Gastroesophageal Reflux Disease (GERD)

Heartburn or acid indigestion is a form of gastroesophageal reflux, or acid reflux, which happens when digestive acids rise up with your food and you feel a burning sensation in your chest or throat.  Occasional heartburn is normal but if you experience it regularly, you may have a more serious condition called gastroesophageal reflux disease (GERD). GERD affects people of all ages and can lead to more serious health problems, such as inflammation of the esophagus, scars that make swallowing difficult or esophageal cancer.

GERD causes Acid reflux occurs when the lower esophageal sphincter—a ring of muscle at the bottom of the esophagus that works like a valve between the stomach and esophagus-- doesn’t close properly allowing stomach acids to leak back into the esophagus and irritate it. An anatomical abnormality, such as a hiatal hernia may contribute to GERD. Other factors such as being obese, pregnancy or smoking also increase your risk.

GERD symptoms If you get acid reflux more than twice a week, it’s considered GERD. The burning pain occurs behind the breast bone and in the middle of the abdomen. You can also have GERD without heartburn. Other symptoms include a dry cough, asthma or difficulty swallowing.

GERD diagnosis/tests If you’ve been using antacids or other over-the-counter medications to treat heartburn for more than two weeks, see your doctor. She may refer you to a gastroenterologist, a doctor who treats stomach diseases, for treatment. There is no one completely accurate test for diagnosing GERD but if your GERD symptoms persist even after treatment, your doctor may recommend a barium swallow radiograph, an X-ray, to spot problems with the espophagus or a hiatal hernia. An upper endoscopy, which involves sliding a tube with a lens attached down your throat to check your esophagus, and other tests to check for abnormalities, may also be recommended.

GERD treatment It may involve lifestyle changes, medications or surgery, depending on how severe your GERD is:

• Make healthy changes Quit smoking, lose weight if you need to, avoid lying down within three hours after eating and steer clear of the foods that make GERD worse.

• Medications Over-the-counter and prescription medications may help.Antacids are effective for mild GERD symptoms.H2 blockers, such as Pepcid AC, decrease acid production and provide short-term relief. Foaming agents, such as Gaviscon, cover the contents of your stomach with foam to prevent reflux.Proton pump inhibitors, such as Prilosec are prescription meds that heal the lining of the esophagus. Prokinetics help make the stomach empty more quickly but they may have side effects, such as sleepiness and anxiety. Talk to your doctor about what medicines will work best for you.

• Surgery If medications and lifestyle changes don’t improve your symptoms, surgery is another option for preventing acid reflux.

GERD prevention If you’re experiencing frequent heartburn, avoid foods that make it worse, which include spicy foods, tomato-based foods, citrus fruits, chocolate, fatty foods and drinks with caffeine and alcohol. Don’t smoke, maintain a healthy weight and avoid eating close to bedtime.

Outside resources
International Foundation for Functional Gastrointestinal Disorders
Gastro-Esophegeal Reflux Disease