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GERD (Gastroesophageal Reflux Disease): Heartburn Symptoms & Treatments

GERD, or Gastroesophageal reflux disease, is a chronic condition that occurs when stomach contents wash up into the throat. Many people with GERD, also known as acid reflux disease, experience heartburn — a burning feeling in the chest behind the sternum — from the exposure of stomach acid in their esophagus.

GERD is very common problem in the United States. An estimated 14-20 percent of adults in the United States suffer from GERD, according to a 2005 study in Clinical Gastroenterology and Hepatology. However, researchers say distinguishing heartburn sufferers from people with GERD complicates finding precise estimates for the prevalence of GERD.

Causes & symptoms

When a person swallows, a ring shaped muscle at the top of their stomach relaxes and loosens to allowed food to pass and then closes again. This muscle is called the lower esophageal sphincter (LES). If the LES weakens or doesn't close completely, stomach acid or bile may leak back into the throat, according to the National Institutes of Health (NIH).

Frequent heartburn is a common symptom of GERD, and often becomes worse when the person bends or lies down. However, heartburn is just a symptom and may also occur from time to time in people who don't have GERD.

Difficulty swallowing, dry cough, sensing a lump in the throat, hoarseness and regurgitating food or a sour taste may also indicate GERD.

Someone who gets these symptoms or heartburn more than twice each week may have GERD, according to the Mayo Clinic.

Obesity, pregnancy and asthma may cause or exacerbate GERD, as can smoking.

Some medications for other conditions may also worsen GERD symptoms including some sedatives, several blood pressure medications, birth control, and antidepressants.

 

Diagnosis & tests

If GERD goes undiagnosed and untreated, the frequent exposure of stomach acid may scar the esophagus and make it difficult to swallow or erode an open sore in the esophageal lining.

In rare cases, untreated GERD can change the composition of the tissue in the lower esophagus into a precancerous state called Barrett's esophagus.

Primary care doctors are often the first to diagnose GERD by taking a detailed history of symptoms, according to the Mayo Clinic.

If the symptoms are severe enough, a primary care doctor may refer a patient to a gastroenterologist who may order further imaging tests such as an Esophagogastroduodenoscopy (EGD).

An EGD involves inserting a small camera on a flexible tube down the throat to ex-amine the lining of the esophagus, stomach and the start of the small intestine, ac-cording to the NIH.

Doctors may also order a “barium swallow” where patients literally swallow a barium-laced drink and then go for a series of X-rays in different positions. Each X-ray allows doctors to track the barium as the person digests the drink.

By using a catheter running from the nose down to the throat, doctors may also use a probe to monitor the amount of stomach acid in the esophagus in a technique called esophageal pH monitoring.

Doctors may also perform an esophageal manometry to measure the pressure where the throat joins the stomach by using a catheter.

Treatments & medications

Many medications and prevention measures can relieve the symptoms of GERD. Over-the-counter antacids can provide quick relief by neutralizing stomach acid. But frequent use of these drugs may cause diarrhea or constipation, according to the Mayo Clinic.

H2-blockers can neutralize acid for a longer period of time, although they may not provide immediate relief. H2-blockers are available both over the counter and by prescription. Proton pump inhibitors, the most potent acid inhibitors, are also avail-able by prescription, according to the NIH.

Extreme cases of GERD may need surgery to increase the pressure at the opening of the stomach.

Sufferers can also try several home remedies, including sleeping with their heads elevated by 6 inches if GERD symptoms bother them during the night.

Avoiding tight-fitting clothing and food that triggers heartburn can also sooth GERD. Common heartburn triggers include alcohol, caffeine, chocolate, citrus fruits, spicy foods, full-fat dairy products and mint, according to the NIH.

Herbal remedies for GERD include licorice, slippery elm and chamomile — although rigorous studies herbal remedies for GERD are lacking.

Healthy eating tips

Excess weight will put pressure on the stomach pushing more acid into the throat, so doctors often recommend overweight patients lose weight to prevent heartburn.

Eating a healthy diet, exercising and counting calories are the most proven methods to losing weight. Doctors advise losing no more than two pounds a week, according to the Mayo Clinic.

In addition to counting calories, the U.S. Department of Agriculture recommends cooking whole grains, varying vegetables, focusing on fruit and choosing lean proteins to eat a healthy diet.

Eating smaller portions will also help GERD, and help weight loss.

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