What is Acid Reflux Disease (GERD)?
Acid reflux disease, often known as gastroesophageal reflux disease (GERD) happens when food that reaches your stomach comes back (refluxes) into your esophagus, which is the connection between your mouth and stomach. People with acid reflux disease may feel a burning sensation or pain in their chest or throat, usually after eating.
Treatment for acid reflux disease usually includes avoiding foods that trigger your symptoms, staying upright for at least one to two hours after eating, and eating smaller portions. Sometimes medications may help to reduce the acid in your stomach and provide you with some relief from these symptoms.
You should visit your primary care physician for consultation, but you can also safely treat this condition on your own by changing the nature of feeding and adding a thickening agent, such as rice cereal or commercial "antireflux" formulas. If these do not work, contact your pediatrician for medical therapies.
How common is Acid Reflux Disease (GERD)?
Symptoms that never occur with Acid Reflux Disease (GERD):
Acid Reflux Disease (GERD) is also known as
- Acid reflux
- Gastroesophageal reflux disease
Acid Reflux Disease (GERD) Symptoms
The symptoms of acid reflux disease may include:
- Heartburn: This might feel like a burning sensation in the middle of your chest, usually occurring after eating.
- Acid taste: When acid and food come back up from your stomach, you might end up with a bad taste in your mouth and throat.
Other symptoms of acid reflux disease can include the following:
- Chest pain: Some people with acid reflux disease experience pain in their chest, usually in the center. This pain may feel different than typical heartburn but often improves with the help of antacids.
- Cough: A cough that lasts for more than four weeks may be due to acid reflux.
- Sore throat: When the acid reflux occurs often, it can irritate the throat and cause constant soreness.
- Hoarseness: Acid reflux can irritate other structures that are near the passage of food, including the vocal cords.
- Difficulty swallowing: Some people might feel a sensation of having something stuck in their throat or having a hard time with swallowing.
Acid Reflux Disease (GERD) Causes
Acid reflux disease is usually caused by a combination of factors including your eating habits and your body's ability to keep food in your stomach. A ring of muscle (sphincter) at the beginning of your stomach attempts to keep the food and acid in place. When this ring is too relaxed or when your stomach is not upright, food is able to move in the wrong direction, causing heartburn.
There are some causes of acid reflux disease that are due to mechanical reasons, that is, the laws of physics might be responsible.
- Anatomy: For some people, their stomach sphincter might be more relaxed than average. This may put you at risk of having acid reflux .
- Obesity: People who are overweight might experience extra pressure on the stomach, which can lead to the sphincter opening up when it is not supposed to .
- Sleeping: When you lie down after eating gravity is working against you. The contents of your stomach can easily slide out.
Our choices in food can also contribute to acid reflux.
- Overeating: When the stomach is too full it does not let your stomach sphincter close the way it should. This makes it easier for foods and stomach acid to reflux.
- Relaxing foods: It is thought that certain foods, like spicy, minty, and acidic foods, contribute to the relaxation of your stomach sphincter. When this muscle is relaxed, it can make it easier for food and stomach acid to go back toward your throat .
- Slow foods: Foods that are fatty might take longer to digest. The longer foods are in your stomach, the more likely that they might lead to heartburn.
Treatment Options and Prevention
Treatment for acid reflux disease can sometimes begin with at-home solutions. Medications can also be used to help control the symptoms. In some cases, surgery might be an option for severe symptoms or symptoms that are not improving with other treatments .
Treatment for acid reflux disease usually begins with making lifestyle changes to avoid possible triggers for your symptoms. These changes usually affect what you eat and when you eat it.
- Avoid foods that trigger your symptoms: This might include avoiding spicy or acidic foods. For some people avoiding caffeine, mint, and alcohol can also make a big difference. Try to identify which foods make your symptoms worse.
- Avoid large meals: You can try to eat smaller meals to see if this improves your symptoms.
- Stay upright after eating: Let gravity help you and stay upright for at least one hour after eating. The longer you can stay upright, the better. If you notice your symptoms are active when you sleep, you can use extra pillows to raise the head of your bed.
- Wear loose clothing: A loose waistband might help put less pressure on your stomach sphincter.
- Stop smoking: Research studies in the past have shown that people who smoke have more episodes of reflux .
- Weight loss: If you are overweight, your stomach sphincter is probably experiencing extra pressure. With only a few pounds of weight loss, you might be able to experience some relief in your acid reflux symptoms .
In some cases, medication is also necessary to help decrease the amount of acid in your stomach. You might see different types of medications used to try to improve your symptoms . They can be broken down into three broad categories:
- Over-the-counter treatments: These include antacids like Tums, Maalox, or Pepto Bismol, which usually only act for a short period of time.
- Histamine H2 receptor antagonists: These medications, which help block the acid in your stomach, include cimetidine (Tagamet), famotidine (Pepcid), ranitidine (Zantac), etc. They are stronger than antacids, but most can be obtained without a prescription from your doctor.
Proton pump inhibitors: These medications are the strongest and also help block the acid in your stomach. This category of medications includes esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), etc.
Surgery is usually the last resort option for people who do not respond to lifestyle changes and medication. For those with severe acid reflux or those who have developed complications from long-term acid reflux, a procedure may be considered to tighten the muscle at the bottom of your esophagus that keeps food in the stomach.
When to Seek Further Consultation
Many people with acid reflux disease can manage their symptoms with lifestyle changes and over-the-counter antacids. If you are experiencing frequent heartburn or if your symptoms are severe, you may need to see your primary care doctor to discuss a plan for treatment. Other symptoms that may require a doctor's visit include chest pain, weight loss, pain with swallowing, stomach pain after eating, if food gets stuck in your throat, or symptoms that are not improving with initial therapies. People who have a first-degree relative, like a parent or sibling, who have had cancer of the esophagus, stomach, or intestines, should also see their doctor for more guidance.
Questions Your Doctor May Ask to Diagnose
To diagnose this condition, your doctor would likely ask about the following symptoms and risk factors.
- Any fever today or during the last week?
- Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?
- Have you experienced any nausea?
- Have you had any changes in your weight?
- Do you have a rash?
The above questions are also covered by our A.I. Health Assistant.
- Gastroesophageal reflux disease (GERD). Harvard Medical School: Harvard Health Publishing. Published August 2015. Harvard Health Publishing Link
- El-Serag H. The association between obesity and GERD: A review of the epidemiological evidence. Dig Dis Sci. 2008;53(9):2307-2312. NCBI Link
- Jarosz M, Taraszewska A. Risk factors for gastroesophageal reflux disease: The role of diet. Prz Gastroenterol. 2014;9(5):297-301. NCBI Link
- Seehusen DA, Escano J. Managing chronic gastroesophageal reflux disease. American Family Physician. 2012;86(7):617-9. AAFP Link
- Kahrilas PJ, Gupta RR. Mechanisms of acid reflux associated with cigarette smoking. Gut. 1990;31(1):4-10. Gut Link
- Singh M, Lee J, Gupta N, et al. Weight loss can lead to resolution of gastroesophageal reflux disease symptoms: a prospective intervention trial. Obesity (Silver Spring). 2013;21(2):284-290. NCBI Link
- Law R, Maltepe C, Bozzo P, Einarson A. Treatment of heartburn and acid reflux associated with nausea and vomiting during pregnancy. Can Fam Physician. 2010;56(2):143-4. NCBI Link