Gastroesophageal reflux disease, commonly referred to as GERD, is a chronic digestive disorder that affects the lower esophageal sphincter (LES), the ring of muscle between the esophagus and stomach. When the LES is weak or relaxed, stomach contents can flow back into the esophagus, causing symptoms like heartburn, regurgitation, and difficulty swallowing.
Symptoms of GERD
The most common symptoms of GERD are:
- Heartburn: a burning sensation in the chest or throat that occurs when stomach acid flows back into the esophagus.
- Regurgitation: the feeling of stomach contents coming back up into the mouth.
- Difficulty swallowing: the sensation of food getting stuck in the throat or chest.
- Chest pain: a burning or stabbing sensation in the chest that may be confused with a heart attack.
- Dry cough: a persistent cough that may be caused by acid reflux into the airways.
- Hoarseness: a change in the voice caused by acid reflux into the larynx (voice box).
- Bad breath: a foul-smelling odor caused by the presence of stomach acid in the mouth.
These symptoms can range from mild to severe and may occur frequently or only occasionally. They may also be worse at night or after eating.
Diagnosis and Evaluation of GERD
If you suspect you may have GERD, it is important to see a healthcare provider for a proper diagnosis. They will take a thorough medical history, perform a physical examination, and may order one or more of the following tests to confirm the diagnosis:
- Esophageal pH monitoring: a test to measure the pH (acid level) in the esophagus over a 24-hour period.
- Upper endoscopy: a procedure in which a thin, flexible tube with a camera on the end is inserted through the mouth and into the esophagus to examine the inside of the esophagus and stomach.
- Barium swallow: a test in which a patient drinks a liquid containing barium (a chalky substance) and then has an X-ray taken to examine the esophagus and stomach.
Treatment of GERD
The treatment of GERD depends on the severity of the condition and the presence of complications. Mild cases may be managed with lifestyle changes and over-the-counter medications, while more severe cases may require prescription medications or surgical intervention.
Lifestyle Changes
Making lifestyle changes can help reduce the frequency and severity of GERD symptoms. These may include:
- Avoiding trigger foods and drinks: common trigger foods and drinks include fatty or fried foods, spicy foods, caffeine, alcohol, and tobacco.
- Eating smaller, more frequent meals: eating larger meals can increase the amount of acid in the stomach and put more pressure on the LES.
- Avoiding eating close to bedtime: lying down after eating can make it easier for stomach acid to flow back into the esophagus.
- Losing weight: carrying excess weight can increase the risk of GERD.
- Wearing loose-fitting clothing: tight clothing can put pressure on the abdomen and increase the risk of acid reflux.
Medications
Over-the-counter medications, such as antacids and acid reducers, can help relieve mild GERD symptoms. Antacids neutralize stomach acid and provide fast relief, while acid reducers work to decrease the production of stomach acid.