Gastroesophageal Reflux Disease (GERD)

Overview Of Gastroesophageal Reflux Disease (GERD)

Gastroesophageal reflux disease (GERD) is a condition in which the stomach contents leak backward from the stomach into the esophagus (food pipe). Food travels from your mouth to the stomach through your esophagus. GERD can irritate the food pipe and cause heartburn and other symptoms.

Commonly Associated With

When you eat, food passes from the throat to the stomach through the esophagus. A ring of muscle fibers in the lower esophagus prevents swallowed food from moving back up. These muscle fibers are called the lower esophageal sphincter (LES).

When this ring of muscle does not close all the way, stomach contents can leak back into the esophagus. This is called reflux or gastroesophageal reflux. Reflux may cause symptoms. Harsh stomach acids can also damage the lining of the esophagus.

The risk factors for reflux include:

• Use of alcohol (possibly)
• Hiatal hernia (a condition in which part of the stomach moves above the diaphragm, which is the muscle that separates the chest and abdominal cavities)
• Obesity
• Pregnancy
• Scleroderma
• Smoking
• Reclining within 3 hours after eating
• Heartburn and gastroesophageal reflux can be brought on or made worse by pregnancy.

Symptoms can also be caused by certain medicines, such as:

• Anticholinergics (for example, seasickness medicine)
• Bronchodilators for asthma
• Calcium channel blockers for high blood pressure
• Dopamine-active drugs for Parkinson disease
• Progestin for abnormal menstrual bleeding or birth control
• Sedatives for insomnia or anxiety
• Tricyclic antidepressants
• Talk to your health care provider if you think one of your medicines may be causing heartburn. Never change or stop taking a medicine without first talking to your provider.

Symptoms Of Gastroesophageal Reflux Disease (GERD)

Common symptoms of GERD include:

• Feeling that food is stuck behind the breastbone
• Heartburn or a burning pain in the chest
• Nausea after eating

Less common symptoms are:

• Bringing food back up (regurgitation)
• Cough or wheezing
• Difficulty swallowing
• Hiccups
• Hoarseness or change in voice
• Sore throat
• Symptoms may get worse when you bend over or lie down, or after you eat. Symptoms may also be worse at night.

Exams & Tests

You may not need any tests if your symptoms are mild.

If your symptoms are severe or they come back after you have been treated, your doctor may perform a test called an upper endoscopy (EGD).

This is a test to examine the lining of the esophagus, stomach, and first part of the small intestine.

It is done with a small camera (flexible endoscope) that is inserted down the throat.

You may also need one or more of the following tests:

• A test that measures how often stomach acid enters the tube that leads from the mouth to the stomach (called the esophagus)
• A test to measure the pressure inside the lower part of the esophagus (esophageal manometry)
• A positive stool occult blood test may diagnose bleeding that is coming from the irritation in the esophagus, stomach, or intestines.

Treatment Of Gastroesophageal Reflux Disease (GERD)

You can make many lifestyle changes to help treat your symptoms.

Other tips include:

• If you are overweight or obese, in many cases, losing weight can help.
• Raise the head of the bed if your symptoms get worse at night.
• Have your dinner 2 to 3 hours before going to sleep.
• Avoid drugs such as aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve, Naprosyn). Take acetaminophen (Tylenol) to relieve pain.
• Take all of your medicines with plenty of water. When your provider gives you a new medicine, ask whether it will make your heartburn worse.
• You may use over-the-counter antacids after meals and at bedtime, although the relief may not last very long. Common side effects of antacids include diarrhea or constipation.

Other over-the-counter and prescription medicines can treat GERD. They work more slowly than antacids, but give you longer relief. Your pharmacist, doctor, or nurse can tell you how to take these medicines.

Proton pump inhibitors (PPIs) decrease the amount of acid produced in your stomach.

H2 blockers also lower the amount of acid released in the stomach.

Anti-reflux surgery may be an option for people whose symptoms do not go away with lifestyle changes and medicines. Heartburn and other symptoms should improve after surgery. But you may still need to take medicines for your heartburn.

There are also new therapies for reflux that can be performed through an endoscope (a flexible tube passed through the mouth into the stomach).