Gastroesophageal Reflux Disease (GERD)

What is GERD?

Gastroesophageal reflux disease (GERD), also known as acid reflux, is a chronic digestive disorder that occurs when stomach acid or contents stream back up through your esophagus and irritate the lining. Over time, the acid can wear on the lining, resulting in complications including bleeding, narrowing of the esophagus or Barret’s esophagus.

What causes GERD?

Normally a ring of muscle fibers located at the end of the esophagus, known as the lower esophageal sphincter (LES), opens to pass food through the esophagus into the stomach and then closes again. In patients with GERD, the ring doesn’t fully close, allowing stomach acid to leak into the esophagus.

Factors that may contribute to GERD include:

  • Alcohol consumption
  • Asthma
  • Connective tissue disorders such as scleroderma
  • Diabetes
  • Dry mouth
  • Hiatal hernia (a portion of the stomach pushes up through the diaphragm muscle)
  • Medications
  • Obesity
  • Pregnancy
  • Smoking

Whom does GERD affect?

Approximately seven million people in the United States have some symptoms of GERD, with five to seven percent worldwide overall.

Those more likely to have GERD include:

  • Age 40 and over: GERD is most frequently diagnosed in adults over 40, with the majority between 45 and 64, although children may also be affected by the condition.
  • Female: Women are more likely to be hospitalized for GERD symptoms than men. Women accounted for 62 percent of all hospitalizations for GERD in 2005.

Do I have GERD?

Symptoms of GERD

Symptoms of GERD are persistent. A visit to a physician may be needed if:

  • You have difficulty or pain with swallowing.
  • Discomfort or pain affects daily activity.
  • You have had an occasional bout of heartburn, but over the course of several years.
  • Heartburn occurs at night.
  • Heartburn occurs twice or more in a week and progressively gets worse.

Other symptoms may include:

  • A sensation of food feeling stuck in the esophagus (dysphagia)
  • Bad breath
  • Coughing or wheezing
  • Hiccups
  • Hoarseness
  • Nausea or upset stomach after eating (indigestion)
  • Sore throat

Symptoms may vary from person to person and are mild in most cases.

Diagnosing GERD

After taking a medical history of your symptoms, your physician may be able to provide an accurate diagnosis of GERD. To confirm, your physician may include additional testing such as:

GERD Treatment

In many cases, making lifestyle changes can aid in the relief of GERD symptoms. For example:

  • If you are overweight or obese, losing weight can improve symptoms.
  • Avoid taking over-the-counter pain medications including naproxen, aspirin and ibuprofen.
  • Take medications with an abundance of water.

Medications

There are a variety of medications your physician can recommend or prescribe to manage your GERD symptoms, including:

  • H-2 receptor blockers: This type of medication reduces acid production. While they don’t work as quickly as antacids, they provide longer relief overall. These are available over-the-counter, but a stronger version can be prescribed.
  • Medications to strengthen the LES: These may decrease the frequency of LES relaxation and are used in severe cases of reflux.
  • Proton pump inhibitors: These are stronger blockers of acid production and aid in the healing of the esophagus. This medication is also available over-the-counter, but a stronger version can be prescribed.

Surgery

In most cases, GERD may be controlled with medication. In the event that medications and all other conservative methods have failed, your physician may recommend surgical procedures such as surgical reinforcement or strengthening of the LES.

For more information on GERD or to schedule an appointment, contact us today.

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