Occasional heartburn isn’t an unusual feeling for most American adults. The medical name for this type of acid indigestion is gastroesophageal reflux (GER). However, 20% of U.S. adults have the more serious type of GER called gastroesophageal reflux disease (GERD). What are the symptoms of GERD and how is the disease different from periodic heartburn?
If these symptoms sound familiar to you, Dr. Chetan J. Patel, MD, FACS, board-certified general surgeon, is trained to detect whether you have GERD and what your best treatment options are.
What Is GER?
GER occurs when the contents of your stomach flow upwards into the esophagus. The esophagus is the tube that connects your mouth to your stomach. When you chew food, it flows down the tube into the stomach. Normally, a small valve at the end of the esophagus called the esophageal sphincter automatically opens to allow food to flow into the stomach, then closes tightly. When that sphincter muscle doesn’t close properly, stomach acids and digested food can move back up the pipe.
How Is GER Different From GERD?
Having occasional GER symptoms is normal for most adults. GER, also called acid indigestion, acid reflux, or heartburn can happen after a heavy meal or eating foods that increase the production of stomach acids such as fatty or acidic foods. However, if you experience heartburn symptoms twice a week or more, you may be diagnosed with the more chronic form of the disease called GERD.
Taking an over-the-counter antacid can stop GER symptoms. Chronic GERD usually needs stronger intervention to prevent other health complications from occurring.
What are the Symptoms of GERD in Adults?
If you have GERD, you may experience:
- Bad breath
- Bloating and gas
- Chest pain or discomfort
- Dental issues and enamel erosion
- Difficulty swallowing
- Excessive salivation
- Food regurgitation into the back of your throat
- Frequent swallowing
- Heartburn, or a burning sensation in the throat and chest, more than twice a week
- Hoarseness or laryngitis
- Problems swallowing
- Sore throat
- Sour taste in the back of your mouth
- Trouble breathing similar to asthma
- Trouble lying flat and sleeping
While each person experiences GERD slightly differently, most people experience heartburn in varying levels of severity. Severe GERD sufferers can experience symptoms daily. The triggers for the disease can vary individually as well; part of your treatment will be to keep a diary to determine your intolerance to certain foods and drinks.
Does GERD Cause Other Health Problems?
If left untreated, GERD can cause other health problems that can reduce your quality of life. Chronic esophageal inflammation caused by stomach acids can wreak havoc on your body and cause:
- Barrett’s esophagus, which is a precancerous change to the tissue in the lower esophagus
- Esophageal stricture, or scar tissue and a narrowing of the esophagus, which makes it harder to swallow
- Esophageal ulcer, or an open sore that forms in the esophagus causing intense pain
GERD can also cause your lungs and throat to inflame and even trigger fluids to collect in your middle ear and sinuses.
Why Would I Get GERD?
Some conditions can increase your risk of developing GERD over time. This could include:
- Alcohol use
- Esophageal trauma
- Frequent use of NSAIDs such as naproxen or ibuprofen
- Hiatal hernia, which is when the stomach bulges up into the diaphragm
- Oral steroid therapy
- Scleroderma, which is a connective tissue disorder
- Slow or delayed emptying of the stomach
If you have GERD, you can also aggravate the condition by engaging in these behaviors:
- Drinking alcohol, coffee, or other trigger beverages
- Eating fatty or fried foods
- Eating large meals
- Eating late at night
- Exercising after eating
- Lying down after eating
- Taking aspirin or other medications
Does GERD Go Away on Its Own?
GERD does not go away on its own. It may be difficult to know when your symptoms are severe enough to make an appointment with your doctor. Some of the signs that it’s time to seek treatment include:
- Acid indigestion or heartburn that continues regularly for more than two weeks
- Acid reflux that affects the quality of your life
- Constant wheezing or hoarseness
- Difficulty or pain when swallowing
- Episodes of heartburn that increase in intensity
- Heartburn that continues even after taking over-the-counter antacids
- Nausea and vomiting that accompanies the heartburn
- Symptoms at night that keep you from sleeping
- Weight loss that you can’t explain
If you’re having any of these symptoms, see your doctor.
How Is GERD Diagnosed?
Your doctor may diagnose GERD from a physical exam and obvious signs and symptoms of the disease. Other times, the doctor may want to confirm suspicions that you have GERD with a few diagnostic tests. This could include:
- Ambulatory acid (pH) test, which places a monitor in your esophagus to track stomach acid
- Esophageal manometry measures the function of the esophagus when you swallow
- Upper endoscopy, which is an insertion of a thin, flexible tube with a light and camera down the esophagus to look for inflammation or other complications
- X-ray of the upper digestive system, which is conducted after you swallow a liquid that coats the inside of the tract so doctors can see it on film
What Is the Treatment for GERD?
GERD can be treated usually with medication and some lifestyle changes. Sometimes over-the-counter meds may be all you need. Other times, you may find yourself taking too many antacids or find that they’re not as effective. In these cases, the doctor may opt to use a medication to reduce the stomach’s production of acids to give your esophagus time to heal.
Some of the typical medications doctors recommend include:
- Antacids to neutralize stomach acid
- H-2 receptor blockers to reduce acid production
- Proton pump inhibitors to block acid and heal the esophagus
Lifestyle changes can also be surprisingly effective in some people. For example, your doctor may counsel you to:
- Avoid lying flat after eating
- Avoid eating foods that trigger your symptoms
- Avoid or minimize taking NSAIDs or aspirin
- Eat smaller portions, perhaps more often throughout the day
- Maintain a healthier weight
- Stop drinking coffee or alcohol and stop eating chocolate
- Stop smoking or using other types of nicotine products
Your doctor may also recommend surgery if the medications fail to work. This could include several procedures to improve the function of the lower esophageal sphincter and repairing a hiatal hernia. These treatments are typically minimally invasive, and practices like Orlando Minimally Invasive Surgery offer these treatments to speed your recovery and get you back to health. If you’re experiencing frequent heartburn, contact us. We can help you heal.