Gastroesophageal Reflux Disease (GERD)

Gastroesophageal reflux disease (GERD) is a common yet chronic digestive disorder that occurs when the stomach's contents flow back up into the esophagus — the tube that carries food from your throat into your stomach.

This happens when the lower esophageal sphincter (LES), a ring of muscle that normally closes after swallowing, becomes weakened or relaxes inappropriately.

GERD is also known as:

• Acid indigestion.
• Acid reflux.
• Acid regurgitation.
• Heartburn.
• Reflux.

GERD Symptoms

The following are possible symptoms of GERD:

• Heartburn: burning sensation or pain in the chest that can radiate to the jaw, caused by gastric acid refluxing into the esophagus.
• Regurgitation: backflow of partially digested food and gastric contents into the mouth.
• Sore throat.
• Dysphagia: difficulty swallowing, or the feeling that food is “stuck” in the esophagus.
• Globus: feeling of a “lump in the throat”.
• Bad breath: from regurgitation.
• Dyspepsia: burping, nausea after eating, bloating, upper abdominal pain and discomfort, etc.

When GERD is Most Likely to Occur

GERD symptoms can occur in various situations, including:

• After eating a meal: a common time for people to experience symptoms, since the stomach produces acid after you eat.
• When bending over or lifting a heavy object: occurs as the “valve” in the lower esophagus that prevents acid regurgitation is sometimes weak. Lifting objects or bending over can increase the pressure on your stomach, which can cause more regurgitation through the weak valve.
• When lying down, especially on your back: occurs for the same reason as bending or lifting.
• At night: occurs for the same reason as lying down.
• During pregnancy: GERD during pregnancy is secondary to hormonal reasons that make the valve in the lower esophagus weaker. Also, the fetus can put increased pressure on the stomach, which in turn can cause a backflow of gastric acid into the esophagus.

GERD Diet: What to Eat and What to Avoid

One should avoid foods in the high-acid column and eat the low-acid foods. The list of high-acid foods below are common acid reflux triggers.

Complications

While GERD isn’t a life-threatening condition, if left untreated, it can result in complications, including:

• Esophageal stricture: a narrowing of the esophagus that happens when damage from stomach acid causes a buildup of scar tissue. It can cause problems with swallowing.
• Esophageal ulcer: an open sore in the esophagus caused by tissue damage from stomach acid. It can lead to pain, bleeding and problems with swallowing.
• Barrett’s esophagus: a precancerous condition in which the cells lining the esophagus change. Barrett's esophagus is associated with an increased risk of developing esophageal cancer. Although the risk is small, it’s important to have regular checkups for precancerous cells (dysplasia). If precancerous cells are discovered, they can be treated to prevent esophageal cancer.
• Esophageal cancer: can result from years of untreated GERD. It is more common among men and is often diagnosed when it is in an advanced stage. In later stages, esophageal cancer can be treated but rarely can be cured.
• Esophagitis: irritation and inflammation caused by stomach acid that can cause ulcers, heartburn, chest pain, bleeding and difficulty swallowing.

Diagnosis

There are a number of diagnostic tools used to detect gastroesophageal reflux disease (GERD), including:

• Upper gastrointestinal GI endoscopy and biopsy: involves using a camera and light through the mouth and throat to look at the lining of GI tract and sampling small bits of tissues for examination.
• Upper GI series: X-rays of GI tract that detect related anatomic problems such as strictures or hiatal hernia.
• pH test: Bravo pH and pH-Impedance testing.
• Esophageal manometry: tests the function of the esophageal body and lower sphincter (“valve”) to help diagnose issues with the structure and movement of the esophagus.