Gastroesophageal Reflux Disease (GERD) – Symptoms & Treatment | MedStar Health

What is GERD?

Gastroesophageal reflux disease, commonly known as GERD, is a severe, chronic form of acid reflux. Acid reflux happens when acidic stomach contents back into your esophagus, causing heartburn and regurgitation. This backward flow occurs when the muscle connecting the stomach to the esophagus becomes weak or relaxes abnormally.

It’s normal to experience the occasional heartburn and acid reflux, especially if you eat a large meal or before lying down. However, if you have ongoing acid reflux, it’s important to seek medical care. Left untreated, chronic acid reflux can lead to serious complications, including Barret’s esophagus, which increases your risk of esophageal cancer.

If acid reflux and heartburn are interfering with your life, it’s time to see a doctor specializing in GERD. At MedStar Health, our gastroenterologists work as a team alongside advanced endoscopists and surgeons to offer comprehensive GERD treatment options, tailored to the unique needs of each of our patients. From antacid medications and conservative therapies to minimally invasive surgery, we’re here to help you prevent minor heartburn from becoming a major health issue.

What an overview of GERD symptoms, causes, and treatments

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If there is too much pressure in the stomach or if the sphincter muscle is not functioning properly, then contents of the stomach can splash back into the esophagus causing symptoms of gastroesophageal reflux disease - or GERD.

GERD symptoms

The most common symptoms of chronic acid reflux disease include:

  • Heartburn, a burning sensation that can extend from the breastbone to the neck and throat. Heartburn sufferers may also experience a sore throat, hoarseness, chronic cough, asthma, or a feeling of a lump in the throat. Because there can be chest pain associated with GERD, heartburn sometimes is mistaken for a heart attack.
  • Regurgitation, or a sensation of acid backed up in the esophagus with or without an accompanying sour taste.

Other common GERD symptoms are:

  • Feeling that food may be trapped behind the breastbone
  • Heartburn or a burning pain in the chest (under the breastbone) that:
    • Increases when bending, stooping, lying down, or eating
    • Is more likely or worse at night
    • Is relieved by antacids
  • Nausea after eating

Because the esophagus is sensitive to citrus and acidic foods, such as tomato-based foods, symptoms can feel more severe after eating foods with these ingredients.

If symptoms are getting in the way of your daily routine and food choices or they aren’t responding to over-the-counter antacids, it may be time to see a gastroenterologist for an evaluation. Early detection and intervention can help to minimize your risk of long-term complications.

Risk factors and GERD causes

At the bottom of the esophagus is a valve called the lower esophageal sphincter. It’s responsible for keeping stomach contents out of the esophagus. However, this valve can become weak or too relaxed, allowing stomach contents to bypass the valve and splash back into the esophagus.

This can be caused by several factors, including:

  • Obesity: Being overweight or obese can increase your stomach pressure, pushing it above the chest and increasing your risk of acid reflux. Obesity can also increase your risk of a hiatal hernia, which occurs when the stomach pushes through the diaphragm, leading to acid reflux.

  • Smoking: Tobacco relaxes the lower esophageal sphincter and can slow down digestion, both of which can contribute to GERD.
  • Pregnancy: Pregnancy hormones can cause the lower esophageal sphincter to relax, and the pressure of the baby can push the stomach. As a result, many women experience temporary acid reflux while pregnant.
  • Eating habits: Eating large meals or right before lying down can cause heartburn and other signs of indigestion.

GERD diagnosis

In most instances, an experienced gastroenterologist can diagnose your acid reflux disease based on your medical history and symptoms. If your symptoms are severe, unresponsive to antacids, or recurrent, one or more tests may help diagnose reflux or any potential complications:

  • Esophagogastric duodenoscopy (EGD) is often used to examine the esophagus for damage. The doctor inserts a thin tube with a camera on the end through your mouth. The tube is then passed into your esophagus, stomach, and small intestine. Biopsies can be taken for evaluation. This can help diagnose a hiatal hernia or rule out H. pylori infection, which can increase the risk of reflux.

  • Barium swallow may be ordered before surgery to measure how much reflux is occurring. It involves swallowing a barium drink while a radiologist uses X-rays to follow the path as the barium goes down the esophagus and back up.

  • BRAVO pH system involves a small capsule that is temporarily attached to the esophageal wall and takes continuous pH measurements. Using these measurements, your physician can analyze and evaluate your symptoms, and determine if you may need treatment for a hiatal hernia. Learn more.

  • Esophageal manometry measures the coordination and movement of the esophagus to determine if there is underlying dysfunction somewhere else in the esophageal muscles. Learn more.

GERD treatment

Our gastroenterologists will partner with you to develop an individualized treatment plan that will treat your GERD and lower your risk of related health problems. GERD treatment options may include one or more of the following:

  1. Lifestyle changes: Several lifestyle and habit modifications may improve acid reflux symptoms. Your doctor may recommend:
    • Achieving and maintaining a healthy weight
    • Eating smaller meals
    • Avoiding eating within two hours of lying down to sleep
    • Quitting smoking
    • Minimizing caffeine
    • Getting active after eating to promote digestion
    • Avoiding citrusy, fatty, or spicy foods
  2. GERD medications: If at-home remedies and over-the-counter antacids (like Tums) don’t help to relieve acid reflux, your doctor may prescribe medication designed to suppress acid. Your medication regimen will be tailored based on when you experience the most prominent symptoms. For example, if your symptoms seem to be worse in the morning, your doctor may recommend you take your medication at night. If your symptoms are worse during the day, taking your medication in the morning might be the most effective.
  3. Surgery: If we’ve exhausted all other medical therapies and you aren’t experiencing relief, or if GERD is occurring alongside a large hiatal hernia, then you may be a candidate for surgery. During surgery to treat GERD, our surgical team uses a minimally invasive approach to wrap the top of the stomach around the bottom of the esophagus. Your care team will help you understand how to prepare for surgery and what to expect on the day of your procedure and during recovery.

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