Gastroesophageal Reflux Disease (GERD)

  • GER occurs when the lower esophageal sphincter (LES) opens spontaneously, for varying periods of time, or does not close properly, allowing stomach contents rise up into the esophagus. The inset shows a healthy LES (left) and an unhealthy one (right).

  • Anatomical abnormalities such as a hiatal hernia may also contribute to GERD. A hiatal hernia occurs when the upper part of the stomach and the LES move above the diaphragm. Normally, the diaphragm helps the LES keep acid from rising up into the esophagus. When a hiatal hernia is present, acid reflux can occur more easily.

  • The main symptom of GERD in adults is frequent heartburn, also called acid indigestion — a burning-type pain that occurs in the lower part of the mid-chest, behind the breast bone and in the mid-abdomen.

  • Most children under 12 years with GERD, and some adults, have GERD without heartburn. Instead, they may experience a dry cough, asthma symptoms, or trouble swallowing.

  • Certain foods may worsen GERD symptoms. These include: citrus fruits, chocolate, drinks with caffeine or alcohol, fatty or fried food, garlic and onions, mint flavorings, spicy foods and tomato-based foods.

  • GERD is treated with a combination of lifestyle changes and medications. In addition to avoiding foods that trigger symptoms the following recommendations can reduce GERD: eating small, frequent meals; wearing lose fitting clothing; avoiding lying down for at least three hours after meals; raising the head of the bed 6 to 8 inches.

  • First line medicine to prevent GERD includes antacids and foaming agents to relieve mild heartburn and prevent symptoms. Prescription strength and over-the-counter H2 blockers also provide symptom relief and heal the esophageal lining. Other medications include proton pump inhibitors and prokinetics.

  • Chronic untreated GERD can cause serious complications. Esophagitis from refluxed stomach acid can damage the lining of the esophagus and cause bleeding or ulcers. Scars from tissue damage can lead to strictures that make swallowing difficult, and some people develop Barrett’s esophagus, in which cells in the esophageal lining take on an abnormal shape and color. Over time, the cells can lead to esophageal cancer, which is often fatal.

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Gastroesophageal reflux disease (GERD) is a form of persistent gastroesophageal reflux (GER) that occurs more than twice a week and can eventually lead to more serious health problems. People of all ages are affected by GERD. Learn more about the causes, symptoms and treatments for GERD in this slideshow

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