What Is Gastroesophageal Reflux Disease (GERD)?
GERD (acid reflux disease) occurs when the acid from the stomach flows up into the esophagus. The acid in the stomach is a strong chemical that helps digesting your food. While the stomach is designed to handle its own acid, the linning of the esophagus will be severly burned by the repititive exposure to this acid. This exposure may cause symptoms that vary in severity depending on the damage. To some extent, every normal person has acid reflux. Normal non pathologic reflux happens after meals. This reflux is usually brief and without symptoms, and rarely occurs during sleep.
The diagnosis of abnormal reflux is easy when heartburn or other related GERD symptoms occur frequently.
Causes of GERD:
There is a valve that is located at the connection of the esophagus and the stomach. This valve is a one way valve that is called the lower esophageal sphincter (LES). The value of this valve is to allow food to pass to the stomach while prevents the acid from flowing up to the esophagus.
Any damage or weakness to the this valve located at the bottom of the esophagus (LES) will cause GERD symptoms. Other causes include:
Increase pressure on the stomach, such as pregnancy and being overweight.
- Hiatal hernia
- Dry mouth
- Asthma and chronic cough
- Delayed stomach emptying
- Connective tissue disorders, such as scleroderma
- Zollinger-Ellison syndrome
A hiatal hernia is the bulging of the upper part of the stomach into the posterior chest through an enlarged hiatal opening.
What Are the Symptoms of GERD?
The most common symptom is heartburn, a burning feeling in the middle of the chest. It sometimes spreads to the throat. An acid taste may occur. Heartburn affects about 10 million adults in the United States daily. Other symptoms include chronic cough, hoarseness, upset stomach, stomach bloating, and wheezing. More serious symptoms are bleeding, weight loss, and diffi culty swallowing.
How Is GERD Diagnosed?
The doctor relies on symptoms and the response to treatment for diagnosis. Life-threatening diseases, such as heart disease, that can cause symptoms similar to those of GERD must be ruled out. Specifi c tests are needed for an unclear diagnosis or more serious symptoms. These tests may include upper GI (gastrointestinal) x-ray series, endoscopy (using a scope to look at your esophagus and stomach directly), 24-hour esophageal pH study (measurement of acidity), and esophageal manometry (measures esophageal muscle pressure).
How Is GERD Treated?
First options for mild refl ux include eating smaller portions and changing the diet. Certain foods, such as tomatoes and fatty foods, and medicines, such as aspirin, can make symptoms worse. Over-the-counter drugs, including antacids and acidblocking medicines called H2-blockers, may help. Antacids neutralize stomach acid. H2-blockers (e.g., ranitidine or famotidine) prevent or block production of stomach acid. These drugs can be taken before eating to prevent heartburn. Omeprazole is another over-the-counter drug now available, which blocks the action of stomach cells responsible for making acid. It is generally more effective than antacids and H2-blockers.
People with severe or frequent symptoms may need prescription drugs. In resistant cases, your doctor may refer you to a surgeon to perform an operation called fundoplication to strengthen the LES.