Gastroesophageal reflux disease, or its commonly used acronym, GERD, is also referred to simply as reflux. GERD occurs when stomach contents, often acidic, flows back into your esophagus. The reflux contents irritate the lining of your esophagus and cause symptoms. A little amount of reflux is normal and expected. However, sometimes people can have excessive reflux which can be bothersome and lead to other problems. It is when people have bothersome symptoms or have complications that we may have to address GERD with a combination of lifestyle, diet, medications, and/or procedures.
Symptoms may include:
Diagnosis of GERD is based on your symptoms; your physician may be able to suspect GERD based on frequent heartburn and other symptoms. If typical heartburn type symptoms resolve with medications such as proton pump inhibitors, then a diagnosis of GERD may be confirmed. However, we do need to make sure that the symptoms we think are related to GERD are from GERD and not another disease. Testing to either confirm there is not another problem or confirm there is reflux may be needed in the following situations:
GERD can also be diagnosed by an ambulatory (pH) probe test to monitor the amount of acid in your esophagus. Sometimes an upper endoscopy, motility test, radiology tests, or other evaluations are needed to exclude other diseases.
GERD is caused by frequent reflux episodes – the backup of stomach contents containing acid and sometimes bile into the esophagus. When you swallow, the lower esophageal sphincter, a circular band of muscle around the bottom part of your esophagus, relaxes to allow food and liquid to flow into your stomach; then it closes again. However, if this muscle is weak or ineffective, stomach acid can flow back up into your esophagus causing frequent heartburn. GERD may also occur more frequently in people who have a hiatal hernia (where part of the stomach comes up into the chest), delayed gastric emptying, or increased pressure in the abdomen (such as with pregnancy or obesity).
Management typically starts with diet and lifestyle changes. This may include both avoiding certain types of triggers that are associated with reflux (such as citrus, tomato-based, chocolates, caffeine, dairy, and alcohol) or maybe to minimize meals that stay in the stomach for a long time (large meals, heavy meals). Lifestyle modifications may include avoiding late-night meals, sleeping with the head and shoulders elevated, and losing weight. Medications that are acid reducing (H2 blockers) or acid-suppressing (proton pump inhibitors (PPI ) may help with symptoms by targeting the acid. Some patients may also benefit from an anti-reflux surgical procedure.
Please talk to your doctor or schedule a consultation at our Baylor Scott & White Center for Esophageal Diseases to determine what approach is best for you.