Overview
Gastroesophageal reflux disease (GERD) is a condition that occurs when stomach acid repeatedly flows back into the tube connecting your mouth and stomach (esophagus). This backwash of acid can irritate the lining of your esophagus, causing common symptoms such as heartburn, backwash of food or sour liquid, upper abdominal or chest pain, trouble swallowing, and a sensation of a lump in your throat. GERD is often managed with lifestyle changes and medications, and some may require surgery to ease symptoms. It is a complication of gastroesophageal reflux, which is the continuous backflow of acid into the esophagus.
Understanding the disease
Symptoms
The symptoms of gastroesophageal reflux disease (GERD) include a burning sensation in your chest (heartburn), usually after eating, which might be worse at night or while lying down. Other common signs and symptoms of GERD include backwash (regurgitation) of food or sour liquid, upper abdominal or chest pain, trouble swallowing (dysphagia), and sensation of a lump in your throat. If you have nighttime acid reflux, you might also experience an ongoing cough, inflammation of the vocal cords (laryngitis), and new or worsening asthma. It's important to discuss your digestive health with your doctor regarding the possibility of GERD if you experience these symptoms frequently or severely.
Risk Factors
Risk factors for developing GERD include obesity, bulging of the top of the stomach up above the diaphragm (hiatal hernia), pregnancy, connective tissue disorders such as scleroderma, delayed stomach emptying, smoking, eating large meals or eating late at night, eating certain foods such as fatty or fried foods, and drinking certain beverages such as alcohol or coffee. Taking certain medications, such as aspirin, can also aggravate acid reflux. Additionally, having a family history of Barrett's esophagus or esophageal cancer and being male, white, and over 50 years old can increase the risk of developing Barrett's esophagus, which is associated with chronic acid reflux.
Development
Gastroesophageal reflux disease (GERD) develops when the lower esophageal sphincter (LES) doesn't close properly, allowing stomach acid to flow back into the esophagus. This can occur due to a hiatal hernia, where the top part of the stomach moves above the diaphragm, or other factors like obesity, pregnancy, or connective tissue disorders. Chronic inflammation in the esophagus can lead to complications such as esophagitis or Barrett's esophagus.
Assessment and Diagnosis
Triage
If you suspect GERD, you should see a doctor if you have had persistent heartburn, regurgitation, or acid reflux symptoms for more than five years. Additionally, seek immediate help if you experience chest pain, difficulty swallowing, vomiting red blood or blood that looks like coffee grounds, passing black, tarry or bloody stools, unintentional weight loss, or an ongoing cough.
Diagnosis
To diagnose Gastroesophageal Reflux Disease (GERD), a healthcare provider may use a combination of a patient's medical history, signs and symptoms, and physical examination. Additional tests that may be recommended to confirm the diagnosis or check for complications include upper endoscopy and tests for H. pylori, such as a stool test or breath test. For GERD diagnosis specifically, an upper endoscopy may be performed to examine the esophagus and stomach, and a biopsy may be taken for further examination.
Management and Treatment
Home Remedies
Home remedies for GERD or acid reflux may include:
- Lifestyle changes: Maintain a healthy weight, wear loose-fitting clothing, avoid lying down after eating, elevate the head of your bed by 6 inches, and avoid smoking and alcohol.
- Diet modifications: Avoid trigger foods, such as fatty or fried foods, chocolate, citrus fruits, tomato-based products, spicy or acidic foods, and carbonated beverages. Eat smaller, more frequent meals, and stay away from late-night meals.
- Elevate the head of your bed: By raising the head of your bed by 6-8 inches, gravity can help prevent acid reflux while sleeping.
- Over-the-counter antacids: Over-the-counter antacids, such as aluminum hydroxide, magnesium hydroxide, or calcium carbonate, can neutralize stomach acid and provide relief from symptoms. However, consult a healthcare professional before taking any medication, especially if you are pregnant or have a medical condition.
- Propping up pillows: Sleeping with extra pillows can help keep your upper body at an angle, which can prevent acid from flowing back into your esophagus while sleeping. Remember, home remedies may help relieve symptoms, but it's essential to consult a healthcare professional for proper diagnosis and treatment, especially if your symptoms persist or worsen.
Treatment
To treat GERD, you can try the following approaches:
- Lifestyle changes: Maintain a healthy weight, eliminate trigger foods such as chocolate, coffee, alcohol, and mint, stop smoking, and elevate the head of your bed by placing wooden blocks under it.
- Medications: Over-the-counter medications like antacids (Maalox, Mylanta), H-2-receptor blockers (cimetidine
Preparing for medical consultation
To prepare for an appointment for GERD, consider the following steps:
- Be aware of any pre-appointment restrictions: At the time you make the appointment, ask if there are any specific restrictions you should follow before the appointment, such as avoiding certain foods or medications.
- Write down your symptoms: Record any symptoms you are experiencing, including the frequency, severity, and any triggers that may worsen your GERD symptoms.
- Make a list of all your medications, vitamins or supplements: This will help your doctor understand your current health status and any potential interactions with medications.
- Write down key personal information: Include any major stresses or recent life changes that may be contributing to your GERD symptoms.
- Note what improves or worsens your symptoms: Keep track of which foods, medications, or other factors seem to improve or worsen your GERD symptoms.
- Consider taking a family member or friend along: Having someone with you can help you remember important details and provide additional support during the appointment. Remember to discuss your GERD symptoms and concerns with your doctor during the appointment, and follow their advice on managing and treating your condition.