GERD / Acid Reflux
What Is Gastroesophageal Reflux Disease?
Gastroesophageal reflux disease, also known as GERD or acid reflux, is a digestive disease. While many people experience acid reflux from time to time, GERD is a constant condition. During normal digestion, the ring of muscle between the esophagus and the stomach, the lower esophageal sphincter, opens to allow food to pass into the stomach. It also closes to prevent food and acidic stomach juices from flowing back into the esophagus.
Acid reflux occurs when the lower esophageal sphincter relaxes at the wrong time or has become weakened, allowing stomach acid to back up into your esophagus. This causes heartburn and irritation of the lining of your esophagus. If you have mild acid reflux at least twice weekly or moderate to severe acid reflux at least once a week, this is categorized as GERD.
Symptoms Of GERD
The severity of GERD depends on the degree of esophageal sphincter dysfunction. Symptoms can include:
- Heartburn after eating and at night
- Difficulty swallowing
- Chest pain
- Regurgitation of food or sour liquid
- The sensation of a lump in your throat
- A chronic cough
- New or worsening asthma
- Disrupted sleep
What Does Heartburn Feel Like?
Heartburn is the most common symptom of GERD. This feels like burning chest pain that begins behind your breastbone and moves upward to your neck and throat. There can be a sour, acidic taste as stomach acid moves upward. It is typical for the heartburn to be worse when lying down or bending over. This chest pain can be mistaken for the pain associated with heart disease, but exercise is often tied to heart disease pain, while heartburn usually doesn’t result from exertion.
Can Infants Have Acid Reflux?
Research has recently shown that GERD is more common in infants and children than was previously thought. This can be the cause of recurrent vomiting, coughing, and other early respiratory problems. In most cases, this reflux in babies is due to a poorly coordinated gastrointestinal tract. Most infants grow out of the condition by their first birthday as their digestive system matures.
GERD Risk Factors
These are conditions that can increase your risk of developing GERD:
- A hiatal hernia – bulging at the top of the stomach
- Delayed stomach emptying
- Connective tissue disorders
These lifestyle choices can aggravate acid reflux:
- Eating large meals
- Eating late at night
- Drinking alcohol or coffee
- Eating fatty or fried foods
- Taking certain medications, such as aspirin
What Foods Should I Avoid With GERD?
Certain foods trigger acid reflux in some people. If you have chronic acid reflux, you should avoid fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine.
What Lifestyle Changes Can Alleviate GERD?
- Lose weight: Extra weight puts pressure on your abdomen, pushing your stomach upwards and causing acid reflux
- Eat slowly and chew thoroughly: Put down your fork after every bite, and pick it up after you have fully chewed and swallowed that bite.
- Don’t lie down after eating: The habit of lying on the couch after eating allows acid reflux to occur. Wait at least three hours before lying down or going to bed.
- Elevate the head of your bed: If you regularly experience acid reflux while in bed, try elevating your head. You can do this by placing wood or blocks under the feet of the head of the bed, or by inserting a wedge between your mattress and box spring. Don’t do this with extra pillows, as that creates pressure on your neck and back.
- Stop smoking: Smoking is shown to relax the esophageal sphincter.
At Vanguard Gastroenterology, our physicians can usually diagnose GERD with a physical examination, but we may recommend certain procedures to confirm our diagnosis. Patients can have an upper endoscopy to examine the esophagus and stomach. We can check for any inflammation or take a tissue sample. An ambulatory acid probe test can also be used. Patients have a monitor placed in their esophagus to identify when stomach acid regurgitates there.
Additionally, patients can have an esophageal manometry which measures the rhythmic muscle contractions and the coordination and force exerted by your esophagus. Lastly, our staff may recommend an x-ray. A chalky liquid coats the inside lining of your digestive tract so the x-ray can provide a silhouette of the esophagus, stomach, and upper intestine.
GERD And Acid Reflux Treatment
Other than the lifestyle changes described above, at Vanguard Gastroenterology we often begin with over-the-counter medications. These include antacids such as Mylanta, medications to reduce acid production such as Pepcid AC and Zantac, and medications that block acid production and heal the esophagus such as Prevacid and Prilosec.
If these treatments don’t prove to be effective, our physicians will prescribe medications for GERD. These commonly include prescription-strength H-2-receptor blockers, prescription-strength proton pump inhibitors, and medication to strengthen the lower esophageal sphincter.
Surgery For Acid Reflux
GERD can usually be controlled with medication and lifestyle changes. However, the long-term use of medication can sometimes create its own problems. In some cases, surgery is a possibility to treat GERD. Surgical options include:
- Fundoplication: The top of the stomach around the lower esophageal sphincter is wrapped to tighten the muscle and prevent reflux. This is usually done with a laparoscope and is minimally invasive.
- LINX device: A ring made of tiny magnetic beads is wrapped around the area of the esophageal sphincter. The magnetic attraction between the beads is strong enough to keep the sphincter closed to keep acid from refluxing, but is weak enough to allow food to pass through.
What Can Result From Untreated GERD?
If your GERD is not addressed, the chronic inflammation can lead to these issues:
Narrowing of the esophagus: Continued stomach acid present in the lower esophagus causes scar tissue to form, which narrows the food passage and leads to problems swallowing.
An ulcer in the esophagus: Stomach acid can break down tissue in the esophagus, creating an open sore, which can bleed and make swallowing difficult.
Precancerous changes to the esophagus: Continued damage from acid can cause changes in the tissue lining the lower esophagus. These changes increase the risk of esophageal cancer.