AMITA Health Endoscopy Center Lincoln Park

Overview

GERD, or gastroesophageal reflux disease, is a condition where acid from your stomach goes backward (or refluxes) into your esophagus. The esophagus is the muscular tube that connects your mouth to your stomach. If you have heartburn in your chest or a burning sensation in your throat after eating, you may have GERD.

At the bottom end of the esophagus is a valve or sphincter called the lower esophageal sphincter. If it weakens or relaxes, acid can reflux into your esophagus, causing GERD. Acid can irritate and redden the inner lining of your esophagus, and over time can cause difficulty swallowing (dysphagia) and even ulcers and bleeding. Chronic GERD can also cause the lining cells to turn precancerous — a condition called Barrett’s esophagus. Esophageal cancer can develop in a small number of patients with Barrett’s. GERD may also cause narrowing or a stricture of the esophagus.

Risk factors for GERD include smoking, obesity, diabetes and overeating. Other risks are pregnancy, asthma, hiatal hernia (bulging of the stomach upwards through an opening in the diaphragm), and connective tissue disorders such as scleroderma. Worsening of GERD can occur with eating fatty foods, eating large meals at night and lying down soon after eating, aspirin, alcohol, and coffee.

Diagnosis of GERD can be obtained by x-rays with swallowed barium, endoscopy (a tube with a camera that is lowered down into the esophagus to view the lining), esophageal acid or pH testing, and esophageal motility testing that measures pressure and movement in your esophagus.

Symptoms

  • Heartburn and chest pain
  • *Please seek immediate medical attention with chest pain, especially with arm pain or shortness of breath
  • Burning sensation in your throat or sour taste in your mouth
  • Sensation of a lump in your throat
  • Trouble swallowing food (dysphagia)
  • Upper abdominal pain
  • Hoarseness or sore throat

Treatments

Lifestyle changes. Your provider may recommend weight loss, stopping smoking, watching portion sizes, not lying down after a meal and avoiding tight-fitting clothing.

Acid suppressors. Acid-reducing medication will likely be prescribed by your provider. Stomach acid can irritate your esophageal lining. The most common medications to reduce acid are proton pump inhibitors or PPIs. Esomeprazole (Nexium) is an example of a PPI. Others include H-2 blockers such as famotidine (Pepcid).

Surgery. Your doctor may recommend surgeries to reinforce the lower esophageal sphincter, such as a Nissen fundoplication or LINK device procedure. Other surgical options also exist.

Prevention

Avoid GERD-triggering foods and drinks. Alcohol, fatty foods, tomato sauce, chocolate, caffeine and certain other foods can worsen your symptoms. Avoid these foods that typically trigger your heartburn.

Elevate the head of your bed. Many patients experience worsening of their symptoms at night. If so, elevating the head of your bed may help. A common way to achieve this is using a wedge between your box spring and mattress. Elevating your head at night can make gravity your friend by keeping acid in your stomach and out of your esophagus.

Establish or maintain a healthy weight. Extra pounds around the abdomen can push up your stomach and force acid into your esophagus, worsening your symptoms. Ask your provider for a weight loss and exercise plan that matches your needs.

Stop smoking.