GERD is short for gastroesophageal reflux disease. It’s a chronic disease of the digestive system. In GERD, acids and other contents from the stomach frequently run back up and irritate the sensitive tissues of your esophagus.
Most people have heartburn or indigestion from time to time. It’s usually a case of overindulgence or that extra spicy sauce you love so much. But if you feel that burning sensation in your chest more than twice a week, you might have GERD. Fortunately, most people can manage GERD with over-the-counter medications and a few lifestyle changes.
Who Gets GERD
Anyone can develop GERD. It occurs across every age group and ethnicity. In the United States, approximately 20 percent of the population has GERD, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
According to the Healthcare Cost and Utilization Project, there were 995,402 hospitalizations for GERD in 1998. In 2005, there were 3,141,965, an increase of 216 percent. In both years, approximately 62 percent of all GERD hospital discharges involved women. The same study showed that the number of adults hospitalized for GERD decreased by 2.4 percent between 1998 and 2005. During the same period, the rate increased by 42 percent for babies. It increased by 84 percent for children aged two to 17.
What Causes GERD
GERD is a result of a weak esophageal sphincter. That weakness allows the contents of your stomach to flow back up into your esophagus. There are a variety of things that can weaken your esophageal sphincter, including:
- being overweight
- wearing tight clothing around your middle
- smoking or regular exposure to secondhand smoke
- hiatal hernia (part of the stomach protrudes into the diaphragm muscle)
Certain foods and beverages can trigger GERD. Some of the more common food triggers include fried or fatty foods, citrus, and chocolate. Coffee, carbonated beverages, and drinks containing alcohol can also be a problem for people with GERD.
Some medications can cause GERD. Among them are alpha blockers, anti-inflammatories, and nitrates. If you take medication and have symptoms of GERD, speak to your doctor or pharmacist.
The most common symptoms of GERD are acid indigestion and heartburn. You may frequently burp and feel bloated. Acid in your esophagus can make it spasm. That causes pain and a feeling of tightness in the chest. Other symptoms of GERD include:
- nausea and vomiting
- tooth erosion and bad breath
- problems swallowing (dysphagia)
- respiratory problems
- abdominal pain
Diagnosis & Treatment
Seek immediate medical attention if you have difficulty swallowing or breathing.
Consider it an emergency if you vomit large amounts, have projectile vomiting, or your vomit contains green or yellow fluid. Vomit that looks like coffee grounds may contain blood.
If you often suffer from heartburn or acid indigestion that won’t go away, make an appointment with your doctor. GERD is sometimes diagnosed based on symptoms, but your doctor may want to rule out other problems. Diagnostic testing may include:
- Upper GI series X-rays. These are taken after you drink a barium solution. This procedure can find ulcers, hiatal hernias, and other abnormalities.
- Endoscopy. A fiber-optic tube is passed down your throat so your doctor can view your esophagus and stomach. Tissue samples can be taken for biopsy.
- Esophageal monitoring. This is a way to measure acid levels in your lower esophagus for 24 hours.
- Manometry. A manometry measures esophageal pressure when you swallow.
GERD can usually be managed with antacids and other over-the-counter medications. A histamine antagonist, such as cimetidine, is available over-the-counter. Proton-pump inhibitors (PPI) reduce the amount of acid your stomach produces. If OTC drugs don’t work well, your doctor can recommend alternative medications. A prescription medication called sucralfate forms a protective film on the surface of your esophagus and stomach. Metoclopramide is a prescription medication that helps your esophagus to contract efficiently and your stomach to empty faster.
Lifestyle changes that ease symptoms:
You may be able to ease your symptoms by making a few simple changes. If you’ve been diagnosed with GERD, you should avoid smoking and being around secondhand smoke. Maintain a healthy weight and avoid tight clothing around your middle.
Eat smaller meals. Keep a food diary so you can pinpoint and avoid the foods that trigger symptoms. Try to move around a little after you eat. A short walk may go a long way.
If you don’t find relief from medication and lifestyle changes, surgery may be an option. Surgery for GERD involves reinforcing the lower esophageal sphincter.
Living with GERD
For most people, GERD is a manageable condition. Untreated, it can lead to serious complications.
Scar tissue can cause the esophagus to become too narrow (esophageal stricture). This can make swallowing difficult and painful.
Stomach acid entering into your lungs can cause serious harm. Lung damage can make you more likely to have chest congestion and wheezing. This puts you at increased risk for recurrent pneumonia or asthma.
Long-term inflammation of the esophagus (esophagitis) increases the risk of precancerous cells in the esophagus. Severe cases of GERD can lead to a condition called Barrett’s esophagus. That’s when your esophagus grows tissue resembling the tissue found in the lining of your intestine. Barrett’s esophagus increases your risk of esophageal adenocarcinoma, a rare type of cancer.
According to the Agency for Healthcare Research and Quality, 4.2 percent of GERD hospitalizations involved an esophageal disorder in 2005. Cases of dysphagia grew by 264 percent between 1998 and 2005. Esophageal adenocarcinoma rose by 195 percent. Esophagitis increased by 94 percent.
If you need to be hospitalized, GERD can be costly. In 1998, a hospital stay for GERD averaged $5,616. By 2005, it had risen to $6,545. Nationally, total hospital costs for GERD were $509 million in 1998. By 2005, costs rose to $622 million, an increase of 22 percent.