What is gastroesophageal reflux disease (acid reflux)?
Gastroesophageal reflux disease (GERD, or GORD) is injury to the esophagus that develops from chronic exposure of the esophagus to acid coming up from the stomach (reflux). In contrast, heartburn is the symptom of acid in the esophagus, characterized by a burning discomfort behind the breastbone (sternum). Findings in GERD include esophagitis (reflux esophagitis) - inflammatory changes in the esophageal lining (mucosa), strictures, difficulty swallowing (dysphagia) and
chronic chest pain. Patients may have only one of those findings. Atypical symptoms of GERD include cough, hoarseness, changes of the voice, and sinusitis. Complicatons of GERD include stricture formation, Barrett's esophagus, esophageal ulcers and possibly even to esophageal cancer.
Gastroesophageal reflux is the return of the stomach's contents back up into the esophagus. In children, this reflux may be aspirated (sucked into the lungs) causing repeated bouts of pneumonia or asthma. In normal digestion, the lower esophageal sphincter (LES) opens to allow food to pass into the stomach and closes to prevent food and stomach juices from flowing back into the esophagus. Gastroesophageal reflux occurs when the lower esophageal sphincter is weak or relaxes allowing the stomach contents to flow up into the esophagus. The degree of the reflux depends on the LES as well as the type and amount of fluid brought up from the stomach.
Gastroesophageal reflux disease or acid reflux disease is the back up of acid from the stomach into the esophagus. At the top of your stomach is a muscle called the lower esophageal sphincter (LES), which normally opens and closes allowing food to enter. It also prevents the acid in your stomach from getting out. With GERD the LES opens inappropriately, allowing acid from the stomach to get into the esophagus. Consequently, acid reflux disease is a clinical condition that occurs when the reflux of stomach acid into the esophagus. Acid and enzymes reflux when the lower esophageal sphincter, the ring-shaped muscle that normally prevents the contents of the stomach from flowing back into the esophagus, is not functioning properly. When a person is standing or sitting, gravity helps to prevent the reflux of stomach contents into the esophagus. This explains why reflux can worsen when a person is lying down. Smoking and certain foods, such as chocolate, interfere with the sphincter muscle, making reflux more likely. Reflux is also more likely to occur soon after meals, when the volume and acidity of contents in the stomach are higher. Alcohol and coffee also stimulate acid production. Delayed emptying of the stomach (for example, due to diabetes or use of opioids) can also worsen reflux.
Occasional heartburn is common but does not necessarily mean one has GERD. Heartburn is a burning pain in the center of your chest, behind your breastbone. It often starts in the upper abdomen and spreads up into the neck. It usually starts about 30-60 minutes after eating and can last as long as 2 hours. Lying down or bending over can bring on heartburn or make it worse. It is sometimes referred to as acid indigestion. Not everyone with GERD has heartburn. Patients that have heartburn symptoms more than once a week are at risk of developing GERD. A hiatal hernia is usually asymptomatic, but the presence of a hiatal hernia is a risk factor for development of GERD.
More information on gastroesophageal reflux disease (acid reflux, GERD)
What is gastroesophageal reflux disease (acid reflux)? - Gastroesophageal reflux disease (GERD) is a condition in which stomach contents, including acid, back up (reflux) into the esophagus, causing inflammation and damage to the esophagus.
What causes gastroesophageal reflux disease? - Gastroesophageal reflux disease is often the result of conditions that affect the lower esophageal sphincter (LES). Dietary and lifestyle choices may contribute to GERD.
What are the symptoms of gastroesophageal reflux disease? - Heartburn, also called acid indigestion, is the most common symptom of reflux. The most common symptoms in children are repeated vomiting, coughing, and other respiratory problems.
What're the complications of gastroesophageal reflux disease? - Chronic gastroesophageal reflux disease can lead to a number of serious problems, such as bleeding ulcers in the esophagus, and scarring leading to narrowing of the esophagus.
How is gastroesophageal reflux disease diagnosed? - Useful diagnosing methods include barium swallow X-rays, esophageal manometry, esophageal pH monitoring and EGD.
What're the treatments for gastroesophageal reflux disease? - Doctors recommend lifestyle and dietary changes for most people with GERD. Lifestyle modifications are a key component in the management of GERD and should be incorporated into all treatment stages.
What GERD medications treat gastroesophageal reflux disease? - Antacids remain the drugs of choice for quick relief of symptoms associated with GERD. H2-Receptor blockers are indicated for the prevention and relief of heartburn, acid indigestion and sour stomach.
What surgery treats gastroesophageal reflux disease? - Surgery is indicated for a small group of patients with GERD. The standard surgical treatment, sometimes preferred over longtime use of medication, is the Nissen fundoplication.
How to prevent gastroesophageal reflux disease with lifestyle? - A correct life style is effective to prevent the symptoms of GERD. Avoid foods that promote opening of the esophageal sphincter and increase acid reflux.
Gastroesophageal reflux disease in infants and children - Infants are more likely to have the lower esophageal sphincter (LES) relax when it should remain shut. Infants are easier for the stomach contents to reflux up into the esophagus.
What is hiatal hernia? - A hiatal hernia is named for the hiatus, an opening in the diaphragm between your chest and your stomach. There are two types of hiatal hernias.