What is GERD?
If you've ever enjoyed a spicy dish or eaten a large meal at your favorite restaurant, you've probably experienced a form of gastroesophageal reflux, or GER.
Typically called acid reflux or acid indigestion, GER occurs when the food and fluids in your stomach leak backward into your esophagus, causing irritation. The most common symptom is heartburn, a fiery sensation that builds up in your chest and throat.
Most of us experience occasional acid reflux. The problem occurs when GER becomes gastroesophageal reflux disease, or GERD. GERD has more severe symptoms and can last much longer. Researchers estimate that around 20% of people in the United States have GERD.
Signs and symptoms of GERD
GERD typically starts as repeated episodes of acid reflux. As the disease progresses, symptoms become more painful and interfere more with your daily life. Sometimes, severe heartburn can cause sharp chest pains that can be mistaken for angina, which is chest pain that's caused by a lack of blood flow to the heart.
Other GERD symptoms include:
- Acid regurgitation (you can taste your food after you eat)
- Noncardiac chest pain (if you're unsure, see a doctor immediately)
- Nausea and vomiting
- Chronic sore throat
- A "full" feeling in the back of the throat
- Coughing or wheezing
- Excess saliva
- Inflamed gum tissue
- Bad breath
- Acid erosion of your teeth
Causes of GERD
There isn't one single factor that causes GERD. When you eat, food travels past your throat and down the esophagus and ends up in your stomach. At the base of the esophagus, there's a ring of muscle fibers called the lower esophageal sphincter (LES) that prevents swallowed food from moving back up. If the LES doesn't close properly, the contents of your stomach can leak.
The severity of GERD depends on the individual. If you constantly have reflux and it damages the esophagus, you may experience more intense symptoms.
Factors that may increase the likelihood of getting GERD include:
Some medications can also cause GERD, including:
When you visit your doctor, be prepared to spend time talking about your medical history and symptoms. There are plenty of over-the-counter (OTC) medications designed to relieve acid reflux symptoms, but if there's damage to your digestive tract, your doctor may suggest diagnostic testing, including:
Upper GI endoscopy
Your doctor will sedate you, then use a thin, flexible tube called an endoscope to examine your gastrointestinal (GI) tract. He or she will check your esophagus, stomach, and small intestine, and take a biopsy if necessary.
Ambulatory pH/impedance monitoring
A thin probe is placed into your nose and threaded through the esophagus. It's connected to a data recorder that measures both acid and non-acidic reflux that travels into your esophagus.
Catheterless pH capsule
A pH sensor is attached to the wall of your esophagus during an endoscopy. The data is transmitted to an external recorder via radio waves, providing information on acid reflux.
Treatments for GERD
Treatment options for GERD include:
- Lifestyle and dietary changes
- OTC and prescription medication
- Endoscopic therapy (treatments performed with an endoscope)
Lifestyle and dietary changes that may alleviate your symptoms include:
- Losing weight if you are obese
- Avoiding foods that increase acid in your stomach, like citrus fruits
- Avoiding high-fat foods, alcohol, and peppermint, which lower the pressure in your esophagus
- Not eating large meals
- Quitting smoking
- Not lying down immediately after eating
- Elevating your head when lying down
If these measures don't help, the next step is medication, including:
OTC antacids can work if you don't have reflux often. They don't stay very long in the stomach, however, and they don't heal inflammation.
Medications called histamine 2 (H2) blockers help lower stomach acid levels. H2 blockers can heal erosions in your esophagus.
Proton pump inhibitors (PPIs)
Prokinetics are medications that enhance the muscles of your gastrointestinal tract, but they typically aren't as effective as PPIs. Your doctor may prescribe them in addition to an H2 blocker or other acid-suppressing medication.
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American Heart Association: "Heartburn or heart attack?"
International Foundation for Gastrointestinal Disorders: "Causes of GERD."
Johns Hopkins Medicine: "Gastroesophageal Reflux Disease (GERD) Treatment."
MedlinePlus: "Gastroesophageal reflux disease."
National Institute of Diabetes and Digestive and Kidney Diseases: "Definition & Facts for GER & GERD."
National Institute of Diabetes and Digestive and Kidney Diseases: "Symptoms & Causes of GER & GERD."
University of Michigan: "GERD (Gastroesophageal Reflux Disease)."
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- Nausea after eating
- A feeling of fullness during or after eating
- Abdominal bloating
- Upset stomach
- Reflux laryngitis
- A tightness in the throat
- Problems swallowing
- In some people, vomiting
Causes of acid reflux and heartburn include:
- Being obese
- Slouching (poor posture)
- Medications like calcium channel blockers, theophylline, nitrates, and antihistamines
- Foods and drinks like caffeine, citrus fruits and vegetables, alcohol, and chocolate
- Increase in stomach acid
- Eating a heavy meal
- Eating before bed
The treatment for heartburn and acid reflux is to treat the underlying cause, for example, GERD, with over-the-counter (OTC) medicine, prescription medicine, natural remedies, and lifestyle changes like a eating a healthy, less fatty, spicy diet, not eating big meals, not eating before bed, and getting regular exercise to improve your posture.
Sometimes a heart attack can mimic heartburn and acid reflux because they feel very similar. If you have symptoms of chest pain, tightness in the chest, heartburn, acid reflux, jaw, tooth, or head pain; shortness of breath, nausea, vomiting, sweating, discomfort in the upper middle of the abdomen, arm or upper back pain, or the general feeling of being ill, go to the nearest Emergency Department immediately because these are the symptoms of a heart attack.
American College of Gastroenterology. "Acid Reflux." 2017.
familydoctor.org. "Heartburn." Updated: Mar 2014.
National Library of Medicine; PubMed Health. "Heartburn and GERD: Treatment options for GERD." Updated: Nov 18, 2015.
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