Gastroesophageal Reflux Disease (GERD)

Gastroesophageal reflux disease, or GERD, is a chronic condition that occurs when the contents of the stomach flow upwards into the esophagus. This backward flow is a mechanical problem with the valve in the bottom of the esophagus that results in symptoms like heartburn, indigestion, and regurgitation and can lead to damage of the esophageal tissues. It is one of the most common gastrointestinal diseases and an estimated 20% of adults in the United States have GERD.

Symptoms

Symptoms of GERD can include:

Heartburn – burning feeling in the chest
Regurgitation – backwashing of acid, food, or liquid into the throat after eating
Nausea or loss of appetite – may feel like food is not digesting
Sore throat – may cause a lump-like feeling in the throat or like it’s hard to swallow
Non-cardiac chest pain – non-burning pain in the esophagus caused by triggering nerves
Asthma symptoms – chronic coughing, wheezing, and shortness of breath

GERD symptoms may be worse at night or when lying down, after a large or fatty meal, after bending over, or after smoking or drinking alcohol.

Risk Factors

Some conditions can cause or put people more at risk for GERD and include:

Pregnancy
Obesity
Smoking
Presence of a hiatal hernia
Birth defects such as esophageal atresia
Connective tissue diseases such as scleroderma
Prior chest or upper abdominal surgery
Medications such as benzodiazepines, calcium channel blockers, tricyclic antidepressants, NSAIDs (such as ibuprofen or aspirin), theophylline, and hormone therapy for menopause

Certain foods can increase stomach acid or relax the lower esophageal sphincter (the valve at the bottom of the esophagus), making GERD more likely. Try to avoid:

Coffee, tea, and cola drinks (with or without caffeine)
Carbonated drinks
Fatty or spicy foods
Mint or chocolate
Onions and tomatoes
Other foods that cause symptoms

When to Seek Care

People experiencing acid reflux or heartburn frequently should have an evaluation by a medical provider since GERD can impact a person’s quality of life and result in serious complications.

Complications

Possible complications from GERD include esophagitis (inflammation in the lining of the esophagus), Barrett’s esophagus (intestinal metaplasia – tissues of the esophagus change to look like the intestinal lining), esophageal stricture (scar tissue formation causing esophageal narrowing), laryngopharyngeal reflux (reflux into the throat), and asthma (worsening of existing asthma or development of asthma-like symptoms in people without existing respiratory disease).

Treatment

Some people can reduce GERD with lifestyle adjustments like changing their eating habits, reducing alcohol and tobacco use, and losing weight. Medications are often recommended to reduce stomach acid and lessen symptoms. Over the counter medications such as antacids or alginates may provide some relief, but healthcare providers can provide prescription medications for GERD including histamine receptor blockers and proton pump inhibitors.

Depending on the severity, GERD can continue to cause complications despite taking medications, requiring additional diagnostic testing and/or surgical intervention by a gastroenterology specialist. People can help manage their GERD at home by eating smaller meals, eating dinner earlier, sleeping on their left side, reducing abdominal pressure by wearing loose-fitting clothes or losing weight, and avoiding smoking and alcohol.