GERD

Many of us have experienced acid reflux, a feeling of food moving back into the esophagus. A condition known as GERD or gastroesophageal reflux disease can be diagnosed when this is more frequently experienced. With the help of an adjusted diet and medications guided by a physician, it can be successfully managed.

What is GERD?

GERD is a digestive disorder that can cause heartburn, regurgitation, or acid indigestion. This disorder is caused by relaxation of the muscle at the end of the esophagus (food pipe) - the lower esophageal sphincter (LES), which allows the stomach’s contents to come back up into the esophagus..

Signs and symptoms

Common signs and symptoms of GERD include heartburn and regurgitation. Heartburn may feel like a warm or burning feeling in the chest that may be worse after eating or when lying down.

Other symptoms of GERD may include chest pain, difficulty swallowing, sore throat, nausea, vomiting, unexplained cough, voice changes, wheezing, or throat clearing.

Risk factors

Most people will experience heartburn or symptoms of GERD at some point. Risk factors include being overweight, pregnant, smoking, or taking certain medications. The presence of a hiatal hernia, where the stomach sits higher up in the chest, is a risk factor for GERD. Eating large meals or lying down shortly after eating can also contribute to experiencing heartburn or GERD symptoms. Certain foods can trigger acid reflux, like chocolate, fried or fatty foods or alcohol.

Diagnosis and Treatment

If you are having symptoms of GERD or frequent acid reflux, schedule an appointment with your physician to be appropriately diagnosed. There are a few tests your physician may perform, which can include:

Barium swallow test:

Also known as an esophagram, this test includes drinking a barium solution and then taking an x-ray of your upper digestive tract.

EGD:

An esophagogastroduodenoscopy, or EGD for short, is a procedure that gastrointestinal specialists perform for patients suffering from symptoms related to the upper digestive tract. During the procedure, a thin, flexible tube (endoscope) is passed through the mouth and advanced through the upper portion of the gastrointestinal (GI) tract, including the esophagus, stomach, and first part of the small intestine known as the duodenum. A light and small camera are attached to the end of the endoscope that allows doctors to visualize the inside of the GI tract, and a small opening beside the camera allows for passage of a small instrument used to collect biopsies (tissue samples) when warranted.

Esophageal manometry:

A manometry will assess your swallowing to look at how the esophagus muscles contract and function. You will likely be awake for this test and be asked to swallow water.

Ambulatory pH monitoring:

A small catheter (tube) with sensors is placed through your nose into your esophagus during this outpatient procedure - attached to a recording device, it will monitor the pH level (acidity) in your esophagus over a period of 24 hours as you carry on your regular routine. The number of times you experience symptoms related to GERD and the number of times stomach acid reaches your esophagus are recorded. The probe is then removed, and your results are analyzed and evaluated by your doctor.

Treatment options for GERD often include medications like antacids or H2 blockers that focus on reducing the acid in the stomach. Medications like proton pump inhibitors (such as Prilosec) may be given to help heal the stomach or esophagus lining, or to better control your symptoms. It may also be recommended that you try to stay away from certain foods or monitor foods that could trigger symptoms. For patients with persistent symptoms or who do not wish to take medication, surgical repair of the hiatal hernia is an option. Surgery can also be performed to strengthen the lower esophageal sphincter.

If you are experiencing long-term symptoms of GERD, contact your doctor to assess if you should get testing or prescribed medications. Your primary care physician may recommend you see a gastroenterologist who is a specialist in digestive disorders.