Gastroesophageal reflux disease (GERD) is a chronic and more severe form of acid reflux. Causes and risk factors include overeating and pregnancy. Most people can manage their symptoms with lifestyle changes or medications.
Acid reflux happens when contents from your stomach move back up into your esophagus. This action is also called acid regurgitation or gastroesophageal reflux.
If you have symptoms of acid reflux more than twice a week, you might have a condition known as gastroesophageal reflux disease (GERD).
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The main symptom of GERD is acid reflux. Acid reflux can cause an uncomfortable burning feeling in your chest, which can move up into your neck and throat. This feeling is often known as heartburn.
If you have acid reflux, you might develop a sour or bitter taste at the back of your mouth. It might also cause the regurgitation of food or liquid from your stomach into your mouth.
Some other symptoms of GERD include:
- chest pain
- pain when swallowing
- difficulty swallowing
- chronic cough
- a hoarse voice
- bad breath
To manage and relieve symptoms of GERD, your doctor might encourage you to make certain lifestyle changes, like:
- maintaining a moderate weight, if applicable
- quitting smoking, if you smoke
- avoiding big, heavy meals in the evening
- waiting a few hours after eating to lie down
- elevating your head during sleep (by raising the head of your bed 6-8 inches)
Your doctor might also suggest taking over-the-counter (OTC) medications like those listed below. All of these medications can cause side effects, so talk with your doctor about which option is the best for you.
H2 receptor blockers
H2 blockers like Pepcid AC work to lower the amount of acid your stomach makes. Many H2 blockers are available OTC, while higher doses of these medicines can also be prescribed.
It’s important to note is that one type of H2 blocker — ranitidine (also known as Zantac) — was recently
Proton pump inhibitors (PPIs)
PPIs like Prilosec also lower the amount of acid your stomach makes. Because they tend to work better than H2 blockers, they’re more helpful when it comes to healing the esophageal lining — which can become damaged when someone is dealing with GERD for a while.
Like H2 blockers, you can buy some PPIs OTC, and your doctor can also prescribe you a higher dose.
Some individuals might prefer to start with home remedies to treat their heartburn. While certain home remedies may help a little when it comes to occasional bouts of acid reflux, if you’ve been diagnosed with GERD, you’re most likely dealing with a chronic issue.
Chronic health issues can sometimes be eased by lifestyle changes, but also typically need some kind of medical intervention. When it comes to chronic issues, it’s best to resist the desire to self-diagnose and self-medicate. Talk with your doctor before starting any new treatments.
A few home remedies floating around out there that may do more harm than good include:
- Drinking a baking soda and water solution. Because baking soda is alkaline, it has the ability to help neutralize acidity, and is mostly safe to consume in small doses. But baking soda is high in sodium, and it’s also possible to experience side effects if you consume too much.
- Chewing gum. The thought here is that because saliva is slightly alkaline, stimulating it by chewing gum after eating may help neutralize the acidity in your mouth and throat. While a very small study from 2005 did find some merit to this approach, the size of the study makes it difficult to draw any real conclusions.
- Consuming ginger. Ginger is a common home remedy for issues like nausea and a sour stomach, but it’s still unclear if it can actually help with occasional heartburn symptoms. In fact,
in many studies, heartburn is a symptom of taking too much ginger.
- Drinking milk. Due to its natural alkalinity, milk is another home remedy that’s often touted as a way to ease heartburn symptoms. Unfortunately, even though it may feel soothing initially, the fat and protein it contains can ultimately make heartburn symptoms worse once the milk is digested. Low fat milk may be easier for some people to tolerate.
If your doctor suspects you might have GERD, they’ll conduct a physical exam and ask about any symptoms you’ve been experiencing.
Your doctor may then recommend you to a gastroenterologist, or may conduct certain tests themselves, including:
- Ambulatory 24-hour pH probe. A small tube is sent through the nose into the esophagus. A pH sensor at the tip of the tube measures how much acid exposure the esophagus is getting, and sends the data to a portable computer. An individual wears this tube for about 24 hours. This method is generally considered the “gold standard” for diagnosisng GERD.
- Esophogram. After drinking a barium solution, X-ray imaging is used to examine your upper digestive tract.
- Upper endoscopy. A flexible tube with a tiny camera is threaded into your esophagus to examine it and collect a sample of tissue (biopsy) if needed.
- Esophageal manometry. A flexible tube is passed through the nose into your esophagus to measure the strength of your esophageal muscles.
- Esophageal pH monitoring. A monitor is inserted into your esophagus to learn how acid is regulated in your body over a period of a few days.
After arriving at a diagnosis, your doctor will decide what interventions will work best for you, and if surgery is an option.
In most cases, lifestyle changes and medications are enough to prevent and relieve symptoms of GERD. But sometimes, surgery is needed.
For example, your doctor might recommend surgery if lifestyle changes and medications alone haven’t stopped your symptoms. They might also suggest surgery if you’ve developed complications of GERD.
There are multiple types of surgery available to treat GERD, including fundoplication (during which the top of your stomach is sewn around your esophagus), and bariatric surgery (usually recommended when a doctor has concluded that your GERD may be exacerbated by too much excess weight).
