Gastroesophageal reflux disease is a commonly diagnosed chronic disease that occurs when stomach contents flow back up into the esophagus. Symptoms may appear as chest pain, sore throat, bad breath, and nausea. Diagnosis of GERD may require endoscopy, pH testing, digestive x-rays, esophageal muscle testing, or other methods. Depending on the severity of your symptoms, your doctor may recommend medication or surgical treatment. Lifestyle changes to your diet and eating habits can help reduce the incidence of gastroesophageal reflux disease. Gastroesophageal reflux disease (GERD) is a chronic disease in which stomach contents sometimes flow back up into the esophagus, or tube that carries food from the throat to the stomach. Doctors may also use the following names for gastroesophageal reflux disease: e60dc2a1-f33c-4a05-9b50-8e3e8e59762963867208-61c2-45b1-851b-974f938ad79e acid indigestion acid reflux acid reflux heartburn Reflux or atypical reflux Gastroesophageal reflux disease can interfere with everyday life, but most people can reduce symptoms with lifestyle changes such as diet, home remedies, and medical care. e60dc2a1-f33c-4a05-9b50-8e3e8e5976290331a913-7314-47f4-a597-489e557b2bcf Resources We Trust Mayo Clinic: Gastroesophageal Reflux Disease (GERD) Cleveland Clinic: Acid Reflux and GERDA Academy of Nutrition and Dietetics: Gastroesophageal Reflux American Gastroenterological Association: Patient Centers: Gastroesophageal Reflux Disease (GERD)National Institute of Diabetes and Digestive and Kidney Diseases: Gastroesophageal Reflux (GER & GERD) Complications Complications of GERD Usually, GERD is not immediately life-threatening, but it can cause symptoms such as: Complications below: e60dc2a1-f33c-4a05-9b50-8e3e8e597629fc26edcb-9724-40bb-9132-f590b 87bd0e3e60dc2a1-f33c-4a05-9b50-8e3e8e59762923fe1296-8374-4377-9e2e-7a5068518aa3 Esophageal Stricture This is a narrowing of the esophagus that occurs when scar tissue builds up due to damage from stomach acid. This condition, also known as peptic stricture, can cause problems with swallowing. Esophageal Ulcer This is an open ulcer in the esophagus caused by tissue damage from stomach acid. It can cause pain, bleeding, and difficulty swallowing. Barrett’s esophagus This is a precancerous condition in which the lining of the esophagus changes to resemble the lining of the intestines. Barrett’s esophagus increases the risk of esophageal cancer by approximately 30 times. Esophageal Cancer r This cancer can develop from years of untreated gastroesophageal reflux disease. Causes and Risk Factors Causes and Risk Factors for Gastroesophageal Reflux Disease Stomach acid helps digest food. When that acid flows into your esophagus, it can cause inflammation and cause symptoms of gastroesophageal reflux disease. An area of the esophagus called the lower esophageal sphincter (LES) acts as a valve between the stomach and esophagus. e60dc2a1-f33c-4a05-9b50-8e3e8e597629699345a5-8392-4efc-8afc-48be8f17770e Gastroesophageal reflux disease occurs when the LES relaxes and opens when it shouldn’t. This allows stomach contents to flow back into the esophagus. e60dc2a1-f33c-4a05-9b50-8e3e8e597629a696a0de-ab81-45f5-bb7d-666e96cdbb0a “The role of the lower esophageal sphincter is to restrict stomach acid to the stomach,” says Chaudhry. “However, there are a variety of conditions that can cause it to loosen.” These include: e60dc2a1-f33c-4a05-9b50-8e3e8e597629ee0469c1-53c4-48eb-aa84-00969a5d69dc Eating large meals Eating certain foods that are high in fat or fried foods Increased pressure on the abdomen due to being overweight, obese, or pregnant Side effects from certain medications such as aspirin Smoking If you have a hiatal hernia, the opening in your diaphragm allows the top of your stomach to move into your chest. This reduces the pressure within the esophageal sphincter. Being pregnant is also a major risk factor for gastroesophageal reflux disease due to increased pressure on the abdomen and hormonal changes. Some pregnant women experience heartburn on a daily basis. e60dc2a1-f33c-4a05-9b50-8e3e8e5976290cf68229-722b-4272-a4f5-4a256f541936 There may be other causes or risk factors. Including: