What is Gastroesophageal Reflux Disease (GERD)?

• What are the symptoms of GERD in adults?
• What causes GERD?
• When is GERD serious?
• How can my doctor help me with GERD?
• Is GERD preventable?

Gastroesophageal reflux disease, or GERD, affects about 30% of the population in the United States. This chronic disorder affects the digestive system. When the muscle at the bottom of your esophagus doesn’t close properly, reflux, or leakage of the stomach contents back up into the esophagus can occur. This causes a burning sensation in the chest and throat that is commonly called heartburn. If you’re experiencing heartburn regularly, you may have a treatable condition known as GERD.

The word “gastroesophageal” refers to the stomach and esophagus, which are the two body parts primarily affected by GERD. Reflux is the flow of acidic stomach contents back into the esophagus. Repeated backup of stomach contents into the esophagus can cause potential tissue damage or other more serious issues.

Almost everyone has acid reflex now and again. But if your heartburn happens more than twice a week, or if it worsens, you may have GERD. The symptoms of GERD in adults can include:

GERD is tricky in the sense that some of these symptoms can appear to be caused by other illnesses. For example, chest pain should be evaluated within the worst-case scenario of heart disease first, before GERD is considered. Bad breath could come from dental disease—and so on.

There is no known single cause for GERD. When it happens, the band of muscles between the stomach and bottom of the esophagus known as the lower esophageal sphincter malfunctions. Normally, this hatch stays closed after food moves down the esophagus and into the stomach. If the hatch relaxes or otherwise malfunctions, reflux, or the flow of stomach contents into the esophagus, occurs. While occasional heartburn is common and not usually a problem, if left untreated, GERD can damage your esophagus and teeth or even lead to cancer.

Untreated GERD can cause a host of serious issues if left untreated:

• Barrett’s esophagus is when GERD causes precancerous cells in the esophagus
• Esophageal strictures are scar tissue on the lining of the esophagus which make it harder to swallow
• Esophageal ulcers, or sores in the lining of the esophagus
• Esophagitis is inflammation of the esophagus, which can lead to pain when swallowing
• Tooth decay which weakens your teeth

Having long-term untreated GERD slightly raises your odds of getting esophageal cancer. WebMD points out that if your family has a history of this type of cancer your risk also increases. Symptoms of cancer could include increased pain or difficulty swallowing, which appear in the later stages of the disease, which make it much harder to treat.

Your doctor will diagnose GERD based on a medical history and physical examination. You may undergo a number of tests to confirm the diagnosis, including:

• Upper endoscopy inserts a small flexible tube with a light and a camera down your throat to look at your esophagus and stomach
• Ambulatory acid pH probe test places a small monitor inside your esophagus to determine how much or how long stomach acid resides there
• Esophageal manometry measures the muscle contractions when you swallow
• X-ray of your upper digestive system which could include drinking a liquid that coats the inside of your digestive tract

GERD is highly treatable, especially if diagnosed early before other complications occur. Your doctor may try over-the-counter medications or lifestyle changes first to lessen the symptoms of GERD. Some options include:

• Antacids to neutralize stomach acid
• Medications to reduce the production of acid
• Medications that reduce acid but also heal the esophagus

Your doctor may also prescribe medications such as:

• Prescription strength famotidine (Pepcid) and nizatidine
• Prescription strength proton inhibitors (Prilosec, Prevacid)
• Medication to strengthen the lower esophageal sphincter

There are also minimally invasive surgeries for GERD that doesn’t respond to other treatments. These may include:

• Fundoplication to wrap the top of your stomach around the lower esophageal sphincter to prevent reflux
• A LINX device, which is a loop of tiny magnetic beads that are wrapped around where the stomach meets the esophagus
• Transoral incisionless fundoplication (TIF) creates a partial wrap around the lower part of the esophagus with polypropylene fasteners

These procedures are all advanced endoscopy surgeries used only when other treatments are not effective at treating GERD. Thanks to advances in modern technology, the surgeries don’t require a lot of downtime or leave significant scars.

If you’re experiencing regular or increasing acid reflux, it’s time to see your doctor.

There are a number of factors that can contribute to GERD:

• Alcohol
• Eating too many fried or fatty foods
• Hiatal hernia
• Overeating
• Too much spicy food
• Pregnancy
• Smoking

To help prevent GERD, here are some at-home lifestyle changes you can try to gain some relief from the disease:

• Always avoid smoking if at all possible
• Avoid the foods that cause you issues like chocolate, garlic, onion, or caffeine
• Consider setting up a food diary to track what types of food cause your problems
• Don’t lie down after eating
• Don’t wear tight fitting clothing around your waist
• Eat smaller meals and try to move around a little after you eat
• Elevate the head of your bed for sleeping at night
• Maintain a healthy weight
• Reduce your stress and relax
• Some herbal remedies like chamomile tea may help your GERD

GERD is a manageable condition for most people. It’s when GERD is left untreated that issues can occur.

If you’re experiencing acid reflux regularly, don’t hesitate to schedule a consultation with our team.