camera is inserted into your digestive tract via a long, thin tube. This procedure is also done in an outpatient or ambulatory setting.
Acid probe test – This test measures how much acid is in your stomach throughout 24
hours. This test is done at an outpatient or ambulatory clinic. A thin tube is run down
your nose and through your esophagus. A small device will track how much acid comes
into your throat from your stomach.
Treatment for GERD
Non-prescription medications – Your doctor may treat your GERD with medicines that you can obtain over-the-counter. These may include antacids like Mylanta and Tums or H-2 receptor-blockers, such as Pepcid AC. These work slower than antacids, but they can control symptoms for up to 12 hours at a time. Your doctor may also recommend protein pump inhibitors (PPIs) like Nexium. PPIs offer stronger relief than other types of non-prescription medications. Plus, they can heal damage to the esophagus.
Prescription medications – If over-the-counter medicines do not work to control your GERD symptoms, then your doctor may use prokinetics, which help your stomach empty faster or stronger doses of protein pump inhibitors.
Lifestyle Changes
There are a variety of lifestyle changes that you can make to manage symptoms of GERD. These include:
Stay at a healthy weight – Keeping your Body Mass Index (BMI) at a normal range for your age and height can help keep reduce symptoms of GERD. It can also help you better manage your diabetes. Your BMI refers to your measure of body fat compared to your height. Check your BMI here .
Quit smoking – Smoking affects your esophagus. Quitting can reduce symptoms of GERD.
Eat smaller meals more often – Not only will eating small, frequent meals help with GERD, but it will also help with your diabetes. Eating small meals frequently helps keep blood glucose levels more stable.
Gastroparesis Vs. GERD
People with diabetes may have a condition known as gastroparesis. This disorder is caused by damage to the vagus nerve, which regulates the digestive system. Uncontrolled blood sugar levels cause it. When the vagus nerve is damaged, it keeps food from moving through the digestive system as it should. 4
The symptoms of gastroparesis are very similar to acid reflux. This disorder is often misdiagnosed as acid reflux, which may account for some of the correlation between acid reflux symptoms and diabetes. Symptoms Of Gastroparesis:
● Heartburn
● Vomiting and nausea
● Abdominal pain or bloating
● Unintentional weight loss
● Lack of appetite
Diagnosis & Treatment
Gastroparesis is often diagnosed using similar tests as those used to diagnose GERD. It is best
to see your doctor if you have any of the above symptoms of gastroparesis.Gastroparesis is treated a little differently than GERD. One of the critical treatments is using insulin to manage your blood glucose levels. Your doctor may recommend H-2 protein pump inhibitors and other medications, as well. But, proper control of diabetes is essential in
managing this condition.
References:
1. https://onlinelibrary.wiley.com/doi/pdf/10.1111/jgh.12777
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3765380/
3. https://www.webmd.com/heartburn-gerd/guide/default.htm
4. https://www.mayoclinic.org/diseases-conditions/gastroparesis/symptoms-causes/syc-203
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