Gastroesophageal reflux disease (GERD)

Also known as: GERD

Topic Overview
This topic is about gastroesophageal reflux disease (GERD) in adults. For information on reflux in babies and children, see Gastroesophageal Reflux in Babies and Children. For information on reflux while pregnant, see Gastroesophageal Reflux Disease During Pregnancy. For information about occasional heartburn, see Heartburn.

What is gastroesophageal reflux disease (GERD)?
Normally when you swallow your food, it travels down the food pipe (esophagus) to a valve that opens to let the food pass into the stomach and then closes. With GERD, the valve doesn't close tightly enough. Stomach acid and juices flow from the stomach and back up (acid reflux) into the esophagus.

All people will occasionally experience acid reflux. The main symptoms of acid reflux include heartburn, regurgitation (bringing a small amount of food back up into the mouth) or dyspepsia (feeling bloated, burping). Eating too much or bending forward after eating sometimes causes this to happen. Occasional reflux is normally tolerated well and does not cause long-lasting problems.

Occasional reflux or feeling heartburn from time to time doesn't mean that you have GERD. GERD is severe or chronic reflux and the most common symptom is chronic heartburn. You should seek treatment experience constant or chronic heartburn because GERD can cause problems such as ulcers and damage to your esophagus.

What are the symptoms?
The main symptom of GERD is heartburn. It may feel like a burning, warmth, or pain just behind the breastbone. It is common to have symptoms at night when you're trying to sleep.

Other symptoms of GERD are not as well known and include:

  • Hoarseness, sore throat or laryngitis. In some cases, acid reflux enters the throat (pharynx) or the voice box (larynx), causing hoarseness or a sore throat.
  • Difficulty swallowing (dysphagia) or feeling as if there is a lump in your throat
  • Chronic dry cough, especially at night.
  • Habitual throat clearing.
  • Asthma. Several studies show a significant link between GERD and asthma. Treating GERD symptoms may relieve asthma symptoms.
  • Nausea after eating
  • Chronic bad breath
  • Earaches
  • Chest pain/discomfort

If you have pain behind your breastbone, it is important to see your doctor to make sure that it isn't caused by a problem with your heart. Pain from the heart usually feels like pressure, heaviness, weight, tightness, squeezing, discomfort, or a dull ache. It occurs most often after you are active.

How is GERD diagnosed and treated?
First, your doctor will do a physical exam and ask you questions about your health. You may or may not need further tests. If your symptoms are mild your doctor may prescribe over-the-counter medicines that reduce or block stomach acid. These include antacids (for example, Tums), H2 blockers (for example, Pepcid), and proton pump inhibitors (for example, Prilosec). Changing your diet, losing weight if needed, and making other lifestyle changes can also help.

Your doctor may recommend surgery if medicine doesn't work or if you can't take medicine because of the side effects. Fundoplication surgery strengthens the valve between the esophagus and the stomach. Fundoplication is usually performed by a general surgeon.

GERD is common in pregnant women. Lifestyle changes and antacids are usually tried first to treat pregnant women who have GERD. Antacids are safe to use for heartburn symptoms during pregnancy. If lifestyle changes and antacids don't help control your symptoms, talk to your doctor about using other medicines. Most of the time, symptoms get better after the baby is born.

How can you manage GERD?
Many people with GERD have it for the rest of their lives. You may need to take medicine for many years to help control the symptoms. But lifestyle changes may also help relieve your symptoms of GERD. Here are some things to try:

  • Change your eating habits. It’s best to eat several small meals instead of 2 or 3 large meals.
  • After you eat, wait 2 to 3 hours before you lie down.
  • Avoid late-night snacks.
  • Avoid chocolate, mint, and alcohol, which can make GERD worse because they relax the valve between the esophagus and the stomach.
  • Spicy foods, foods that have a lot of acid (like tomatoes and oranges), and coffee can make GERD symptoms worse in some people. If your symptoms are worse after you eat a certain food, you may want to stop eating that food to see if your symptoms get better.
  • Don't smoke or chew tobacco.
  • If you get heartburn at night, raise the head of your bed 6 inches (15 cm) to 8 inches (20 cm) by putting the frame on blocks or placing a foam wedge under the head of your mattress. (Adding extra pillows doesn't work.)
  • Don't wear tight clothing around your middle.
  • Lose weight if you need to. Losing just 5 to 10 pounds can help.

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