fbpx

Gastroesophageal Reflux Disease Summary

Learn

Introduction

Gastroesophageal reflux disease (GERD) is a disease involving the stomach and esophagus. Reflux occurs when stomach content backs up into the esophagus. Stomach acid then burns the lining of the esophagus which causes heartburn.

GERD can be called many names such as:

  • acid reflux

  • acid regurgitation

  • reflux

  • acid indigestion

  • heartburn

Statistics

Having gastric reflux occasionally is normal. Having it three days a week for an extended period of time is more serious and can lead to additional health problems for the patient. If the reflux is frequent enough, it may indicate that a patient has GERD. Approximately 20 percent of people in the United States are affected with GERD.

People who are most predisposed to having GERD include:

  • pregnant women (especially in the third trimester)

  • overweight or obese people

  • cigarette smokers

Complications

Without treatment GERD can cause serious health problems. Below are some of the most common complications:

Esophagitis

Esophagitis is an inflammation of the esophagus. Patients who have had esophagitis for many years are at higher risk for cancer of the esophagus.

Esophageal Stricture

An esophageal stricture refers to a narrowing of the esophagus. This narrowing can lead to difficulty swallowing.

Barrett’s esophagus

Barrett’s esophagus is a precancerous condition that requires treatment. Barrett’s can turn into cancer of the esophagus in a small number of patients. Some of the treatments for Barrett’s are:

  • Changes in lifestyle such as: smoking, drinking alcohol and diet changes

  • Radiofrequency ablation (RFA)

  • Endoscopic mucosal resection (EMR)

  • Cryotherapy

Respiratory Problems

When stomach acids back up in the esophagus droplets of the acidic fluid can be inhaled into the lungs. When this happens a variety of complications with the respiratory system may occur including:

  • hoarseness

  • raspiness of the voice

  • laryngitis

  • chest congestion

  • persistent cough especially at night while laying down

  • asthma

  • wheezing

  • pneumonia

Causes

GERD is caused by a weakness of the lower esophageal sphincter. This sphincter normally closes tightly after swallowing preventing food and stomach acid from leaking out of the stomach. There are several reasons the esophageal sphincter may become weak.

  • Medications used to treat other health problems and diseases that can include:

    • narcotics

    • sedatives

    • calcium channel blockers

    • antihistamines

    • asthma medications

    • antidepressants​

    • ​obesity
    • pregnancy

  • smoking or second hand smoke

  • alcoholism

  • hiatal hernia

    • an opening in the diaphragm allowing the stomach to move up into the chest, which in turn lowers the pressure in the esophageal sphincter allowing it to relax

 

Signs and Symptoms

The most common symptom of GERD is frequent heartburn. The patient may complain of any of the following:

  • heartburn

  • painful feeling in the middle of the chest (behind the breast bone)

  • bad breath

  • nausea

  • problems swallowing or painful swallowing

  • wearing of the enamel on the teeth

  • respiratory problems

Diagnosis

Diagnosis may be made by patient history combined with symptoms and physical exam. The physician may order an endoscopy to rule out more serious causes of reflux if they are suspected.

 

Prevention

Making healthy choices can go a long way in avoiding gastritis. Some ways that patients may be able to improve their health include:

  • alcohol abstinence

  •  smoking cessation

  • avoiding unnecessary medications

  • limiting caffeinated beverage intake

  • avoiding stress

  • eating healthy meals

  • not eating late at night

Lifestyle Changes

Making some small changes in a person’s routine can reduce symptoms and possibly stop the reflux all together:

  • lose weight

  • wear loose fitting clothing (especially around the abdomen)

  • sleep with head slightly elevated (about 30 degrees)

  • don’t eat 2-3 hours before bed

  • avoid slouching when sitting


Treatment

Treatment is dependent upon the cause of the GERD. If lifestyle is the cause, it will be up to the patient to make some changes in their diet, routine and choices. Some other treatments commonly used are:

  • Antacids – found over the counter – will treat the heartburn and indigestion but not an ulcer

  • H2 blockers – reduce the amount of gastric acid secreted

  • Proton pump inhibitors – decrease the amount of gastric acid produced

 

Prognosis

Permanent damage to the esophagus is rare. With proper treatment and willingness of the patient to change behaviors that may be causing the GERD, symptoms are likely to improve.

References:

Acid Reflux (GER & GERD) in Adults. (2015). Retrieved from https://www.niddk.nih.gov/health-information/digestive-diseases/acid-ref…

GERD. Retrieved from https://medlineplus.gov/gerd.html.

Gastroesophageal Reflux Disease. Retrieved from https://medlineplus.gov/ency/article/000265.htm