What is GERD?
GERD is defined as the reflux of gastric contents (acid, bile, digestive enzymes and even undigested food) into the esophagus. It is very common and affects more than 20 percent of the population. Most of the time the symptoms are not severe, but in some patients, they can be quite bothersome.
What is the difference between GERD and heartburn?
Almost everyone has experienced heartburn in the past. Heartburn is the burning sensation in the chest or throat that can occur after eating a big meal or spicy food. It is usually promptly relieved by antacids. Heartburn is the most common symptom of GERD. Gastroesophageal reflux disease (GERD) is a chronic condition with acid reflux occurring more than two times per week for several months.
What causes GERD?
GERD most commonly develops when gastric contents escape from the stomach into the esophagus. The lower esophageal sphincter and the diaphragm muscle work together to provide a protective barrier to reflux. When this barrier fails due to inappropriate relaxation or a weak sphincter, reflux occurs. In some patients the problem lies in the esophagus itself. If the esophagus lacks normal peristalsis, then even a small amount of acid can cause GERD symptoms.
What are the symptoms of GERD?
GERD can cause a variety of symptoms. Some patients have no symptoms at all. The most common symptoms include:
- Chest pain
- Sore throat
- Difficulty swallowing
- Sensation of a lump in the throat
- Dental abnormalities (sore gums or loss or enamel)
- Bad breath
- Sinus problems
- Chronic cough
How is GERD diagnosed?
The best way to diagnose GERED is with an upper endoscopy (Esophagogastroduodenoscopy). This allows for a direct view of the lining of the esophagus, stomach and duodenum. Tissue can be sampled and tested for infection and a pre-malignant condition known as Barrett’s Esophagus which is a complication of chronic reflux.
In some cases, a special study called a 24-hour pH test is used to measure the amount of acid that comes back up into the esophagus.
Occasionally a barium x-ray (barium swallow) is used to help diagnose reflux. This is most commonly recommended as a preliminary test in patients with difficulty swallowing.
How is GERD treated?
Lifestyle modification is a primary treatment for GERD patients. This involves weight loss and dietary modification. Patients are asked to eat frequent small meals, avoid greasy or spicy foods and limit alcohol, caffeine and chocolates. Elevation of the head of the bed is recommended for night-time reflux sufferers.
Medications for GERD include:
- Antacids (Maalox, Mylanta, Gaviscon)
- H-2 blockers (Pepcid, Tagamet, Zantac)
- Proton pump inhibitors (Prilosec, Nexium, Prevacid, Protonix)
Surgery is an option for those patients who have chronic and difficult to control symptoms or who wish to avoid taking medications long term.
The Nissen Fundoplication is a widely used surgical procedure.
A newer less invasive operation known as the Linx procedure is now gaining popularity.
Is GERD serious?
In most patients GERD is an annoyance, but some patients develop complications such as esophageal stricture, Barrett’s esophagus or esophageal cancer.
Chronic and poorly treated reflux can cause scarring or stricturing of the esophagus resulting in difficulty swallowing and food sticking. Barrett’s esophagus is a change in the lining of the esophagus due to reflux which can predispose patients to developing esophageal cancer. Barrett’s patients require close follow up to watch for changes that can indicate esophageal cancer.
When should I see a doctor about my GERD?
Red flag/alarm symptoms of GERD include:
- Heartburn two or more times a week
- Worsening heartburn
- Nighttime heartburn
- Chronic heartburn (intermittent symptoms for years)
- Difficulty swallowing or food sticking
- Painful swallowing
- Nausea and Vomiting
- Vomiting blood
- Black and tarry bowel movements
- Weight loss
- Chronic cough
- Chest pain
Disclaimer: The information presented on this website is not intended to take the place of your personal physician’s advice and is not intended to diagnose, treat, cure or prevent any disease. Discuss this information with your healthcare provider to determine what is right for you. All information is intended for your general knowledge only and is not a substitute for medical advice or treatment for specific medical condition.
This website is owned and managed by Brian Cooley, MD. Any information, offers or instruction as written, inferred or implied is the sole responsibility of Brian Cooley, MD and does not warrant claim or representation, inherent, or implied of DHAT, its subsidiaries or employees.