What is GERD?
Gastroesophageal reflux disease (GERD) is a long-term condition where acid from the stomach comes up into the esophagus.
GERD can look and feel different for each patient. Although chronic reflux can involves a wide range of symptoms, they can be principally grouped as typical or atypical depending on their severity.
Mild sufferers may experience heartburn and regurgitation on occasion, perhaps after indulging in a heavy meal or greasy or acidic foods. Changes to diet are sometimes sufficient to alleviate these symptoms and control mild acid reflux. Severe chronic GERD sufferers can experience symptoms as often as several times a week or even daily.
Contrary to popular belief, you don’t always experience heartburn when you have GERD. Although this is the most common symptom, it is not a guaranteed warning sign of GERD — nor is the absence of heartburn enough to rule out GERD.
People managing GERD will often blame acid reflux for some or all of their symptoms. However, there are other stomach fluids besides acid that can reflux and cause discomfort and damage. In fact, non-acid reflux carries enormous risk to the esophagus, even if they aren’t as obvious a sign of GERD.
Occasional acid reflux is quite common, often occurring as a result of overeating, lying down after eating, or eating particular foods.
However, recurrent acid reflux, diagnosed as GERD, typically has other causes and risk factors and can have more serious complications.
Gastroesophageal reflux disease occurs in people of all ages, and sometimes for unknown reasons.
In short, GERD occurs when the sphincter at the bottom of the esophagus becomes weak, or opens when it should not.
GERD occurs more commonly in people who are:
- overweight or obese because of increased pressure on the abdomen
- pregnant, due to the same increased pressure
- taking certain medications, including some asthma medications, calcium channel blockers, antihistamines, sedatives, and antidepressants
- smoking, and being exposed to second-hand smoke
The main symptom of GERD is heartburn.
Heartburn is discomfort felt behind the breastbone as a burning sensation. It tends to get worse if the person lies down or bends over, and also after eating food.
However, not all people with GERD experience heartburn, and there are other possible symptoms:
- nausea or vomiting
- bad breath
- respiratory problems
- difficulty or pain when swallowing
Anyone who is experiencing frequent acid reflux symptoms should talk to their doctor, who may refer them to a specialist in gut medicine known as a gastroenterologist for further investigation.
There are several possible tests to diagnose GERD, including:
- Esophageal pH and impedance monitoring: This measures the amount of acid in the esophagus while the body is in different states, such as while eating or sleeping.
- Upper gastrointestinal (GI) endoscope: This is a tube with a camera attached, which is used to inspect the esophagus. A small sample of tissue may also be taken at the same time in a biopsy.
- Upper GI series: This is a type of X-ray that shows up certain physical abnormalities that might cause GERD.
- Esophageal manometry: This measures muscle contractions in the esophagus during swallowing. It can measure the strength of the sphincter.
- Bravo wireless esophageal pH monitoring: In this test, a small temporary capsule is attached to the esophagus. This measures the acidity continuously for around 48 hours.
GERD will often be treated with medications before attempting other lines of treatment.
Proton pump inhibitors are one of the main pharmaceutical treatment options for people with GERD. They decrease the amount of acid produced by the stomach.
Other lifestyle and behavior changes can help relieve GERD include:
- Eat moderate amounts of food and avoid overeating.
- Stop eating 2 to 3 hours before sleeping.
- Quit or avoid smoking.
- If a person is overweight, losing weight can help prevent symptoms.
- Do not wear clothing that is tight around the abdomen.
- Sleep at a slight angle with the head slightly elevated.
If you are avoiding these types of food and still experience regular heartburn, it is important to visit a doctor as there may be other underlying issues causing the symptoms.
Here are some reference links.