GERD

Gastroesophageal reflux (GER) happens when your stomach contents come back up into your esophagus. Acid reflux and heartburn are common conditions many people experience from time to time. However, if symptoms are chronic (two or more times a week), you may be diagnosed with Gastroesophageal reflux disease (GERD).

Symptoms

Signs and symptoms of GERD may include:

• A burning sensation in your chest (heartburn/acid indigestion)
• Chest pain*
• Dry cough, hoarseness or sore throat
• Regurgitation of food/liquid (acid reflux)
• Sour taste in the mouth

*Seek immediate medical attention if you have chest pain, especially with other symptoms like arm pain, as these may be signs of heart attack.

GERD Risk Factors

Certain factors can increase your risk for developing GERD; other factors can aggravate your acid reflux associated with GERD. Risk factors for developing GERD include:

• Obesity
• Having a hiatal hernia, which is when the top of your stomach bulges up into your diaphragm
• Pregnancy
• Having scleroderma or another connective tissue disorder that affect the smooth muscle tissue of the LES
• Delayed stomach emptying, which is a condition in which food stays in your stomach longer than it should

Risk factors for aggravating acid reflux can include:

• Eating large meals or eating late at night
• Smoking
• Eating “trigger” foods, such as spicy or fried foods
• Drinking coffee, alcohol, or other certain beverages
• Taking certain medications, such as aspirin, which may prevent the body from protecting the esophagus

Causes

GER and GERD happen when your lower esophageal sphincter becomes weak or relaxes when it shouldn’t, causing stomach contents to rise up into the esophagus (reflux). Things that may cause this include:

• Increased abdominal pressure from being overweight, obese or pregnant
• Certain medicines, including some blood pressure and depression medications
• Dry mouth, which can also be a side effect of some medication
• Smoking, or inhaling secondhand smoke​

Constant acid reflux can wear away the esophageal lining, causing complications such as bleeding or esophageal narrowing.

Diagnosis

Your Northeast Digestive Health Center doctor may diagnose GERD following a physical exam and reviewing your medical history. Additional tests may be required to confirm or rule out other causes. This may include blood, stool or breath tests. Your doctor may also order an endoscopy to examine your upper digestive system.

Treatment

You may be able to control GERD by avoiding reflux triggers, like:

• Not consuming food/liquids that cause symptoms, such as spicy foods and alcoholic drinks
• Not overeating
• Not eating 2-3 hours before bedtime
• Losing weight if you’re overweight or obese
• Quitting smoking and avoiding secondhand smoke
• Taking over-the-counter medicines, such as acid reducers

Many people can manage GERD on their own. But some people may need stronger medications, or even surgery. Your gastroenterologist will recommend treatment following determination of potential underlying causes of your reflux symptoms.

Frequently Asked Questions about GERD

What is GERD?

GERD is a condition in which acid backs up, or refluxes, into the esophagus.

I have heartburn – does that mean I have GERD?

If you have occasional and mild symptoms of heartburn, you probably do not have GERD. However, if you have symptoms of heartburn all the time, have large amounts of acid refluxing into your esophagus, or tissue damage, you may have GERD.

Why does GERD occur?

GERD occurs when your lower esophageal sphincter (LES) weakens so much that it does not close tightly, which allows the acid to reflux into your esophagus.

Can GERD cause other problems?

Over time, GERD can cause complications, such as:

• Narrowing of the esophagus, which can lead to problems with swallowing
• An esophageal ulcer, or open sore, which can bleed, cause pain and make swallowing difficult
• Precancerous changes to the esophagus, a condition known as Barrett’s esophagus, which is associated with an increased risk of esophageal cancer

How do I know if I have GERD?

Only your doctor can determine if you have GERD. Consult with your doctor if you experience heartburn that:

• Occurs two or more times a week
• Wakes you up at night
• Has been around for a few years
• Is getting worse over time
• Is causing difficulty or pain when you swallow
• Is causing discomfort that interferes with your daily activities

What is the treatment for GERD?

Treatment for GERD is a long-term approach that focuses on reducing or controlling symptoms, healing injured esophageal tissue, and preventing or managing complications. Treatment typically includes lifestyle changes, medicines, surgery, or a combination of approaches.

What should I do if I think I have GERD?

Make an appointment with your Concord gastroenterologist, who determine if you have GERD and suggest a course of treatment.

Sources

• U.S. National Library of Medicine
• National Institute of Diabetes and Digestive and Kidney Diseases (NIH)