Gastroesophageal Reflux Disease (GERD)

Gastroesophageal Reflux Disease (GERD) is also called acid reflux. Put simply, it means that acid produced by your stomach to help digest the food you eat is flowing backward, or refluxing into your esophagus. Without treatment, including lifestyle and diet modifications and medications, chronic GERD can cause worsening symptoms and lead to inflammation or ulcers. It can also lead to changes in the cells that line your esophagus, called Barrett's esophagus, which can increase your risk of esophageal cancer.

Causes of GERD

• Hiatal hernia
• Consuming alcohol
• Being overweight or obese
• Pregnancy
• Smoking
• Consuming certain foods or beverages
• Snacking close to bedtime

When you eat, food passes from the throat to the stomach through the esophagus (also called the food pipe). Once food is in the stomach, a ring of muscle fibers prevents food from moving backward into the esophagus. These muscle fibers are called the lower esophageal sphincter, or LES. In most people with GERD, the esophageal sphincter does not seal tightly. It remains relaxed between swallows, allowing digestive juices to move up into the esophagus and irritate the esophageal lining.

 

When to see a doctor

Symptoms of GERD may vary, but if you experience a number of the following signs, see your doctor about treatment.

• Heartburn, a painful burning sensation in the middle of the chest that strikes after meals and can last several hours
• Regurgitation, a sour or bitter-tasting acid backing up into your throat or mouth
• Difficulty swallowing, a feeling that food is stuck in the chest or throat
• Hoarseness in the morning
• Persistent burping, hiccupping and dry coughing

Tests and procedures

Your doctor may suggest tests and procedures used to diagnose GERD, including:

• An X-ray of your upper digestive system. Sometimes called a barium swallow or upper GI series, this procedure involves drinking a chalky liquid that coats and fills the inside lining of your digestive tract.
• An endoscopy is a way to visually examine the inside of your esophagus through the passing of a flexible tube down your throat.
• A test to monitor the amount of acid in your esophagus
• A test to measure the movement of the esophagus

 

Treatment of GERD

Initial treatments to control heartburn:

• Antacids
• Medications to reduce acid production called H2-receptor blockers
• Medications that block acid production and heal the esophagus
• Prescription-strength medications:
• Prescription-strength H2-receptor blockers
• Prescription-strength proton pump inhibitors
• Medications to strengthen the lower esophageal sphincter

Other procedures used if medications don't help:

• Surgery to reinforce the lower esophageal sphincter (Nissen fundoplication)
• GERO LINX surgical treatment for GERD

 

Things you can do to manage GERD

• Reduce meal size
• Avoid fried, fatty and spicy foods
• Avoid alcohol and caffeinated beverages (colas, coffee, tea)
• Avoid chocolate
• Avoid acidic foods like citrus fruits and tomatoes
• Stop smoking
• Lose weight
• Wear loose-fitting clothes
• Avoid lying down for 3 hours after a meal