
Gastroesophageal reflux disease (GERD) occurs when stomach contents frequently flow back into the esophagus. This backward movement often includes stomach acid, which can cause irritation and discomfort.
Acid reflux, indigestion, or heartburn are common experiences for many people. However, if you experience these symptoms more than twice a week, it may be a sign of gastroesophageal reflux disease (GERD).
GERD impacts approximately 40% of people in the India, and if left untreated, it can lead to serious health issues.
Below, we’ll explore the symptoms, causes, and treatments associated with GERD.
Symptoms of GERD
The most prevalent symptom of GERD is persistent heartburn, which can cause:
- A burning sensation that starts in the stomach and can spread to the chest, neck, or throat
- A sour or bitter taste at the back of the mouth
- Regurgitation of stomach contents into the mouth
Other symptoms of GERD may include:
- A sensation of fullness or a lump in the throat (globus sensation)
- Chronic coughing
- A hoarse voice
- Bad breath
In some instances, people may experience more serious or “alarm” symptoms that worsen over time despite treatment. These symptoms may also indicate other underlying health conditions.
Alarm symptoms include:
- Difficulty swallowing (dysphagia)
- Painful swallowing (odynophagia)
- Nausea or vomiting
- Unexplained weight loss
- Anemia
- Bleeding
If you experience any of these symptoms, it’s important to seek medical attention.
Heartburn vs. Heart Attack
Both heartburn and heart attacks can cause chest pain, but the sources and sensations are different:
- Heartburn occurs when stomach acid flows back into the esophagus, causing a burning sensation in the chest that can spread upwards.
- A heart attack happens when blood flow to the heart is reduced or blocked, leading to sharp or uncomfortable chest pain, which may radiate to the neck, jaw, or shoulders.
If you experience any signs of a heart attack, such as shortness of breath or fainting, seek medical assistance immediately.
GERD Symptoms in Infants
It’s common for babies to spit up food occasionally, but frequent vomiting or spitting up could be a sign of GERD.
Additional signs of GERD in infants may include:
- Refusal to eat
- Trouble swallowing
- Gagging or choking
- Wet burps or hiccups
- Irritability or arching of the back during or after feeding
- Weight loss or poor growth
- Recurring cough or pneumonia
- Difficulty sleeping
If you believe your baby may have GERD, consult a healthcare professional.
Causes of GERD
GERD often results from acid reflux, which occurs when the lower esophageal sphincter (LES) doesn’t function properly.
The LES is a ring of muscle at the base of the esophagus that opens to let food into the stomach and closes afterward. When the LES doesn’t close correctly, stomach contents can flow back up into the esophagus.
Some factors that can affect the LES function include:
- Hiatal hernia: This condition happens when part of the stomach moves above the diaphragm and can impact the LES.
- Large meals: Eating too much can distend the stomach and put pressure on the LES, preventing it from closing properly.
- Lying down too soon after eating: This position can reduce the pressure needed for the LES to close properly.
Other factors contributing to frequent acid reflux include:
Lifestyle Factors
- Smoking or exposure to secondhand smoke
- Eating large meals before lying down
- Excessive use of nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin or ibuprofen
Health Conditions
- Obesity
- Pregnancy
- Connective tissue disorders
- Older age
Other Contributing Factors
- Anxiety
- Asthma
- Irritable bowel syndrome
- Alcohol consumption: Research suggests that alcohol can increase the likelihood of GERD, with greater risk linked to higher amounts and frequency of alcohol intake. Reducing or eliminating alcohol may help relieve GERD symptoms.
Dietary Triggers
Certain foods and beverages can trigger GERD symptoms, including:
- High-fat foods such as fried and fast food
- Spicy foods
- Some fruits and vegetables like tomatoes, citrus, and pineapples
- Beverages like coffee, tea, and carbonated drinks
Diagnosing GERD
A doctor typically reviews your medical history and performs a physical exam to assess GERD symptoms.
For more severe symptoms, your doctor may refer you to a gastroenterologist or request diagnostic tests like:
- Ambulatory 24-hour pH probe: A small tube with a pH sensor is placed in your esophagus to measure acid exposure.
- Esophagram: After drinking a barium solution, X-rays are taken to examine your digestive tract.
- Upper endoscopy: A tube with a camera is inserted into your esophagus to visually inspect and possibly biopsy tissue.
- Esophageal manometry: A tube is used to measure the strength of esophageal muscles.
- Esophageal pH monitoring: A monitor helps measure acid levels in the esophagus over several days.
Treatment for GERD
Lifestyle Changes
Certain lifestyle adjustments can help manage and reduce GERD symptoms:
- Practicing breathing exercises
- Eating foods and drinks that reduce acid reflux
- Maintaining a moderate weight
- Quitting smoking
- Avoiding large meals late in the evening
- Waiting 2–3 hours after eating to lie down
- Elevating the head of your bed
Medications
If lifestyle changes are not enough, doctors may prescribe medications to reduce stomach acid production, including:
- Proton pump inhibitors (PPIs)
- Antacids
- H2 receptor blockers
Always consult a doctor before taking any medications, as they may have side effects.
Surgery
In more severe cases, surgery might be recommended if other treatments fail. Some surgical options include:
- Fundoplication
- LINX reflux management system
- Bariatric surgery
These procedures aim to prevent acid reflux and manage GERD symptoms effectively.