GERD (gastroesophageal reflux disease)

WHAT IS IT?

When you swallow, the lower esophageal sphincter — a circular band of muscle around the bottom part of your esophagus — relaxes to allow food and liquid to flow down into your stomach. Then it closes again. If this valve relaxes abnormally or it weakens, stomach acid can flow back up (reflux) into your esophagus.

Acid reflux is common. Most people experience the condition on occasion, often due to overeating. When it occurs frequently — at least twice each week — or it interferes with your daily life, you may have gastroesophageal reflux disease (GERD).

GERD is a chronic digestive disease caused by frequent acid reflux that irritates and inflames the lining of the esophagus. Over time, the inflammation can erode the lining, causing complications such as bleeding, esophageal narrowing, or a precancerous condition called Barrett’s esophagus.

Conditions that can increase your risk of GERD include a hiatal hernia, obesity, pregnancy, smoking, asthma, diabetes, and delayed stomach emptying.

SYMPTOM

A burning sensation in your chest (heartburn), sometimes spreading to your throat, along with a sour taste in your mouth

• Regurgitation of food or a sour liquid (acid reflux)
• Chest pain
• Difficulty swallowing
• Dry cough
• Hoarseness or sore throat
• The sensation of a lump in your throat

WHAT TESTS TO EXPECT

A diagnosis of GERD can sometimes be made based on symptoms alone. Other times, certain tests may be needed before a diagnosis is made.

Types
Tests used to diagnose GERD include the following:

• Acid tests. Ambulatory acid (pH) probe tests use a device placed in your esophagus to measure acid for 24 hours. It identifies when, and for how long, stomach acid regurgitates into your esophagus.
• Upper digestive system X-ray. Sometimes called a barium swallow, or upper GI series, this test involves drinking a chalky liquid that coats and fills the inside lining of your digestive tract before X-rays are taken. The coating allows your doctor to see a silhouette of your esophagus, stomach, and upper intestine.
• Endoscopy. During this procedure, your doctor inserts a catheter equipped with a light and camera (endoscope) down your throat to view your esophagus and esophageal sphincter. A sample of tissue (biopsy) may be taken for further testing.
• Esophageal motility test. It measures movement and pressure in the esophagus. For the test, a catheter is threaded through your nose and into your esophagus.

TREATMENT

Treatment of GERD usually begins with over-the-counter products that control acid. If you don’t experience relief within a few weeks, your doctor may recommend other treatments, including medications or surgery.

• Antacids, medications to reduce acid production, medications that stop acid production.
• Surgery. Surgical options are rarely needed because medications are often effective.

LIFESTYLE

To help reduce symptoms of GERD:

• Maintain a healthy weight. Excess pounds put pressure on your abdomen, pushing on your stomach and causing acid to back up into your esophagus. If you’re overweight, try to lose weight.
• Avoid foods and drinks that trigger heartburn. Common triggers include fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine.
• Eat smaller meals. Overeating can trigger symptoms.
• Don’t lie down after a meal. Wait at least three hours after eating.
• Adjust your bed. Place blocks under the top legs so your head is elevated. Insert a wedge between your mattress and box spring.

Excerpt From: The Mayo Clinic. “Mayo Clinic A to Z Health Guide”.