Gastroesophageal Reflux Disease

WHAT YOU SHOULD KNOW:

• Gastroesophageal (gas-troh-ee-sof-ah-JEE-al) reflux disease is also called GERD. This disease occurs when the lower muscle of the esophagus does not close properly. The esophagus is the tube that carries food and liquid from the throat to the stomach. This makes the stomach acid and food in the stomach reflux (back up) into the esophagus. When acid touches and irritates the esophagus, it may cause a burning feeling called heartburn. The muscle in the lower esophagus is called the lower esophageal sphincter.
  
  
• GERD is diagnosed by having an endoscopy, esophageal manometry or pH monitoring, or x-rays of your esophagus and stomach. Treatment may include medicines and surgery. You may also need to make diet and lifestyle changes to cure GERD. Ask your caregiver about these tests and treatments.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

RISKS:

Treatment for GERD may cause unpleasant side effects. You may bleed too much or develop an infection. If you have surgery to treat GERD, you may feel bloated after meals. If GERD is not treated, the lining of the esophagus may form ulcers and bleed. These may heal into scars that can narrow the esophagus. Untreated GERD may also cause changes in the cell lining of the esophagus and lead to other medical problems.

WHILE YOU ARE HERE:

Informed consent: You have the right to understand your health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your condition. Your doctor should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.

Soft food diet: You may be allowed to eat soft foods. Some examples are applesauce, baby food, bananas, cooked cereal, cottage cheese, eggs, gelatin, pudding, and yogurt.

12-lead ECG: This test, also called an EKG, helps caregivers look for damage or problems in different areas of the heart. Caregivers may need to prepare your skin by shaving off some hair, or cleaning it with a gritty lotion. Sticky pads are placed on your chest, arms, and legs. Each sticky pad has a wire that is hooked to a machine or TV-type screen. A short period of electrical activity in your heart muscle is recorded. Caregivers will look closely for certain problems or changes in how your heart is working. This test takes about 5 to 10 minutes. It is important that you lie as still as possible during the test. You may need this test more than once.

Tests: You may have one or more of the following tests:

• Esophageal manometry: This test measures the pressure within the esophagus and stomach.
  
  
• Esophageal pH monitoring: A small probe is placed inside the esophagus to check the pH in the stomach and esophagus. The pH measures how much acid is in your esophagus and stomach. It can also measure the amount of acid that refluxes into the esophagus.
  
  
• Imaging tests:
  
  
  • Upper gastrointestinal endoscopy: This test is also called an EGD. Caregivers use a device called a scope to look at, and take pictures of the inside of your esophagus, stomach, and duodenum. The duodenum is the first part of the small intestine and helps your body digest the food that you eat.
    
    
  • Upper gastrointestinal x-ray: This is also called an upper GI series. Pictures of your esophagus, stomach, and intestines (bowel) are taken during an upper GI.

Treatment options: You may have one or more of the following treatments:

• Medicines:
  
  
  • Antacids: This medicine group decreases the stomach acid that can irritate your esophagus and stomach.
    
    
  • Histamine type-2 receptor blocker: H2 blockers is another name for this group of medicines which blocks acid production in the stomach.
    
    
  • Promotility agents: These medicines cause the lower esophageal sphincter and stomach to contract (tighten) more. These medicines may cause miscarriages and should not be used by pregnant women.
    
    
  • Proton pump inhibitor: This medicine group is also called a PPI. This medicine blocks acid from forming in the stomach.
  
  
• Surgery: Surgery may be done when your medicines cannot control your symptoms or other problems are present. Fundoplication is surgery to wrap the upper part of the stomach around the esophageal sphincter to strengthen it. Ask your caregiver for more information about surgery used to treat GERD.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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