Gastroesophageal Reflux Disease (GERD)
Gastroesophageal reflux disease (GERD), also known as reflux, is a common digestive disorder that occurs when a muscle at the end of your esophagus does not close properly. This allows the contents of the stomach to leak back, or reflux, into the esophagus and irritate it.
Characterized by burning in the chest or throat, known as heartburn, GERD can be caused by many conditions such as hiatal hernia or lifestyle choices such as smoking.
Heartburn or acid indigestion are the most common symptoms of GERD and usually feel like a burning chest pain beginning behind the breastbone and moving upward to the neck and throat. Other common signs and symptoms of GERD include:
- Difficulty or pain when swallowing
- Regurgitation of food or sour liquid
- The sensation of a lump in your throat
- Nausea or vomiting
- Bad breath
- Respiratory problems
If you have nighttime acid reflux, you might also experience:
- Chronic cough
- New or worsening asthma
- Disrupted sleep
GERD happens when gastric acid from your stomach backs up into your food pipe (esophagus).
The lower esophageal sphincter (LES), a muscle at the bottom of the esophagus, opens to let food in and closes to keep food in the stomach. When your LES relaxes too often or for too long, acid backs up into your esophagus.
Some lifestyle issues that can cause GERD include:
- Being overweight
- Eating foods such as citrus, chocolate, fatty foods, or spicy foods
- Caffeine consumption
- Alcohol intake
- Using aspirin and over-the-counter pain and fever medicines, including nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen
Some health problems that may cause heartburn include:
- Swelling of your stomach lining (gastritis)
- Painful sores (ulcers) on the lining of your stomach, esophagus, or the first part of your small intestine (duodenum)
- An allergic condition in the esophagus (eosinophilic esophagitis)
Your physician will conduct a physical exam and ask about any symptoms you’ve been experiencing. They might use one or more of the following procedures to confirm a diagnosis or check for complications of GERD:
- Barium swallow: after drinking a barium solution, X-ray imaging is used to examine your upper digestive tract
- Upper endoscopy: a flexible tube with a tiny camera is threaded into your esophagus to analyze it and if necessary, collect a sample of tissue (biopsy)
- Esophageal manometry: a flexible tube is threaded into your esophagus to measure the strength of your esophageal muscles
- Esophageal pH monitoring: a monitor is inserted into your esophagus to learn if and when stomach acid enters it
Lifestyle modifications and over-the-counter medications are typically the first lines of defense against GERD. If you don’t experience relief within a few weeks, your physician might recommend prescription medication or surgery.
Lifestyle changes include:
- Maintaining a healthy body weight
- Quitting smoking
- Elevating the head of your bed
- Waiting at least three hours after eating before lying down
- Eating food slowly and chewing thoroughly
- Avoiding foods and drinks that trigger reflux, including fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine
Over-the-counter medication options include:
- Antacids that neutralize stomach acid, such as Mylanta, Rolaids, and Tums are used for quick short-term relief
- Medications to reduce acid production known as H-2-receptor blockers — such as cimetidine (Tagamet HB) and famotidine (Pepcid AC)
- Proton pump inhibitors are medicines that block acid production and heal the esophagus
Prescription-strength treatments for GERD include:
- Prescription-strength H-2-receptor blockers
- Prescription-strength proton pump inhibitors
- Medication to strengthen the lower esophageal sphincter
The team at Digestive Disease Consultants is standing by to help you manage GERD. Talk to us today if you have symptoms—we can help.