Gastroesophageal reflux disease (GERD) is a long-term disorder in which stomach acid sprouts into the esophagus.
Many people experience gastroesophageal reflux (GER) sometimes.
If an individual experiences chronic acid reflux occurring more than twice a week, they may be diagnosed with GERD, however. In other words, GERD is GERR’s lengthy, regular occurrence.
This page covers information regarding GERD signs, causes, diagnosis, and treatment.
Fast facts on GERD
Here are some key points about GERD. More detail and supporting information is in the main article.
- Stomach acid that washes up into the esophagus can cause dangerous tissue damage.
- GERD may result from a dysfunctional valve at the top of the stomach and bottom of the esophagus.
- Maintaining a healthy weight, quitting smoking, and reducing stress can help reduce the risk of GERD.
- Treating GERD may involve the use of protein pump inhibitors, antacids, and other medications, as well as lifestyle changes.
What is GERD?
Gastroesophageal reflux disease is a condition in which stomach acid flows into the esophagus with consistency and regularity.
The esophagus can also be called the food pipe or gullet, and is the conduit that brings food from the mouth to the stomach.
The acid in the esophagus causes heartburn and other symptoms, along with possible damage to the tissues.
The American College of Gastroenterology says heartburn is experienced every day by at least 15 million Americans, or 20 percent of the American population.
Causes
Occasional reflux of acids is quite common, often caused by overeating, lying down after eating, or consuming specific foods.
Chronic acid reflux, however, which is treated as GERD, typically has other causes and risk factors, and may have more serious complications.
In people of all ages, and sometimes for unknown reasons, gastroesophageal reflux disease occurs.
In short, GERD takes place when the sphincter at the bottom of the esophagus is rigid, or opens when it is not supposed to.
More generally GERD occurs in people who are:
- overweight or obese because of increased pressure on the abdomen
- pregnant, due to the same increased pressure
- taking certain medications, including some asthma medications, calcium channel blockers, antihistamines, sedatives, and antidepressants
- smoking, and being exposed to second-hand smoke
Hiatal hernia is a condition in which a diaphragm breach lets the stomach top move up into the chest. This lowers oesophageal sphincter pressure and increases GERD risk.
Symptoms
GERD’s main symptom is heartburn.
Heartburn is the pain that is felt as a burning sensation behind the breastbone. If the person lies down or bends over, and also after eating food, it tends to get worse.
Not all people with GERD suffer heartburn, however, and other possible symptoms do exist:
- nausea or vomiting
- bad breath
- respiratory problems
- difficulty or pain when swallowing
- decay
Complications
GERD can worsen and turn into other conditions if left untreated.
These include:
- Esophagitis: This is an inflammation of the esophagus.
- Esophageal stricture: In this condition, the esophagus becomes narrow, making it difficult to swallow.
- Barrett’s esophagus: The cells lining the esophagus can change into cells similar to the lining of the intestine. This can develop into cancer.
- Respiratory problems: It is possible to breathe stomach acid into the lungs, which can cause a range of problems including chest congestion, hoarseness, asthma, laryngitis, and pneumonia.
Diagnosis
Anyone experiencing severe acid reflux symptoms should talk with their doctor, who may refer them for further examination to a specialist in gut medicine known as gastroenterologist.
There are several potential GERD diagnostic tests available including:
- Esophageal pH and impedance monitoring: This measures the amount of acid in the esophagus while the body is in different states, such as while eating or sleeping.
- Upper gastrointestinal (GI) endoscope: This is a tube with a camera attached, which is used to inspect the esophagus. A small sample of tissue may also be taken at the same time in a biopsy.
- Upper GI series: This is a type of X-ray that shows up certain physical abnormalities that might cause GERD.
- Esophageal manometry: This measures muscle contractions in the esophagus during swallowing. It can measure the strength of the sphincter.
- Bravo wireless esophageal pH monitoring: In this test, a small temporary capsule is attached to the esophagus. This measures the acidity continuously for around 48 hours.
Treatment
GERD is mostly treated with medications before other treatment lines are attempted.
One of the major prescription treatment options for people with GERD is the proton pump inhibitors. We lower the amount of acid the stomach produces.
Any services include:
- H2 blockers: These are another option to help decrease acid production.
- Antacids: These counteract the acid in the stomach with alkaline chemicals. Side effects can include diarrhea and constipation.
- Prokinetics: These help the stomach empty faster. Side effects include diarrhea, nausea, and anxiety.
- Erythromycin: Ths is a type of antibiotic that also helps empty the stomach.
Surgical options
If changes in lifestyle do not significantly improve GERD symptoms or drugs do not have the desired effect, surgery may be recommended by a gastroenterologist.
Surgical treatments include:
- Fundoplication: The surgeon sews the top of the stomach around the esophagus. This adds pressure to the lower end of the esophagus and is generally successful at reducing reflux.
- Endoscopic procedures: This is a range of procedures include endoscopic sewing, which uses stitches to tighten the sphincter muscle, and radiofrequency, which uses heat to produce small burns that help tighten the sphincter muscle.
Prevention
Other lifestyle and behavior changes can help relieve GERD include:
- Eat moderate amounts of food and avoid overeating.
- Stop eating 2 to 3 hours before sleeping.
- Quit or avoid smoking.
- If a person is overweight, losing weight can help prevent symptoms.
- Do not wear clothing that is tight around the abdomen.
- Sleep at a slight angle with the head slightly elevated.
Diet
Certain foods may trigger GERD symptoms in some people.
These include:
- greasy foods
- spicy foods
- chocolate
- peppermint
- coffee
- foods containing tomato products
- alcoholic drinks
If you are avoiding these types of food and are still having frequent heartburn, seeing a doctor is crucial as there may be other underlying issues that cause the symptoms.
