Gastroesophageal reflux disease, or GERD, occurs when the lower esophageal sphincter (LES) does not close properly, and stomach contents splash back, or reflux, into the esophagus.
The LES is a ring of muscle at the bottom of the esophagus that acts like a camera shutter between the esophagus and stomach.
The esophagus carries food from the mouth to the stomach.
When refluxed stomach acid touches the lining of the esophagus, it causes a burning sensation in the chest or throat called heartburn.
The fluid may even be tasted in the back of the mouth, and this is called acid indigestion.
Occasional heartburn is common but does not necessarily mean one has GERD.
Heartburn that occurs more than twice a week may be considered GERD, which can eventually lead to more serious health problems.
What Are the Symptoms of GERD? The main symptoms are persistent heartburn and acid regurgitation.
Some people have GERD without heartburn.
Instead, they experience pain in the chest, hoarseness in the morning, or trouble swallowing.
You may feel like you have food stuck in your throat or like you are choking or your throat is tight.
GERD can also cause a dry cough and bad breath.
What Causes GERD? No one knows why people get GERD.
A hiatal hernia may contribute.
A hiatal hernia occurs when the upper part of the stomach is above the diaphragm, the muscle wall that separates the stomach from the chest.
The diaphragm helps the LES keep acid from coming up into the esophagus.
When a hiatal hernia is present, it is easier for the acid to come up.
In this way, a hiatal hernia can cause reflux.
A hiatal hernia can happen in people of any age; many otherwise healthy people over 50 have a small one.
alcohol use
Also, certain foods can be associated with reflux events, including :
citrus fruits
How Is GERD Treated?
Lifestyle Changes :
If you smoke, stop.
Your doctor may recommend over-the-counter antacids, which you can buy without a prescription, or medications that stop acid production or help the muscles that empty your stomach.
What if Symptoms Persist?
If your heartburn does not improve with lifestyle changes or drugs, you may need additional tests.
A barium swallow radiograph uses x rays to help spot abnormalities such as a hiatal hernia and severe inflammation of the esophagus. With this test, you drink a solution and then x rays are taken. Mild irritation will not appear on this test, although narrowing of the esophagus--called strictures--ulcers, hiatal hernia, and other problems will.
Upper endoscopy is more accurate than a barium swallow radiograph and may be performed in a hospital or a doctor's office. The doctor will spray your throat to numb it and slide down a thin, flexible plastic tube called an endoscope. A tiny camera in the endoscope allows the doctor to see the surface of the esophagus and to search for abnormalities. If you have had moderate to severe symptoms and this procedure reveals injury to the esophagus, usually no other tests are needed to confirm GERD.
The doctor may use tiny tweezers (forceps) in the endoscope to remove a small piece of tissue for biopsy. A biopsy viewed under a microscope can reveal damage caused by acid reflux and rule out other problems if no infecting organisms or abnormal growths are found.
In an ambulatory pH monitoring examination, the doctor puts a tiny tube into the esophagus that will stay there for 24 hours. While you go about your normal activities, it measures the amount of and when acid comes up into your esophagus. This test is useful in people with GERD symptoms but no esophageal damage. The procedure is also helpful in detecting whether respiratory symptoms, including wheezing and coughing, are triggered by reflux.
Surgery is an option when medicine and lifestyle changes do not work.
What Are the Long-Term Complications of GERD? Sometimes GERD can cause serious complications.
Inflammation of the esophagus from stomach acid causes bleeding or ulcers.
In addition, scars from tissue damage can narrow the esophagus and make swallowing difficult.
Some people develop Barrett's esophagus, where cells in the esophageal lining take on an abnormal shape and color, which over time can lead to cancer.
Also, studies have shown that asthma, chronic cough, and pulmonary fibrosis may be aggravated or even caused by GERD.
Points To Remember Heartburn, also called acid indigestion, is the most common symptom of GERD. Anyone experiencing heartburn twice a week or more may have GERD.
You can have GERD without having heartburn. Your symptoms could be excessive clearing of the throat, problems swallowing, the feeling that food is stuck in your throat, burning in the mouth, or pain in the chest.
In infants and children, GERD may cause repeated vomiting, coughing, and other respiratory problems.
Most babies grow out of GERD by their first birthday.
If you have been using antacids for more than 2 weeks, it is time to see a doctor.
Most doctors can treat GERD. Or you may want to visit an internist--a doctor who specializes in internal medicine--or a gastroenterologist--a doctor who treats diseases of the stomach and intestines.
Doctors usually recommend lifestyle and dietary changes to relieve heartburn.
Many people with GERD also need medication or surgery.
Other factors that may contribute to GERD include :
overweight
pregnancy
smoking
chocolate
drinks with caffeine
fatty and fried foods
garlic and onions
mint flavorings
spicy foods
tomato-based foods, like spaghetti sauce, chili, and pizza
If you have had heartburn or any of the other symptoms for a while, you should see your doctor.
You may want to visit an internist, a doctor who specializes in internal medicine, or a gastroenterologist, a doctor who treats diseases of the stomach and intestines.
Depending on how severe your GERD is, treatment may involve one or more of the following lifestyle changes and medications or surgery.
Do not drink alcohol.
Lose weight if needed.
Eat small meals.
Wear loose-fitting clothes.
Avoid lying down for 3 hours after a meal.
Raise the head of your bed 6 to 8 inches by putting blocks of wood under the bedposts--just using extra pillows will not help.
Medications
Paralumun