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Gastroesophageal Reflux Disease

WHAT YOU NEED TO KNOW:

What is gastroesophageal reflux disease?

Gastroesophageal reflux occurs when acid and food in the stomach back up into the esophagus. Gastroesophageal reflux disease (GERD) is reflux that occurs more than twice a week for a few weeks. It usually causes heartburn and other symptoms. GERD can cause other health problems over time if it is not treated.


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 such as spicy foods, chocolate, foods that contain caffeine, peppermint, and fried foods
  • Hiatal hernia
  • Certain medicines such as calcium channel blockers (used to treat high blood pressure), allergy medicines, sedatives, or antidepressants
  • Pregnancy or obesity
  • Lying down after a meal
  • Drinking alcohol or smoking

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. The pain gets better when you change positions. You may also have any of the following:

  • Bitter or acid taste in your mouth
  • Dry cough
  • Trouble swallowing or pain with swallowing
  • Hoarseness or sore throat
  • Frequent burping or hiccups
  • Feeling of fullness soon after you start eating

How is GERD diagnosed?

Your healthcare provider will ask about your symptoms and when they started. Tell him or her 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 manage GERD?

  • Do not have foods or drinks that may increase heartburn. These include chocolate, peppermint, fried or fatty foods, drinks that contain caffeine, or carbonated drinks (soda). Other foods include spicy foods, onions, tomatoes, and tomato-based foods. 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. Smoking weakens the lower esophageal sphincter and increases the risk of GERD. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.
  • Do not wear clothing that is tight around your waist. Tight clothing can put pressure on your stomach and cause or worsen GERD symptoms.

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.

When should I contact my healthcare provider?

  • You vomit large amounts, or you vomit often.
  • You have trouble breathing after you vomit.
  • You have trouble swallowing, or pain with swallowing.
  • You are losing weight without trying.
  • Your symptoms get worse or do not improve with treatment.
  • You have questions or concerns about your condition or care.

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.

© 2017 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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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