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Gastroesophageal Reflux Disease


What is gastroesophageal reflux disease?

Gastroesophageal reflux disease (GERD) occurs when acid and food in the stomach back up into the esophagus.

What causes GERD?

GERD often occurs when the lower muscle (sphincter) of the esophagus does not close properly. The sphincter normally opens to let food into the stomach. It then closes to keep food and stomach acid in the stomach. If the sphincter does not close properly, stomach acid and food back up (reflux) into the esophagus. The following may increase your risk for GERD:

  • Certain foods that contain caffeine, chocolate, peppermint, and fried or fatty foods
  • Hiatal hernia
  • Medicines, such as NSAIDs, aspirin, or some antibiotics
  • Weight gain or pregnancy
  • Lying down after a meal
  • Cigarettes or alcohol

What are the signs and symptoms of GERD?

Heartburn is the most common symptom of GERD. You may feel burning pain in your chest or below the breast bone. This usually occurs after meals and spreads to your neck, jaw, or shoulder. You may also have any of the following:

  • Bitter or acid taste in your mouth
  • Coughing, choking, or shortness of breath
  • Trouble or difficulty swallowing
  • Frequent burping or hiccups
  • Vomiting blood or having black, tarry bowel movements
  • Weight loss without trying

How is GERD diagnosed?

Your healthcare provider will ask about your symptoms and when they started. Tell him about other medical conditions you have, your eating habits, and your activities. You may also need any of the following:

  • Esophageal pH monitoring is used to place a small probe inside your esophagus and stomach to check the amount of acid.
  • An endoscopy is a procedure used to look at the inside of your esophagus and stomach. An endoscope is a bendable tube with a light and camera on the end. Your healthcare provider may remove a small sample of tissue and send it to a lab for tests.
  • Upper GI x-rays are done to take pictures of your stomach and intestines (bowel). You may be given a chalky liquid to drink before the pictures are taken. This liquid helps your stomach and intestines show up better on the x-rays.
  • Esophageal manometry is a test that shows how your esophagus pushes food and fluid to your stomach. It also shows the pressures in your esophagus and stomach. It may show a hiatal hernia.

How is GERD treated?

  • Medicines are used to decrease stomach acid. Medicine may also be used to help your lower esophageal sphincter and stomach contract (tighten) more.
  • Surgery is done to wrap the upper part of the stomach around the esophageal sphincter. This will strengthen the sphincter and prevent reflux.

How can I help prevent GERD?

  • Do not have foods or drinks that may increase heartburn. These include chocolate, peppermint, fried or fatty foods, and drinks that contain caffeine. Do not have foods or drinks that can irritate your esophagus, such as citrus fruits, juices, and alcohol.
  • Do not eat large meals. When you eat a lot of food at one time, your stomach needs more acid to digest it. Eat 6 small meals each day instead of 3 large ones, and eat slowly. Do not eat meals 2 to 3 hours before bedtime.
  • Elevate the head of your bed. Place 6-inch blocks under the head of your bed frame. You may also use more than one pillow under your head and shoulders while you sleep.
  • Maintain a healthy weight. If you are overweight, weight loss may help relieve symptoms of GERD.
  • Do not smoke. If you smoke, it is never too late to quit. Smoking weakens the lower esophageal sphincter. Ask for information if you need help quitting.

When should I contact my healthcare provider?

  • Your symptoms get worse or do not improve with treatment.
  • You have questions or concerns about your condition or care.

When should I seek immediate care?

  • You feel full and cannot burp or vomit.
  • You have severe chest pain and sudden trouble breathing.
  • Your bowel movements are black, bloody, or tarry-looking.
  • Your vomit looks like coffee grounds or has blood in it.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. 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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