Gastroesophageal Reflux Disease
GERD
Gastroesophageal reflux disease (GERD) occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus.
Many people experience acid reflux from time to time. GERD is mild acid reflux that occurs at least twice a week, or moderate to severe acid reflux that occurs at least once a week.
Most people can manage the discomfort of GERD with lifestyle changes and over-the-counter medications. But some people with GERD may need stronger medications or surgery to ease symptoms.
Causes
GERD is caused by frequent acid reflux.
When you swallow, a circular band of muscle around the bottom of your esophagus (lower esophageal sphincter) relaxes to allow food and liquid to flow into your stomach. Then the sphincter closes again.
If the sphincter relaxes abnormally or weakens, stomach acid can flow back up into your esophagus. This constant backwash of acid irritates the lining of your esophagus, often causing it to become inflamed.
Complications
- Narrowing of the esophagus
- Esophageal ulcer
- Upper GI bleeding
- Precancerous changes to the esophagus (Barrett’s esophagus). Damage from acid can cause changes in the tissue lining the lower esophagus. These changes are associated with an increased risk of esophageal cancer.
Diagnosis
Your doctor might be able to diagnose GERD based on a physical examination and history of your signs and symptoms.
To confirm a diagnosis of GERD, or to check for complications, your doctor might recommend:
- Upper endoscopy
- Ambulatory acid (pH) probe test
- Esophageal manometry
- X-ray of your upper digestive system
Treatment
Medical Treatment may include:
- Antacids that neutralize stomach acid
- Medications to reduce acid production
- Medications that block acid production and heal the esophagus
- Medication to strengthen the lower esophageal sphincter
Prescription-strength treatments for GERD include:
- Prescription-strength H-2-receptor blockers. These include (Pepcid and Zantac).
- Prescription-strength proton pump inhibitors. These include (Nexium, Prevacid, Prilosec, Zegerid, Protonix, Aciphex and Dexilant).
Surgical Treatment
GERD can usually be controlled with medication. But if medications don’t help or you wish to avoid long-term medication use, your doctor might recommend:
- Fundoplication
- Linx Device
When to see my Doctor?
- Experience severe or frequent GERD symptoms
- Take over-the-counter medications for heartburn more than twice a week
Risk Factors
Conditions that can increase your risk of GERD include:
- Obesity
- Bulging of the top of the stomach up into the diaphragm (hiatal hernia)
- Pregnancy
- Connective tissue disorders, such as scleroderma
- Delayed stomach emptying
Factors that can aggravate acid reflux include:
- Smoking
- Eating large meals or eating late at night
- Eating certain foods (triggers) such as fatty or fried foods
- Drinking certain beverages, such as alcohol or coffee
- Taking certain medications, such as aspirin
Recommendation
Your doctor is likely to recommend that you first try lifestyle modifications and over-the-counter medications. If you don’t experience relief within a few weeks, your doctor might recommend prescription medication or surgery.