Gastroesophageal Reflux Disease (GERD)

By:    Published: February 23, 2012

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If you don’t feel well after eating, it’s something that you shouldn’t overlook. In some cases, feeling chest pain, heartburn or other uncomfortable symptoms after eating could be sign of something serious, such as gastroesophageal reflux disease (GERD). This condition can be treated, but it’s important to be aware of the signs and symptoms since there are potential complications associated with GERD.

Definition

Gastroesophageal reflux disease (commonly known as GERD) is a chronic digestive disease. The condition occurs when stomach acid flows back up from the stomach into the esophagus. In some cases, bile may flow into the esophagus as well. Many of the uncomfortable and painful signs and symptoms of GERD are caused by the backwash of acid irritating the lining of the esophagus.

Acid reflux is sometimes confused with GERD because the conditions are very similar. With acid reflux, the same symptoms occur – stomach acid flows up into the esophagus. However, GERD is a more severe form of this condition that also includes other symptoms, such as heartburn.

Symptoms

There are several common symptoms of GERD, including:

  • Acid reflux (regurgitating food or sour liquid)
  • Dry cough
  • Chest pain
  • Heartburn (burning feel in the chest and, in some cases, the throat)
  • A sour taste in the mouth
  • Difficulty swallowing
  • Feeling as though there is a lump in the throat
  • Feeling as though there is food stuck behind the breastbone
  • Nausea after eating
  • Hiccups
  • Sore throat
  • Hoarseness or changes in the voice

It’s important to note that the frequency and intensity of these symptoms may be an indicator of whether a person has GERD. In general, these symptoms are either frequent or severe in those who have GERD.

Causes And Risk Factors

The main cause of GERD is the chronic failure of the lower esophageal sphincter (LES) to close after a person has eaten. When this ring of muscle fibers doesn’t close correctly, the food can leak back into the esophagus along with stomach acid or bile (otherwise known as acid reflux). GERD occurs when someone’s LES continues to fail in preventing acid reflux from occurring and it becomes a chronic problem. Symptoms like sore throat and difficulty swallowing can occur as a result of the continual irritation of the esophagus by stomach acid.

There are several key risk factors which increase the chances of an individual having GERD. Those risk factors include:

  • Obesity
  • Pregnancy
  • Smoking
  • Scleroderma (a connective tissue disorder)
  • Hiatal hernia (when the stomach moves above the diaphragm)
  • Asthma
  • Diabetes
  • Zollinger-Ellison syndrome
  • Delayed stomach emptying
  • Taking certain medications, such as beta-blockers, tricyclic antidepressants, progestin, anticholinergics, etc.

Prevention

It’s important to help prevent this disease from developing since it can lead to serious complications, including esophageal ulcers and an increased risk of esophageal cancer. Some of the best ways to prevent GERD are to make the following lifestyle changes, if applicable:

  • Maintain a healthy weight: Obesity is a leading cause of GERD because too much weight adds pressure to the abdomen and increasing the risk of acid reflux occurring. Those who need to lose weight should aim to lose 1 to 2 pounds a week until they have reached their target weight.
  • Avoid certain foods and drinks: Some food and drinks trigger heartburn and increase your risk of developing GERD. Chocolate, mint, garlic, onion, alcohol, tomato sauce, caffeinated drinks and fatty and fried food are all common triggers. Pay attention to what triggers heartburn for you personally since some people may have different triggers than others. (For more information, see 10 Foods To Avoid If You Suffer From Heartburn.)
  • Eat smaller meals: By avoiding overeating, you can decrease the risk of GERD developing.
  • Don’t wear tight clothes: When your clothes fit tightly, it can add pressure to your abdomen and make it more likely that acid reflux will occur.
  • Quit smoking: If you smoke, your lower esophageal sphincter is less likely to function properly, increasing your risk for GERD.
  • Don’t lie down after eating: Try to wait for at least three hours before lying down or going to bed.
  • Elevate the head of your bed: Many people are more likely to experience heartburn at night or when they go to bed. To counteract this, raise the feet of the bed under your head by about 6 to 9 inches. You can also purchase special wedges which can be placed between the mattress and the box spring.
  • Avoid certain medications: In addition to the medications mentioned in the causes section, you should also avoid taking aspirin, ibuprofen and naproxen if you can.

Treatment

Most doctors will try to first treat GERD by making the lifestyle changes described above. In addition to those adjustments, patients with GERD can take certain over-the-counter treatments to help control their symptoms, including:

  • Antacids: These neutralize stomach acids to provide relief for heartburn. However, constipation and diarrhea are fairly common side effects.
  • Medications to reduce acid production: These medications are called H-2 receptor blockers, and examples include ranitidine (Zantac) and famotidine (Pepcid AC). These may also be available in prescription form.
  • Medications to block acid production: These medications are called proton pump inhibitors and may also help the esophagus to heal. Examples include lansoprazole (Prevacid) and omeprazole (Prilosec). These may also be available in prescription form.
  • Medications to strengthen the lower esophageal sphincter: These medications help the stomach empty faster and tighter the valve between the esophagus and the stomach. However, side effects like depression, anxiety and fatigue may prevent some individuals from using them.

If medications and lifestyle changes are not effective in treating GERD, more invasive procedures may be required. Common strategies include performing surgery to either reinforce the lower esophageal sphincter or to create a barrier to prevent stomach acid backup. There is also a newer procedure to form scar tissue in the esophagus which may be helpful for those with GERD.

Sources:

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