e60dc2a1-f33c-4a05-9b50-8e3e8e5976293c45258b-a3b6-42d9-9b39-b24d7091645ae60dc2a1-f33c-4a05-9b50-8e3e8e59 76292b3a59dd-6bb5-4c65-896a-10603fe3b98de60dc2a1-f33c-4a05-9b50-8e3e8e5976299ca4cc8a-b3ff-4522-aad1-75373cf93be3Consumption of alcoholic, caffeinated, or carbonated beverages Eating certain foods, such as chocolate, citrus fruits, onions, peppermint, tomatoes, and spicy or fried foods Eating large meals Eating just before bedtime Lying down immediately after eating Taking certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and certain medications for asthma, high blood pressure, allergies, depression, sleep disorders, and pain Lifestyle changes and prevention Lifestyle changes and prevention of gastroesophageal reflux disease Certain lifestyle changes, including dietary changes, may help reduce the frequency of gastroesophageal reflux disease episodes. Below: e60dc2a1-f33c-4a05-9b50-8e3e8e59762991480b60-d4f4-4674-a889-f621655 a4623e60dc2a1-f33c-4a05-9b50-8e3e8e597629d19c59a2-0080-4681-b22f-d094684ae7e0 Avoid foods and drinks that can trigger gastroesophageal reflux disease, such as alcohol, caffeine, fatty and spicy foods, peppermint, citrus fruits, tomatoes, and carbonated drinks. Sit up straight during meals Eat at least 3 hours before bedtime Maintain a healthy weight Eat food slowly Don’t smoke Don’t wear tight-fitting clothes Don’t lie down after eating Elevate the head of your bed It may also be helpful to keep a diary of the foods that trigger your gastroesophageal reflux symptoms and detail your symptoms. healthcare provider. We will discuss a personalized approach to prevent future episodes. e60dc2a1-f33c-4a05-9b50-8e3e8e5976293239955c-554e-4946-bcf6-2d04f49b4374 GERD Signs and Symptoms “GERD is becoming an increasingly individualized disease,” doctors say. Dr. Abraham Kahn is a gastroenterologist and director of the Center for Esophageal Health at NYU Langone Health in New York City. Not all patients with gastroesophageal reflux disease have the same underlying causes, symptoms, or degree of damage to the esophagus or aerodigestive tract, he says. Still, there are some typical signs of gastroesophageal reflux disease. The most common symptom of GERD is frequent heartburn. This is a painful, burning sensation in the center of your chest. “Typically, if your heartburn is mild and occurs less than twice a week, it’s considered mild gastroesophageal reflux disease,” says Dr. Saleem Chaudhry, a gastroenterologist at University Hospital in Westlake, Ohio. “If you have symptoms more than once a week and are concerned about inflammation of your esophagus, you may have moderate or severe gastroesophageal reflux disease.” Depending on where in your esophagus or digestive tract the acid causes problems, other symptoms of gastroesophageal reflux disease include: e60dc2a1-f33c-4a05-9b50-8e3e8e597629defe94ed-e8c3-4566-b155-fd34d6a3397a Chest pain Regurgitation of stomach contents Cough or hoarseness Severe breathing Nausea and vomiting Sore throat or irritation of the esophagus Diagnosis GERD How is it diagnosed? The diagnosis of gastroesophageal reflux disease is primarily based on the symptoms and their frequency. There are no hard and fast rules as to how often it should occur. “While some epidemiological studies suggest that clinically significant symptoms occur at least twice a week, some studies suggest that patients with gastroesophageal reflux disease only experience symptoms about once a month,” Kahn says. Your doctor will work with you to determine if you have gastroesophageal reflux disease. Formal diagnostic tests for gastroesophageal reflux disease include: e60dc2a1-f33c-4a05-9b50-8e3e8e597629c3059448-b327-4f9c-a6f9-8e7ae67101ef Upper endoscopy In this test, your doctor inserts a thin tube with a light and camera attached to your throat. This allows us to examine your esophagus and stomach to detect inflammation and other complications. Portable Acid (pH) Probe Test This test involves placing a probe in your esophagus for 24 hours to measure when (and for how long) stomach acid flows back up into your esophagus. The monitor is connected to a small computer worn on the waist and may be a thin tube (called