What Is Gerd?

GERD (gastroesophageal reflux disease) is a condition that causes the esophagus to become irritated, inflamed, and sometimes damaged. It is fairly common, affecting 20 to 40 percent of people who experience heartburn regularly. GERD is most common in people over 40 years old, and is associated with being overweight, smoking and drinking alcohol regularly.

Function

• GERD is defined as the passage of stomach acid into the esophagus. This happens when the lower esophageal sphincter, a ring of muscles at the bottom of the esophagus, does not contract sufficiently to prevent acid from escaping the stomach. Due to the effect of gravity, GERD is most likely to occur when lying down or bending over.

Effects

• The most common symptom associated with GERD is frequent heartburn, which may last as long as two hours. Heartburn causes a burning pain in the chest that spreads upwards into the neck. GERD can also cause regurgitation of stomach acid into the throat or mouth, a dry cough, hoarseness, and occasional wheezing.

Identification

• In most cases, GERD is diagnosed based on the patient's symptoms. However, if initial treatments fail, further diagnostic procedures and possibly a referral to a gastroenterologist may be required. Tests used to determine the extent of GERD and to rule out other problems include an upper GI series (barium swallow), an upper GI endoscopy, and a 24-hour pH probe study to monitor episodes of acid reflux.

Considerations

• Although the mainstay of treatment for GERD is medication, there are some lifestyle changes that can improve the condition. Avoiding acidic foods, coffee and alcohol can improve symptoms in some people, as can eating small amounts frequently throughout the day. Elevating the head of the bed approximately six inches is an effective measure to reduce the frequency of GERD at night.

Prevention/Solution

• Treatment of GERD may include one or more medications. Drugs for GERD that reduce or neutralize acid in the stomach include antacids (such as Tums), H2 blockers (such as Pepcid) and proton pump inhibitors (such as Nexium). Carafate (sucralfate) is a coating agent sometimes used to treat GERD; it works by creating a protective layer in the esophagus. Promotility agents, such as Reglan (metoclopramide) are occasionally used for severe GERD. These drugs work by moving food more quickly out of the stomach and into the intestines. However, they are not usually prescribed for GERD because they can cause significant side effects.