Gastroesophageal reflux disease (GERD) is a condition in which the stomach contents leak backwards from the stomach into the esophagus (the tube from the mouth to the stomach). This can irritate the esophagus and cause heartburn and other symptoms.
When you eat, food passes from the throat to the stomach through the esophagus. A ring of muscle fibers in the lower esophagus prevents swallowed food from moving back up. These muscle fibers are called the lower esophageal sphincter, or LES.
When this ring of muscle does not close all the way, stomach contents can leak back into the esophagus. This is called reflux or gastroesophageal reflux. Reflux may cause symptoms. Harsh stomach acids can also damage the lining of the esophagus.
The risk factors for reflux include:
Use of alcohol (possibly)
Hiatal hernia (a condition in which part of the stomach moves above the diaphragm, which is the muscle that separates the chest and abdominal cavities)
A positive stool occult blood test may diagnose bleeding that is coming from the irritation in the esophagus, stomach, or intestines.
You can make many lifestyle changes to help treat your symptoms.
Other tips include:
If you are overweight or obese, in many cases, losing weight can help.
Avoid drugs such as aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve, Naprosyn). Take acetaminophen (Tylenol) to relieve pain.
Take all of your medicines with plenty of water. When your doctor gives you a new medicine, ask whether it will make your heartburn worse.
You may use over-the-counter antacids after meals and at bedtime, although the relief may not last very long. Common side effects of antacids include diarrhea or constipation.
Other over-the-counter and prescription drugs can treat GERD. They work more slowly than antacids, but give you longer relief. Your pharmacist, doctor, or nurse can tell you how to take these drugs.
Proton pump inhibitors (PPIs) decrease the amount of acid produced in your stomach
H2 blockers also lower the amount of acid released in the stomach
Anti-reflux surgery may be an option for patients whose symptoms do not go away with lifestyle changes and drugs. Heartburn and other symptoms should improve after surgery. But you may still need to take drugs for your heartburn.
There are also new therapies for reflux that can be performed through an endoscope (a flexible tube passed through the mouth into the stomach).
Most people respond to lifestyle changes and medicines. However, many patients need to continue taking drugs to control their symptoms.
Stricture (a narrowing of the esophagus due to scarring)
When to Contact a Medical Professional
Call your health care provider if symptoms do not improve with lifestyle changes or medicine.
Also call if you have:
Choking (coughing, shortness of breath)
Feeling filled up quickly when eating
Loss of appetite
Trouble swallowing (dysphagia) or pain with swallowing (odynophagia)
Following heartburn prevention techniques may help prevent symptoms. Obesity is linked to GERD, so maintaining a healthy body weight may help prevent the condition.
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Galmiche JP, Hatlebakk J, Attwood S, et al. Laparoscopic antireflux surgery vs esomeprazole treatment for chronic GERD: the LOTUS randomized controlled trial. JAMA. 2011;305:1969-1977.
George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.