GERD (Gastroesophageal Reflux Disease) Specialist

What is GERD?

GERD is a condition where acid from the stomach comes up into the esophagus, often damaging the lining of the esophagus. Over 7 million Americans have GERD.

More commonly known as reflux or heartburn, GERD often presents as chest pain or burning or a bitter taste in the back of your mouth. It often occurs after eating a large meal or lying down after eating. Of concern is the fact that with chronic GERD comes the potential for developing a precancerous condition called Barrett’s esophagus, which is discussed in another section.

What are the symptoms of GERD?

GERD most often presents as heartburn, but may also cause other symptoms, including cough, wheezing, chest pain, tooth enamel decay, hoarseness, and difficulty swallowing. Symptoms often occur after eating or if a patient lies down after a meal. Certain foods are often the symptom-inducing culprits of GERD, such as fatty foods, tomatoes, citrus fruits, chocolate, peppermint, spearmint, and caffeinated drinks.

Should I be concerned if I develop heartburn?

No. Heartburn is very common, with 30% of Americans experiencing it at least once a month and 10% having heartburn on a daily basis. On the other hand, when it occurs more frequently as chronic GERD, it should be evaluated by your physician, particularly if it’s associated with difficulty swallowing, Barrett’s esophagus, or unexplained blood loss.

What causes GERD?

GERD is caused by stomach acid that refluxes into the esophagus, resulting in inflammation in the distal esophagus and causing the associated symptoms. Factors that predispose a person to developing GERD include gastric and esophageal dysmotility, poor muscle function in the distal esophagus, and early distention of the stomach with overeating. Patients with hiatal hernias where part of the upper stomach moves through the diaphragm also have increased risk of reflux.

What is the treatment for GERD?

GERD is treated with a combination of lifestyle and dietary changes, with or without medicines. H2 blockers such as TagametⓇ, ZantacⓇ, and AxidⓇ are often initially prescribed as they are not as strong as proton pump inhibitors (PPI) and potentially have less adverse effects. Refractory reflux as well as patients with Barrett’s usually require PPIs such as omeprazole, PrilosecⓇ, NexiumⓇ, PrevacidⓇ, or pantoprazole.

Are there risks associated with long-term use of PPIs?

There have been numerous studies looking at the chronic use of PPIs. Initial studies suggested that certain complications of long-term PPI use included osteoporosis, metabolic disarray with low magnesium, atherosclerosis, and kidney disease. Based on efforts in the gastrointestinal field, it is felt that the benefits of PPI use outweigh the risk of potential PPI complications, although your physician should use the lowest dose possible in order to control your reflux symptoms.

What dietary and lifestyle changes do I need to make?

When it comes to managing GERD, your diet and lifestyle play important roles. Some changes that you can make to improve your symptoms include:

• Avoid tobacco
• Eat small, frequent meals
• Don’t eat within four hours of going to bed
• Decrease caffeine, chocolate, peppermint, spearmint, and alcohol
• Wear loose, comfortable clothes, particularly after eating
• Exercise (and lose weight, if needed)
  
  

It’s also advisable to elevate the head of the bed at night time. Just sleeping propped up on numerous pillows is not adequate and may actually make reflux worse.

Certain conditions suggest that you need to be seen by your physician or gastrointestinal specialist. These include:

• Symptoms that occur for longer than two weeks
• Heartburn that persists despite medical intervention
• Increase in frequency or intensity of your heartburn
• Unexplained weight loss
• Difficulty swallowing
• Nausea or vomiting
• Chronic hoarseness
• Wheezing
  
  

If you’ve had chronic reflux for year and have any changes in your symptoms, it may suggest you’re developing complications of reflux, such as Barrett’s esophagus, and you should be evaluated.

To get expert care for your GERD, call Edmunds Gastroenterology today or request an appointment online.

This information is not intended to diagnose or treat any condition. Please consult with your primary care physician or a specialist regarding your symptoms.