What's in this article?
Gastroesophageal reflux disease (GERD) is a chronic disease on digestive system. GERD occurs when stomach acid or occasionally, stomach content will flow back into your food pipe (esophagus). The backwash (reflux) irritates the lining of your esophagus and causes GERD.
Both acid reflux and heartburn are common digestive conditions that many people experience from time to time. When these signs and symptoms occur for at least twice each week or interfere with your daily life, or when your doctor can see damage to your esophagus, you may be diagnosed with GERD.
Most people can manage the discomfort of GERD with lifestyle changes and over-the-counter medications. But some people with GERD may need stronger medications, or even surgery, to reduce symptoms.
What Causes Acid Reflux Disease?
One common cause of acid reflux disease is a stomach abnormality called a hiatal hernia. This will occur when the upper part of the stomach and LES move above the diaphragm, a muscle which separates your stomach from the chest. Normally, the diaphragm helps keep acid in the stomach. But if you have a hiatal hernia, acid will move up into the esophagus and cause symptoms of acid reflux disease.
The following are the other common risk factors for acid reflux disease:
- Eating a large meal or lying down right after a meal
- Being overweight or obese
- Eating heavy meal and lying on your back or bending over at the waist
- Snacking close to bedtime
- Eating certain foods, such as tomato, citrus, chocolate, mint, onions, garlic, spicy, or fatty foods
- Drinking certain beverages, such as coffee, tea, carbonated drinks, alcohol
- Being pregnant
- Taking aspirin, ibuprofen, certain muscle relaxers, or medications for blood pressure
Acid Reflux (GERD) Symptoms
GERD is the most common symptom in persistent heartburn.
Heartburn is a burning pain in the center of the chest, behind the breastbone. It frequently starts in the upper abdomen and spreads up into the neck or throat.
- The pain can last as long as 2 hours.
- Heartburn is usually worse when done eating.
- Bending over or lying down can bring on heartburn or make it worse.
- The pain is usually does not start or get worse with physical activity.
- Heartburn is sometimes related to as acid indigestion.
- Not everyone with GERD has heartburn.
Other symptoms of GERD includes:
- Regurgitation of the bitter acid up into the throat while sleeping or bending over
- Bitter taste in the mouth
- Persistent dry cough
- Hoarseness (especially in the morning)
- Feeling of tightness in throat, as if a piece of food is stuck in there
- The most common symptoms in children and infants are coughing, repeated vomiting, and other respiratory problems
How Is Acid Reflux Disease Diagnosed?
It’s time to see your doctor if you have acid reflux symptoms two or more times a week or if medications don’t bring lasting relief. Symptoms like heartburn are the key to the diagnosis of acid reflux disease, especially if lifestyle have changes, antacids, or acid-blocking medications help reduce these symptoms.
If these steps don’t help or if you have frequent or severe symptoms, then your doctor may order tests to confirm a diagnosis and check for other problems. You may need one or more tests like:
- Barium swallow (esophagram) can check for ulcers or a narrowing of the esophagus. You first will swallow a solution to help structures show up on an X-ray.
- Esophageal manometry can check function of the esophagus and lower esophageal sphincter.
- pH monitoring can check for acid in your esophagus. The doctor will insert a device into your esophagus and leaves it in place for 1 to 2 days to measure the amount of acid in your esophagus.
- Endoscopy can check for problems in your esophagus or stomach. This test involves inserting a long and flexible lighted tube down your throat. First, the doctor sprays an anesthetic at the back of your throat and give you a sedative to make you more comfortable.
- During endoscopy, a biopsy may be taken to check the samples of tissue under a microscope for infection or abnormalities.
Acid Reflux (GERD) Diagnosis
Your doctor usually diagnose reflux disease by the symptoms you report.
Diet and changes in lifestyle may be recommended first and perhaps an over-the-counter antacid.
If symptoms continues more than 4 weeks despite this therapy, the person may be referred to a gastroenterologist, which is a doctor who specializes in the gastrointestinal (GI) tract.
Acid Reflux Disease Can Be Treated With Diet and Lifestyle Changes
One of the most effective ways to treat acid reflux disease is to avoid the foods and beverages that trigger symptoms. Here are other steps that you can do:
- Eat a smaller amount of meals more frequently throughout the day.
- Quit smoking.
- Put some blocks under the head of your bed to raise it at least 4 inches to 6 inches.
- Do not eat for at least 2 to 3 hours before lying down.
- Try sleeping on a chair for daytime naps.
- Do not wear a tight clothing or tight belts.
- If you are obese or overweight, take steps to lose weight with exercise and diet changes.
- Also, ask your doctor if any medication could be triggering your heartburn or other symptoms of acid reflux disease.
Acid Reflux Disease Can Be Treated Using Medications
In many cases, changes in lifestyle combined with over-the-counter medications are all you need to control the symptoms of acid reflux disease.
Antacids can neutralize the acid from your stomach. But they may cause a diarrhea or constipation, especially if you overuse them. It is best to use antacids that contain both magnesium hydroxide and aluminum hydroxide. When combined, they may help to counteract these gastrointestinal side effects.
If antacids don’t help, your doctor may try other medications. Some requires a prescription. Your doctor may suggest more than one type or suggest you try a combination of medications such as these:
- Foaming agents helps coat your stomach to prevent reflux.
- H2 blockers to decrease acid production.
- Proton pump inhibitors also reduces the amount of acid your stomach makes.
- Prokinetics can help strengthen the LES, empty your stomach faster, and reduce acid reflux.
Do not combine more than one type of antacid or other medications without your doctor’s guidance.
Is Acid Reflux Disease Can Be Treated With Surgery?
If medications don’t completely resolve your symptoms of acid reflux disease and the symptoms are severely interfering with your life, your doctor could recommend a surgery. There are two types of surgical treatment used to relieve symptoms of GERD if daily use of medication isn’t effective.
The most recently approved procedure involves surgically placing a ring known as a LINX device around the lower end of the esophagus, the tube that will connect the mouth to the stomach. This ring consists of magnetic titanium beads held together by titanium wires. The device can help reflux by preventing stomach content from backing up into the esophagus. In one study, patients will able to stop taking medicine or cut down the amount they took. You should not get the LINX device if you are allergic to certain metals, and once you have a LINX device you should not get any type of MRI test.
When to Seek Medical Care
Although that many people can relieve their reflux disease symptoms by changes in their habits, diet, and lifestyle, others need to consult their health-care professional.
Call your health-care professional when the symptoms of GERD occur frequently, disrupt your sleep, interfere with work or other activities, or are not relieved by self-care measures alone.
Make your health-care professional know that you are using self-care measures or over-the-counter medications so that they can monitor how well they work and how often you need to use them.
Go immediately to the emergency department if you have any of the following:
- Severe chest pain or pressure, especially if it radiates to your back, neck, or arm
- Vomiting followed by severe chest pain
- Vomiting blood
- Dark, tarry stools
- Difficulty swallowing
- Shortness of breath