Gastroesophageal Reflux Disease (GERD)
Gastroesophageal reflux disease (GERD) is a more serious form of the more common gastroesophageal reflux (“acid reflux”).
Reflux occurs when the lower esophageal sphincter (a ring of muscle) either opens spontaneously or else does not close properly, allowing stomach contents to rise up into the esophagus.
This sphincter acts like a valve connecting the stomach to the esophagus, and when that valve stops working properly, reflux develops.
The digestive juices of the stomach contain powerful acid that can, over time, damage the lining of the esophagus. While reflux may occur commonly, GERD is a more serious condition, occurring more than twice a week, and can cause health problems if untreated.
What Causes GERD?
Why some people develop GERD is not fully understood at this time. In individuals with GERD, the lower esophageal sphincter tends to relax while the rest of the esophagus is working. In individuals who have a hiatal hernia (in which the upper part of the stomach moves into the lower esophagus), GERD is likelier to develop.
Signs and Symptoms
Frequent heartburn (acid indigestion) is the most common symptom of patients with GERD. It may be a burning pain or ache in the lower part of the middle of the chest, behind the breastbone, or mid-abdomen. In children and some adults, GERD may occur without heartburn, but may have other symptoms, such as:
Risk Factors for GERD
Some factors that may increase the risk of GERD are:
Some foods may also worsen reflux symptoms, including:
What is the Treatment of GERD?
If you have had GERD symptoms or have been using antacids or over-the-counter acid reducers for more than 2 weeks to attempt to relieve those symptoms, you should contact your physician, who may refer you to a gastroenterologist, a specialist who treats diseases of the stomach and intestines.
Changes in lifestyle may help lessen the symptoms of GERD, including:
Elevating the head of the bed is one of the most effective lifestyle changes one can adopt in coping with GERD, but it should be noted that using extra pillows will not help—the bed itself should be elevated by means of blocks.
There are a number of medications that can help alleviate the pain and discomfort of GERD, many of them over-the-counter medications, such as:
Sometimes combinations of drugs may be taken to help treat symptoms of GERD. For example, taking an antacid and an H2 blocker may help an individual by first neutralizing the acid in the stomach (the antacid) and then limiting additional acid production (the H2 blocker). Your doctor will suggest the proper combination of medications, if this approach is used.
Diagnosis and Testing
If GERD symptoms do not resolve from changes in lifestyle and medications, additional tests may need to be done.
In some cases, surgery may be considered as an alternative to long-term use of drugs or physical discomfort.
It is important to treat GERD, as failure to do so can cause a number of serious complications, including:
Why Choose Northwestern Memorial?
The Thoracic Surgery Program at Northwestern Memorial Hospital offers the latest surgical procedures for benign and malignant diseases of the esophagus. Your doctor will discuss the most appropriate treatment for esophageal disease.