GERD
What is GERD?
GERD is a medical condition that occurs when a small amount of food or liquid from the stomach leaks backward, into the patient’s esophagus, instead of continuing down through gastrointestinal (GI tract). Patients who have GERD generally feel discomfort after eating or drinking, while content is being digested, and experience heartburn as a primary symptom. Occasionally, people can have other symptoms of GERD including chest pain, cough, hoarseness of the voice, or sour taste in their mouths. Sometimes GERD may worsen with position, especially laying flat on your back. The esophagus can also be damaged by reflux. GERD is an acronym for gastroesophageal reflux disease but has several different names—it is also known as peptic esophagitis, reflux esophagitis, chronic heartburn, dyspepsia and acid reflux disease.
What Causes GERD?
There is a fibrous muscle located between your esophagus and your stomach called the lower esophageal sphincter (LES). Its primary function is to close after food or liquid enters the stomach and prevent anything from moving back up the esophagus. If the lower esophageal sphincter muscle is malfunctioning or fails to close all the way, GERD occurs. GERD can also be related to increased acid production in the stomach, which is why the mainstay of medical treatment involves drugs that lower the acid produced.
You have a higher chance of being diagnosed with GERD if you have a hiatal hernia, which happens when the stomach is pushed up past the diaphragm. Obese patients, pregnant women and smokers also have increased risk. In some cases, patient’s taking medication for pregnancy, heart disease, asthma, high blood pressure, birth control, anxiety or depression may experience worse symptoms of GERD. Talk to your doctor before discontinuing any medication to “treat” GERD symptoms.
What Acid Reflux Symptoms Does GERD Trigger?
Almost all patients with GERD complain of pain behind and around the breastbone in their chests. This pain could result from heartburn, nausea or a feeling that food has lodged itself in that area of the body. It usually worsens when a patient eats or simple as the day goes on, especially at night or if the patient participates in physical activity. New onset of chest pain or pressure in the chest should not be ignored; however, since this can also be a symptoms of cardiac (or heart) disease and should be evaluated by a physician.
Other GERD symptoms also include food being regurgitated or brought back up the throat, coughing, hiccups and voice changes—although these occur less often. Patients sometimes find that they have trouble swallowing—a medical condition called dysphagia—and have sore throats, as well.
How is GERD Treated?
Usually, GERD symptoms can be controlled by simple heartburn remedies, such as avoiding certain foods that irritate your digestive system and taking acetaminophen with several glasses of water to relieve pain. Antacids after you eat and before you go to sleep may also be helpful, but may have side effects such as diarrhea and constipation for some patients. Drugs taken to treat GERD symptoms usually are taken long-term. People with GERD should also be tested for a treatable bacterium called Helicobacter pylori (or H.pylori).
If at-home remedies don’t work for you, there are endoscopy procedures that are thought to be therapeutic, such as EGD (upper endoscopy). Talk to a gastroenterologist (GI doctor) if you feel this may be an option for you.
Reviewed 12/29/2011 by David M. Nolan, M.D.
Diplomate of the American Board of Internal Medicine, 2011
Currently a Fellow of Gastroenterology, at UCI 2011-2014
