Gastroesophageal Reflux Disease
What is gastroesophageal reflux disease (GERD)?
Gastroesophageal reflux disease (commonly known as GERD or GORD) is a condition in which stomach acid leaks backwards up the esophagus (the tube between mouth and stomach). It is a common condition, especially in people over the age of 40 and pregnant women. People who smoke and/or regularly drink alcohol, and those who are obese are also more likely to develop GERD.
Common symptoms include a burning pain in the chest (heartburn) and an acidic taste in the mouth. The symptoms of GERD can be managed through diet and lifestyle changes (for example, losing weight, quitting smoking and/or reducing alcohol intake) and by taking medications to reduce stomach acidity. Gastroesophageal reflux disease can be effectively managed and usually causes no long-term problems.
Gastroesophageal reflux disease (GERD) vs. Gastroesophageal reflux
It is important to recognise the difference between gastroesophageal reflux disease (GERD) and gastroesophageal reflux, also known as acid reflux. Both conditions occur when the contents of the stomach back up into the esophagus, however, simple gastroesophageal reflux rarely causes symptoms or complications, whereas GERD does.
Gastroesophageal reflux disease (GERD) symptoms
Heartburn is the most common symptom of GERD. It is usually experienced as a burning sensation in the center of the chest which may spread to the throat. Typically, heartburn is experienced following meals, though it may also be triggered by lying down or bending over and can, in some cases, occur at night.
- Stomach pain
- Non-burning chest pain
- Pain when swallowing and an acidic taste in the mouth.
- Regurgitation of food
- Bad breath
- Nausea and/or vomiting
- Coughing and wheezing
- A hoarse voice
- Persistent sore throat
- Getting full quickly
- A feeling of a lump in the throat that is present despite swallowing
- Enamel erosion
The symptoms experienced and the severity of these symptoms may differ from person to person.
Gastroesophageal reflux disease (GERD) causes
The esophageal sphincter, a circular band of muscle at the base of the esophagus, usually prevents acid from leaking. Gastroesophageal reflux disease occurs when the sphincter becomes weakened and does not function as it should. The exact reason why this occurs is not known.
Most people will experience acid reflux at some point in their lives, but some people are more at risk of developing GERD. These people include:
- People over the age of 40
- Pregnant women
- Overweight or obese people
- People who smoke or drink alcohol regularly
- People with hiatus hernia, a condition involving part of the stomach pushing through the diaphragm
Gastroesophageal reflux disease (GERD) diagnosis
Tests are not usually necessary to confirm a diagnosis of GERD. A doctor will usually be able to identify the condition from a description of the symptoms being experienced. Tests, however, may be necessary if the symptoms are severe and/or other more serious conditions are suspected.
- A gastroscopy (endoscopy): Using a flexible telescopic tube, doctors are able to see inside the esophagus and identify any signs of inflammation or injury. This will typically be the first diagnostic test performed.
- Esophageal manometry: A tube is swallowed which is able to measure the muscle contractions of the esophagus and detect whether the sphincter is functioning as it should. Typically only performed if a gastroscopy is unrevealing.
- Acidity test: A test to check the acid levels in the esophagus may be ordered if a gastroscopy is unrevealing.
- Other tests: Alternative diagnostic tests, such as a chest X-ray or heart tracings may also be ordered if the diagnosis is not clear.
Gastroesophageal reflux disease (GERD) complications
- Ulcers: Burning stomach acid can cause esophageal ulcers. These ulcers may bleed, something which will not be outwardly detectable.
- Stricture: If the esophagus becomes damaged, it can scar and narrow, potentially causing a blockage (stricture). This blockage can prevent food and medication from reaching the stomach. This should be treated as a medical emergency.
- Barrett’s esophagus: A condition that occurs when the normal cells of the esophagus (squamous cells) are replaced by intestinal cells, usually as a result of damage to the lining of the esophagus. Barrett’s esophagus is a risk factor for esophageal cancer.
- Esophageal cancer: Cancer as a complication of GERD is very rare. Difficulty swallowing is the most typical symptom of this type of cancer.
Gastroesophageal reflux disease (GERD) treatment
The treatment method used for gastroesophageal reflux disease will depend on the severity of the condition. Mild cases will usually be treated with lifestyle changes and over-the-counter medication.
Lifestyle changes include:
- Losing weight
- Avoiding reflux-inducing foods and drinks, such as caffeine, chocolate and alcohol
- Quitting smoking
- Avoiding late meals
If medication is required, doctors will generally prescribe proton pump inhibitors. This type of medication is generally safe to use and causes few side-effects. If the condition responds well to the medication, the affected person may only need to use them in the short-term, usually for around eight weeks. However, if symptoms are recurrent, long-term use may be required. Antacids, such as H2-antagonists, may also be prescribed in some cases.
Gastroesophageal reflux disease (GERD) prevention
Losing weight, avoiding alcohol and quitting smoking can help to prevent gastroesophageal reflux disease. Treating the symptoms of gastroesophageal reflux helps to prevent long-term complications of this condition.
Other names for gastroesophageal reflux disease
- Acid reflux disease
NCBI. “Complications of gastro-oesophageal reflux disease.” June 27, 2013. Accessed May 24, 2018. ↩
Cleveland Clinic. “Long-Term Complications of Gastroesophageal Reflux Disease (GERD).” Accessed May 24, 2018. ↩