GERD (Gastroesophageal Reflux Disease)

Heartburn is a common condition. It often follows a binge at the buffet, or a stressful day at work. Heartburn can make you uncomfortable, and even disturb your sleep. But if you get heartburn more than twice a week, you may have a condition known as GERD.

GERD stands for gastroesophageal reflux disease. Gastroesophageal refers to your stomach and esophagus. The esophagus is the tube that carries food from your mouth down to your stomach. Reflux means to flow back. Gastroesophageal reflux is the return of stomach acid and food from your stomach back up your esophagus.

Symptoms

The most common symptom of GERD is heartburn. Heartburn is also known as acid indigestion. This refers to a burning feeling in your chest, which can move up into your throat. It often causes a bad taste in your mouth. It can last up to 2 hours, and is usually worse after eating. Lying down or bending over can also make GERD symptoms worse.

Occasional heartburn does not mean you have GERD. But heartburn more than twice a week may be GERD, and can lead to more serious health problems.

Causes

The burning feeling is caused by stomach acid moving into your esophagus. The lining of your stomach is designed to handle the acid. The lining of your esophagus is not.

At the end of the esophagus, there is a valve called your lower esophageal sphincter or L-E-S. The valve opens to let food move into your stomach, and then closes to keep it there.

If you have GERD, the L-E-S valve relaxes too often or for too long. This allows acid to move backwards from your stomach and up into your esophagus causing heartburn.

There are some things that can weaken the valve, and make reflux more likely. They include diabetes, pregnancy, and medications used to treat high blood pressure and heart conditions. Lifestyle factors that can contribute to GERD include drinking too much alcohol, overeating, being overweight, and smoking.

Diagnosis

To diagnose GERD, your healthcare provider will ask about your medical history and your symptoms. If your symptoms are severe or do not get better with treatment, you may have certain tests.

One of these tests is called an upper gastrointestinal or G-I series. This is a special X-ray that shows the esophagus, stomach, and upper part of the small intestine. The upper G-I series does not provide a lot of information about GERD.  But it can help to identify other problems that can cause similar pain.

Another test is called endoscopy. This procedure uses an endoscope, which is a thin, flexible tube with a light and a camera on the end. The scope is moved down through your mouth and throat into your esophagus. Your healthcare provider can then look at the L-E-S and esophagus. A small sample of tissue may be taken for testing.

Treatment

GERD is treated with lifestyle changes and medication. Lifestyle changes include weight loss if you are overweight, not lying down right after eating, quitting smoking, and avoiding certain foods and drinks. Not having alcohol or caffeine can help prevent symptoms. And avoiding the foods that cause symptoms will help. Common foods to avoid include fried, spicy, and fatty foods, plus acidic foods such as citrus fruits and tomatoes. You should also avoid peppermint, which causes the stomach to make more acid.

To help prevent reflux while you sleep, raise the head of your bed by 6 inches by placing blocks of wood or thick books under the legs.

Medication called antacids can also help stop heartburn. Many chewable and liquid antacids give quick relief. These make the stomach acid less acidic. Other drugs such as histamine-2 or H-2 blockers and proton pump inhibitors cause the stomach to make less acid. These are available over the counter and by prescription. Talk with your healthcare provider before you take any of these medications.

In severe cases that don’t get better with lifestyle changes and medications, surgery may be needed. Your healthcare provider can tell you more about the types of surgery that can help.

Things to Remember

  • Don’t lie down right after eating. Raise the head of your bed by placing woodblocks or thick books under the legs.
  • Avoid foods and drinks that can make heartburn worse.
  • Take antacid medications as your healthcare provider recommends.

Not all heartburn is GERD. Talk with your healthcare provider about your symptoms. Medications and some simple changes can help you feel better right away.

What We Have Learned

  1. Heartburn is caused by stomach acid in the esophagus. True or false?
    The answer is True. The acid burns the lining of the esophagus.

  2. Stomach acid backs up because of a weak valve. True or false?
    The answer is True. The L-E-S valve at the end of the esophagus does not stay closed as it should.

  3. Reflux means backing up. True or false?
    The answer is True. In GERD, stomach acid backs up into the esophagus.