It’s important to note that there’s a very real distinction between occasional heartburn (which may not need medical intervention), and GERD.
Most people experience heartburn from time to time, and in general, occasional heartburn isn’t a cause for concern.
But if you’ve been experiencing heartburn more than twice a week, and especially if you’ve also been experiencing a chronic cough and chest pain, you might be dealing with GERD.
While there’s no single cause of GERD, there is a mechanism in your body that — when not functioning properly — can increase the likelihood of it.
The lower esophageal sphincter (LES) is a circular band of muscle at the end of your esophagus. When it’s working correctly, it relaxes and opens when you swallow. Then it tightens and closes again afterward.
Acid reflux happens when your LES doesn’t tighten or close properly. This allows digestive juices and other contents from your stomach to rise up into your esophagus.
Other possible causes include:
- Hiatal hernia. This is when a part of the stomach moves above the diaphragm towards the chest area. If the diaphragm is compromised, it can increase the likelihood that your LES can’t do its job correctly.
- Frequently eating large meals. This can cause the distension of the upper part of the stomach. This distension sometimes means there isn’t enough pressure on the LES, and it doesn’t close properly.
- Lying down too soon after large meals. This can also create less pressure than the LES needs to function properly.
While again, there’s no one cause of GERD, there are lifestyle choices and certain health factors that can make a diagnosis more likely. These include:
- living with obesity
- being pregnant
- living with a connective tissue disorder
- frequently eating large meals
- consistantly lying down or going to sleep shortly after eating
- eating a lot of certain types of foods, like deep fried or tomato products
- drinking certain types of beverages, like soda, coffee, or alcohol
- using an abundance of nonsteroidal anti-inflammatory drugs (NSAIDS), like aspirin or ibuprofen
Alcohol and GERD
Alcohol consumption and GERD have been connected in many studies, and it seems like the more alcohol you drink, the higher the likelihood you might develop GERD.
While the connection is not crystal clear — does alcohol affect the LES directly, or do people who drink a lot of alcohol also have other behaviors that can lead to GERD? — what is clear is that limiting alcohol intake, or stopping it completely, after you’ve been diagnosed, may provide some symptom relief.
Some people who’ve been diagnosed with GERD find that certain foods and beverages can trigger their symptoms. While triggers can be very personal, there are a few foods that are routinely cited as more triggering than others. They include:
- high fat foods (like fried foods and fast foods)
- citrus fruits and juices
- tomatos and tomato sauces
The symptoms of GERD can sometimes be exacerbated by other conditions you may be living with.
Anxiety and GERD
If you suspect that anxiety is making your symptoms worse, consider talking to your doctor about strategies to relieve it.
Pregnancy and GERD
Hormonal changes during pregnancy can cause the muscles in your esophagus to relax more frequently. A growing fetus can also place pressure on your stomach. This can increase the risk of stomach acid entering your esophagus.
Many medications that are used to treat acid reflux are safe to take during pregnancy. But in some cases, your doctor might advise you to avoid certain antacids or other treatments.
Asthma and GERD
Asthma and GERD
While more research is needed to understand the exact relationship between asthma and GERD, it’s possible that GERD might make symptoms of asthma worse. Additionally, asthma and some asthma medications might increase your risk of experiencing GERD.
If you have asthma and GERD, it’s important to manage both conditions.
IBS and GERD
Irritable bowel syndrome (IBS) is a condition that can affect your large intestine. Common symptoms include:
- abdominal pain
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If you have symptoms of both IBS and GERD, make an appointment with your doctor. They might recommend changes to your diet, medications, or other treatments.
It’s normal for babies to spit up food and vomit sometimes. But if your baby is spitting up food or vomiting frequently, they might have GERD.
Other potential signs and symptoms of GERD in infants include:
- refusal to eat
- trouble swallowing
- gagging or choking
- wet burps or hiccups
- irritability during or after feeding
- arching of their back during or after feeding
- weight loss or poor growth
- recurring cough or pneumonia
- difficulty sleeping
If you suspect your baby might have GERD or another health condition, make an appointment with their doctor.
In most people, GERD doesn’t cause serious complications. But in rare cases, it can lead to serious or even life-threatening health problems.
Potential complications of GERD include:
- esophagitis, an inflammation of your esophagus
- esophageal stricture, which happens when your esophagus narrows or tightens
- Barrett’s esophagus, involving permanent changes to the lining of your esophagus
- esophageal cancer, which affects a small portion of people with Barrett’s esophagus
- tooth enamel erosion, gum disease, or other dental problems
To lower your chances of complications, it’s important to take steps to manage and treat the symptoms of GERD.
If you experience occasional heartburn every so often, you’re not alone.
Treating these occasional occurrences with OTC antiacids and some lifestyle changes, like waiting a few hours to lie down after eating, can usually create relief. But if you find yourself experiencing heartburn more than twice a week and small lifestyle changes don’t seem to be fixing anything, you may be dealing with GERD.
If you’ve been diagnosed with GERD, your doctor will help you come up with a treatment plan that works for you. OTC medication, prescription meds, and even surgery are all options, depending on where you are with the condition.
Don’t let persistent heartburn get in the way of living your life. Talk with your doctor if you believe you may have symptoms of GERD.