GERD

GERD can cause pain, discomfort and long-term damage to your esophagus. Gastrointestinal experts at Atrium Health Floyd and Harbin Clinic can help you manage your symptoms, identify aggravating factors and related conditions, and provide treatment.

What is GERD?

Gastroesophageal reflux describes what happens when your stomach contents rise into the esophagus, causing heartburn or acid indigestion. When the condition persists for more than a few weeks, it’s considered chronic and referred to as gastroesophageal reflux disease, or GERD.

What causes GERD?

Reflux happens when your lower esophageal sphincter weakens or relaxes when it shouldn’t. The lower esophageal sphincter opens to allow swallowed food into the stomach. If it opens at the wrong time, digestive acids may rise out of the stomach and into the esophagus, causing a burning sensation in your chest or throat.

Things that weaken or relax the lower esophageal sphincter include:

• Antidepressants
• Antihistamines
• Calcium channel blockers
• Hiatal hernia
• Increased pressure on your abdomen from being overweight
• Painkillers
• Sedatives
• Smoking or inhaling secondhand smoke

GERD symptoms

The most common GERD symptom is regular heartburn, but not all adults with GERD have heartburn.

Other common GERD symptoms include:

• Bad breath
• Chest or upper abdomen pain
• Damage to teeth
• Difficult or painful swallowing
• Nausea
• Pain in the chest or upper abdomen
• Respiratory problems
• Vomiting

GERD diagnosis

Your doctor may refer you to a gastroenterologist to diagnose GERD.

Your doctor may order one or more of the following tests:

• Bravo wireless esophageal pH monitoring
• Esophageal manometry
• Esophageal pH and impedance monitoring
• Upper GI endoscopy and biopsy
• Upper GI series

GERD risk factors

GERD affects about 20% of the U.S. population. Anyone can develop GERD, some for unknown reasons. You are more likely to have GERD if you are:

• A smoker or regularly exposed to secondhand smoke
• Overweight or obese
• Pregnant
• Taking certain medicines

Barrett’s esophagus or intestinal metaplasia

Of those with GERD, somewhere between 5-10% develop a condition known as Barrett’s esophagus. This condition causes the esophageal lining to be replaced with intestinal lining, a process called intestinal metaplasia.

GERD treatment

GERD can be painful and disruptive, but at Atrium Health Floyd and Harbin Clinic we’re here to help you find the lifestyle changes to manage GERD, including any combination of the following:

• Avoiding greasy or spicy foods
• Quitting smoking and avoiding secondhand smoke
• Restricting alcoholic consumption
• Refraining from overeating or eating two to three hours before bedtime
• Weight loss if overweight

Medication to treat GERD

• Antacids – Over-the-counter antacids neutralize digestive acids, for fast but short-term relief. Overusing antacids may cause diarrhea or constipation. Look for antacids that contain both magnesium hydroxide and aluminum hydroxide to avoid constipation and diarrhea.
• H2 blockers – H2 blockers reduce the amount of acid your stomach produces.
• Prescription medications – Omeprazole (brand name Prilosec) and lansoprazole (brand name Prevacid) reduce how much acid the stomach makes. Metoclopramide (brand name Reglan) reduces acid reflux.

Surgery to treat GERD

If medicine and lifestyle changes fail to bring relief, surgery may be an option. However, complications from surgery are more likely than from medicines.

Surgical options can include:

• Fundoplication – This is the most common surgery for GERD. In most cases, it leads to long-term reflux control. A surgeon performs fundoplication using a laparoscope, a thin tube with a tiny video camera. During the operation, the surgeon sews the top of the stomach around the esophagus to add pressure and reduce reflux.
• Endoscopic techniques – Techniques such as endoscopic sewing and radiofrequency help control GERD in a small number of people. Endoscopic sewing uses small stitches to tighten the sphincter muscle. Radiofrequency creates heat lesions, or sores, that help tighten the sphincter muscle.