Gastroesophageal Reflux Disease (GERD)

What Is GERD?
Gastroesophageal reflux disease, or GERD, occurs when the lower esophageal sphincter (LES) does not close properly and stomach contents splash back, or reflux, into the esophagus (the esophagus is the tube which carries food from the mouth to the stomach). The LES is a ring of muscle at the bottom of the esophagus that acts like a camera shutter between the esophagus and stomach, keeping the stomach contents from coming back up.

When refluxed stomach acid touches the lining of the esophagus, it can cause a burning sensation in the chest or throat called heartburn. The fluid may even be tasted in the back of the mouth, and this is called acid indigestion. Occasional heartburn is common, especially after overeating. Heartburn that occurs more than twice a week may be considered GERD, which sometimes leads to more serious health problems.

The main symptoms are persistent heartburn and acid regurgitation. Some people have GERD without heartburn. Instead, they experience pain in the chest, hoarseness in the morning, dry cough, a lump in the throat, or trouble swallowing.

What Causes GERD?
A hiatal hernia could be one cause of GERD. A hiatal hernia occurs when the upper part of the stomach is above the diaphragm, the muscle wall that separates the stomach from the chest. The diaphragm helps the LES keep acid from coming up into the esophagus. When a hiatal hernia is present, it is easier for the acid to come up causing the symptoms of GERD.

Other factors that may contribute to GERD include alcohol use, being overweight, pregnancy and smoking. Lying down soon after eating makes it easier for stomach contents to move up into the esophagus and can worsen reflux. Certain foods can be associated with GERD including chocolate, caffeine, fatty and fried foods, garlic and onions, peppermint.

What Can I Do to Lessen My Symptoms?
Several lifestyle changes can help. These include:
• Avoiding food 2 to 3 hours before bed
• Avoid specific foods that trigger your symptoms
• If you are overweight, lose weight
• Eat smaller meals

Lifestyle measures aren’t enough for everyone. Some people need to take medications occasionally or daily to reduce symptoms. If your symptoms occur frequently you should discuss them with your doctor. They can advise you on the best medication to take and whether any tests should be done.

What We Are Doing at CNS/WH:
Patients with GERD are seen by physicians in our Digestive Diseases clinics.

Currently we have no research trials on GERD.

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