What is GERD?
Gastroesophageal reflux disease, or GERD, is a digestive disorder that affects the lower esophageal sphincter (LES), the ring of muscle between the esophagus and stomach.GERD occurs when the lower esophageal sphincter (LES) opens spontaneously, for varying periods of time, or does not close properly and stomach contents rise up into the esophagus. The esophagus is the tube that 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 valve between the esophagus and stomach. GERD is also called acid reflux because the digestive juices and food that rises up into the esophagus has acid mixed in with it.
When acid reflux occurs, food or fluid can often be tasted in the back of the mouth. When refluxed stomach acid touches the lining of the esophagus it may cause a burning sensation in the chest or throat called heartburn or acid indigestion. Occasional reflux is common and does not necessarily mean one has a serious problem. Persistent reflux that occurs more than twice a week is considered GERD, and it can eventually lead to more serious health problems. People of all ages can have GERD.
What are the symptoms of GERD?
The main symptom of GERD in adults is frequent heartburn, also called acid indigestion. Patients often describe a burning type pain in the mid-chest, behind the breastbone, and in the mid-abdomen. Often a foul or oily taste accompanies the pain. Some adults, have GERD without heartburn. Instead, they may experience a dry cough, asthma symptoms, or trouble swallowing. This condition is called laryngeal pharyngeal reflux or LPR.
The reason some people develop GERD is still unclear. In some people with GERD, the LES simply relaxes at an inappropriate time. Anatomical abnormalities such as a hiatal hernia may also contribute to GERD. A hiatal hernia occurs when the upper part of the stomach and the LES move above the diaphragm (a thin layer of muscle that separates the stomach cavity from the chest cavity). When the LES is in its normal position the diaphragm helps keep stomach contents and acid from rising up into the esophagus. When a hiatal hernia is present, acid and non-acid reflux can occur more easily. A hiatal hernia can occur in people of any age and is most often a common finding in otherwise healthy people over age 50. Like hernias in other parts of the body, this defect can be acquired over time from straining, coughing or gaining weight. Fortunately every hiatal hernia does not cause GERD or significant symptoms.
What are the long-term complications of GERD?
Chronic GERD that is untreated can cause serious complications. Inflammation of the esophagus from refluxed stomach acid can damage the lining and cause bleeding or ulcers—also called esophagitis. Scars from tissue damage can lead to strictures—narrowing of the esophagus—that make swallowing difficult. Some people develop Barrett’s esophagus, in which cells in the esophageal lining take on an abnormal shape and color. Over time, the cells can lead to esophageal cancer,which is often fatal. Persons with GERD and its complications should be monitored closely by a physician.
Studies have shown that GERD may worsen or contribute to asthma, chronic cough and pulmonary fibrosis.
Points to Remember about GERD
- Frequent heartburn, also called acid indigestion, is the most common symptom of GERD in adults. Anyone experiencing heartburn twice a week or more may have GERD.
- You can have GERD without having heartburn. Your symptoms could include a dry cough, asthma symptoms, or trouble swallowing.
- If you have been using antacids for more than 2 weeks, it is time to see your health care provider. Most doctors can treat GERD. Your health care provider may refer you to a gastroenterologist, a doctor who treats diseases of the stomach and intestines.
- Health care providers usually recommend lifestyle and dietary changes to relieve symptoms of GERD. Many people with GERD also need medications. Surgery is a treatment option when medical management fails or is too burdensome for the patient over time. It can be performed by specially trained surgeons with a brief hospitalization and a short recovery when laparoscopic techniques are used.