GERD-Gastroesophageal Reflux Disease

Acid reflux affects over half of the population in the United States, with about 20% of people experiencing symptoms several times per week. Reflux occurs when stomach acid, bile, or occasionally food, washes back up into the esophagus. The lower esophageal sphincter (LES) is supposed to close to prevent food and acid from traveling back up into the esophagus. When this sphincter is damaged or weakened, acid reflux occurs.

There is a wide range of symptoms that can happen when acid washes back up into the esophagus. These include:

• Burning
• Chest pain
• Cough
• Hoarseness
• Sore throat
• Difficulty swallowing
• Lump in throat
• Bloating
• Burps/Hiccups
• Nausea
• Vomiting

Over time, acid can cause severe irritation to the esophagus that can lead bleeding, scar tissue, ulcers, and narrowing of the esophagus. Chronic acid reflux can cause Barrett’s Esophagus which is a precancerous change in esophageal tissue. Some people have reflux symptoms that occur less than twice a week. “Heartburn” is a term that many people are familiar with, and is often used by patients to describe reflux symptoms. GERD is severe and chronic form of acid reflux.

Reflux is often diagnosed by physicians by just listening to patient symptoms. X-rays done with barium solution may be ordered by your doctor. Often further testing is performed called an endoscopy. During this procedure, a small tube with a camera is glided down through a patient’s esophagus to take pictures of the tissue in the esophagus.

Some individuals have an increased incidence of reflux due to obesity, smoking, diabetes, pregnancy, and/or those people with a hiatal hernia. There are several lifestyle changes that can be made, that may lessen the frequency and severity of reflux symptoms. These include:

• maintaining a healthy weight
• not wearing clothing that is too tight around the stomach
• avoiding certain foods
• eating smaller meals
• staying upright after eating
• not smoking
• raising head of bed (if nighttime symptoms)

In addition there is a list of foods that probably should be avoided to help to avoid reflux symptoms:

Fatty foodsFried foodsTomato sauceAlcoholChocolate
MintGarlicOnionCaffeineCitrus
SpicesDairyWineTeaVinegar

When lifestyle changes do not provide adequate relief of symptoms, medications can be used. Antacids make the stomach acid more neutral and work quickly. Acid reducers such as H2 blockers decrease the amount of stomach acid, and usually provide fairly quick relief that lasts about 12 hours. A more potent type of medications is called PPI’s or proton pump inhibitor. They provide much longer lasting relief from symptoms, but do not provide immediate relief.

Antacids are such medications as Maalox, Mylanta, and Tums. H2 blockers are the drugs famotidine (Pepcid), ranitidine (Zantac), nizatidine (Axid), and cimetidine (Tagamet). PPI’s include lansoprazole (Prevacid), dexlansoprazole (Dexilant), omeprazole (Prilosec), esomeprazole (Nexium), rabeprazole (Aciphex), and pantoprazole (Protonix). Any of these medications should be used only on short term basis until a patient can see their doctor. Persistent acid reflux or GERD should be evaluated and treated by your physician. They will they determine if long term use of any of the above medications should be used on a long term basis.