GERD, or Gastroesophageal reflux disease, is a chronic condition in which acid from the stomach comes up into the esophagus. You may be familiar with this experience under the name “acid reflux” or “heartburn,” since an estimated 44% of American adults have at least one episode every month.
GERD, however, is a chronic disease with symptoms that can affect quality of life.
Is it GERD?
Otherwise healthy people may have heartburn or acid reflux because they eat something that disagrees with them, as a side effect of some medications, or even because of stress. Smokers and pregnant women can also get heartburn.
Heartburn is also a symptom of GERD. Other symptoms include sore throat, a feeling that food is sticking in the esophagus, painful swallowing, and hoarseness.
But heartburn is the most common symptom. You should ask your doctor about GERD if you have heartburn
- more than once a week
- that wakes you up at night
- that gets worse over time
Get to know your esophagus
The esophagus is a tube that connects your mouth to your stomach. The stomach contains acids that begin the process of digesting the food you eat. The lining of the stomach has special cells that protect your stomach from the acid. The esophagus does not have this kind of protection.
The esophagus has muscles that help move food from your mouth to your stomach, and a special group of muscles that make a sphincter that keeps food and stomach acids from moving upwards from the stomach to the esophagus.
If the esophagus fails to keep stomach acids from moving back up into the esophagus, it can be a very painful sensation. It can also cause damage. Chronic, frequent heartburn can cause ulcers in the esophagus or even make it narrower through scarring. In that case, the sufferer may have trouble swallowing.
At this point, there is no cure for GERD. Since GERD is a chronic condition, treatment must usually be continued even once the symptoms are under control. In fact, keeping the symptoms under control and avoiding complications is generally the goal of GERD treatment.
Your doctor might be able to diagnose GERD from your symptoms, but there are also other kinds of tests, including X-ray, examination with an endoscope (an internal camera), and other kinds of monitoring.
Once GERD is diagnosed, your doctor might suggest lifestyle changes. If you smoke, you could reduce your symptoms of GERD by quitting smoking. If you are overweight, your doctor might recommend that you lose weight to reduce the pressure that might be contributing to heartburn.
You may be told to sleep propped up on pillows to give gravity a chance to help keep stomach acids from rising into the esophagus. Another habit that can help with nighttime GERD symptoms is to eat a small dinner portion and to finish eating three hours before bedtime.
There are some foods and drinks that can make GERD symptoms worse. Your doctor might ask you to eliminate these foods, or to track your use of them and your symptoms to see if they cause you additional symptoms:
- spicy foods
- coffee and other caffeine sources
- high-fat foods
- acidic foods and drinks like citric juice
Eating smaller meals in a stress-free environment can also help.
If lifestyle changes don’t help with symptoms, your doctor might recommend medications. Antacids and histamine blockers can limit the amount of acid produced by the stomach. Proton pump inhibitors (PPIs) can also reduce the amount of acid available. Prokinetic agents increase muscle activity.
There are other kinds of therapies and surgical options for GERD. Your physician can explain your options and help you make the best decision for treatment.
Finding a treatment plan that limits symptoms is a primary goal. You may need to take medications even after your symptoms are under control. Visit a gastroenterologist to learn more about GERD and treatment options.