a catheter) that is passed through the nose and into the esophagus. In some cases, the monitor is a clip inserted into the esophagus during the endoscopy and passed in the stool after two days. Esophageal manometry This procedure measures muscle contractions during swallowing. This will help your doctor determine whether your symptoms are due to sphincter weakness. This is often done when the probe is in place for 24 hours. Upper digestive system x-ray This test, taken after you drink a chalky liquid, allows your doctor to see the silhouette of your esophagus, stomach, and upper intestines. You may also be asked to swallow a Valium tablet to check for strictures in the esophagus or other conditions such as hiatal hernias or ulcers. Prognosis How long does gastroesophageal reflux disease last?The burning sensation in the chest associated with gastroesophageal reflux disease can last from minutes to hours. Although occasional heartburn is normal, heartburn associated with gastroesophageal reflux disease is regular or severe. e60dc2a1-f33c-4a05-9b50-8e3e8e597629ec570db3-a90e-4205-8c10-b231784529a5 Generally, heartburn related to gastroesophageal reflux disease may occur more than once a week, or once or once a week. Khan said it happens twice a month, but it recurs for several years. But again, severity and frequency vary from person to person. e60dc2a1-f33c-4a05-9b50-8e3e8e597629f5f2698f-c44e-401a-adbc-1697513e6c97 The length of time a person survives with gastroesophageal reflux disease also varies greatly from person to person. “Some patients can reverse the triggers that cause gastroesophageal reflux disease by adjusting their diet,” Kahn says. “If you are overweight, some people need to lose weight to change pressure changes in the upper gastrointestinal tract and reverse the cause of reflux. However, some people may not be able to significantly reverse their reflux, even with the right diet and lifestyle for gastroesophageal reflux disease.” Treatment and Medication Options GERD Treatment and Medication Options Your doctor may recommend different treatments for GERD. Often the first thing recommended is a lifestyle change. This includes eliminating or avoiding certain foods, eating smaller portions, and staying upright for several hours after eating. e60dc2a1-f33c-4a05-9b50-8e3e8e597629a9763758-fb47-4a7a-a782-07b5984b7df6 Antacids These neutralize stomach acid and provide quick and mild symptom relief. Overuse of antacids can cause side effects such as diarrhea, constipation, and kidney problems. H-2 receptor blockers These reduce acid production and provide relief for longer than antacids, but they may not work as quickly. These can reduce acid production from the stomach for up to 12 hours. Proton pump inhibitors called PPIs also suppress stomach acid and are most closely associated with healing esophageal inflammation caused by reflux. If you don’t see much improvement with OTC medications, your doctor may prescribe prescription-strength versions of H-2 receptor antagonists or PPIs. One commonly used drug is Reglan (metoclopramide), which can come with a number of side effects. Another newly introduced drug, vonoprazan (Voquenza), is FDA-approved for gastroesophageal reflux disease when PPI drugs are ineffective. If you have gastroesophageal reflux disease, you may be a candidate for surgery. Surgical options to treat gastroesophageal reflux disease include: e60dc2a1-f33c-4a05-9b50-8e3e8e597629241402d2-4285-4de6-accd-12adb8247b8e Fundoplication In this minimally invasive surgery, the surgeon stitches the top of the stomach around the esophagus. This puts pressure on the lower end of the esophagus and prevents reflux. LINX Device Another minimally invasive procedure involves wrapping a ring of small magnetic beads around the area where the stomach and esophagus meet. The magnetic attraction between the beads is strong enough to prevent backflow, but weak enough to allow food to pass through. Transoral Incisionless Fundoplication (TIF) This new procedure uses a nonsurgical approach to tighten the lower esophagus. TIF is performed using an endoscope inserted through the mouth and does not require a surgical incision.
