GERD

About GERD

GERD is an abbreviation for gastroesophageal reflux disease, a condition that refers to damage to the lining of the lower esophagus (the tube that carries food from the mouth to the stomach). GERD occurs as a result of frequent or prolonged exposure to stomach acid.  The primary symptom is acid reflux (also known as heartburn), which is felt as a burning sensation in the pit of the stomach or in the middle of the chest beneath the breastbone.  Sometimes pain can be felt between the shoulder blades or in the jaw or teeth.

Symptoms are usually experienced after eating and are most often triggered by fried, fatty foods, tomato products, citrus fruits and juices, chocolate and anything containing caffeine.  People with acid reflux may also experience a feeling of regurgitation (food coming back into the mouth) after eating and a bitter or acid taste.  Other symptoms include chest pain, difficulty swallowing, nausea, vomiting or bad breath. Lying down or bending over makes the symptoms worse.

Frequently Asked Questions about GERD

Q. Should I be concerned if I get occasional heartburn?
A. No.  Everyone experiences mild heartburn from time to time.  Statistics show that 30 percent of Americans experience it at least once a month and 10 percent get it every day.  If the symptoms become severe or keep occurring over a long period of time, however, you should consult your doctor.

Q. What causes GERD?
A. GERD is caused by the malfunction of a valve called the lower esophageal sphincter (LES).  This area of the esophagus  is supposed to open to allow food and liquid to pass into the stomach and quickly clamp shut to keep stomach acid from leaking back into the esophagus.

The lining of the stomach is protected from digestive acid, but the lining of the esophagus is not.  So, when the LES does not close properly and acid seeps into the esophagus, its lining can become inflamed (causing esophagitis), resulting in a burning sensation known as heartburn.

Q. How do I know if I’m having occasional heartburn or GERD?
A. In general, if your symptoms are severe, frequent or getting worse, you need to be seen by a medical professional. Some specific indications that you should schedule an appointment are:

  • If you take antacids two or more times a week,
  • If you take heartburn medicines other than antacids,
  • If heartburn interferes with your daily activities,
  • If your symptoms usually occur after meals,
  • If your symptoms interfere with your sleep, or
  • If medicine only helps relieve your symptoms for short periods of time.


Q. Besides the burning sensation, are there other complications involved?
A. Yes.  Over time, inflammation can make swallowing painful and even cause a buildup of scar tissue, which narrows the opening of the esophagus and can interfere with eating solid food.  If left untreated, this can lead to ulcers, bleeding and further complications.

Another complication of prolonged acid exposure is called Barrett’s esophagus, in which the cells in the lining of the lower esophagus change to resemble those found in the intestines.  Patients with this condition may experience an improvement in their heartburn symptoms, but they are at greater risk for esophageal cancer.

Q. How is GERD treated?
A. Usually with a combination of lifestyle changes and medications.  Your physician may recommend over-the-counter antacids with common names such as Tagamet®, Zantac®, Pepcid®, Axid®, and Prilosec OTC. It is also very common for physicians to prescribe stronger medications known as proton pump inhibitors for control of reflux symptoms with common names such as Prilosec®, Nexium®, Zegerid®, Protonix®, Aciphex®, and Prevacid®.

Q. Are there risks associated with proton pump inhibitor use?

A. There have been studies citing a possible link between the use of proton pump inhibitors (PPIs) and various medical problems. Based on recommendations from experts in the field, the benefits of PPI use still outweigh the risks, although it is always advisable to use the lowest effective dose for the shortest period of time. Most patients only require these medications episodically, but some patients suffer from more chronic conditions, requiring prolonged use of medications. For these patients, the benefits of preventing more serious complications such as ulcers, swallowing trouble, and esophageal cancer outweigh the risks of PPI use. Read more. 

Q. If I have GERD, what changes should I make in my lifestyle?

  • Avoid all tobacco products.
  • Eliminate or cut down on caffeine, alcohol, chocolate, peppermint, fried and fatty foods and anything else that you find causes your heartburn.
  • Eat smaller meals and eat more frequently than three times a day—but not within three hours of going to bed.
  • Don’t bend or stoop after you eat to avoid pressure that can push acid into the esophagus.
  • Wear loose, comfortable clothes to avoid pressure on your stomach.
  • Exercise and lose weight, if appropriate.  (Be aware that sit-ups and leg lifts can make acid reflux worse.)
  • Raise the head of your bed or mattress six to eight inches to help keep acid in the stomach.  This works better than simply wedging pillows under your head, which causes you to bend at the waist, pushing fluid back up into the esophagus.

 

This content is not a substitute for medical advice, diagnosis or treatment provided by a qualified healthcare provider. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.