What are Acid Reflux and GERD

Acid reflux (also known as heartburn), which is most commonly recognized as a burning sensation in the chest beneath the breastbone or the upper abdomen. Acid reflux occurs when stomach acid splashes up in the esophagus: the muscular tube that connects the throat to the stomach. GERD is an abbreviation for gastroesophageal reflux disease, a condition that refers to damage to the lining of the lower esophagus GERD occurs as a result of frequent or prolonged exposure to stomach acid.

When should I be concerned about Acid Reflux?

Everyone experiences mild heartburn from time to time. If the symptoms progress or keep occurring over a long period of time, however, you should consult your doctor.

What causes Acid Reflux?

Acid Reflux is caused by the malfunction of a valve called the lower esophageal sphincter (LES). This area of the esophagus is supposed to open to allow food and liquid to pass into the stomach and quickly clamp shut to keep stomach acid from flowing back into the esophagus.

The lining of the stomach is protected from digestive acid, but the lining of the esophagus is not. So, when the LES does not close properly and acid flows back into the esophagus, its lining can become inflamed causing esophagitis, readily seen on upper endoscopy.

When do I know if it is heartburn or GERD?

In general, if your symptoms are severe, frequent or getting worse, you need to be seen by a medical professional. Some indications that you may need an evaluation are:

  • If you take antacids three or more times a week,
  • If you take heartburn medicines other than antacids,
  • If heartburn interferes with your daily activities,
  • If your symptoms usually occur after meals,
  • If your symptoms interfere with your sleep, or
  • If medicine only helps relieve your symptoms for short periods of time.

What can I do to treat GERD?

A combination of lifestyle changes and medications are usually sufficient to control most individuals who suffer from GERD. Medications such as rainitidine or Zantac may be used in milder cases and omeprazole or Prilosec may be required for moderate to severe cases.

How can I change my lifestyle to improve my symptoms?

  • Avoid caffeine, alcohol, tobacco, fried/fatty foods, chocolate and peppermint.
  • Minimize foods that may otherwise be healthy such as citrus, marinara sauce, garlic, and onions
  • Eat smaller meals and avoid eating within three hours of bedtime
  • Raise the head of the bed 6 to 8 inches to keep fluid out of the esophagus using gravity
  • Avoid activities such as bending or stooping and wear loose clothing
  • Maintain a healthy weight and lifestyle (BMI of 28 or less)

Are there any complications from GERD?

Complications occur when GERD is severe or long-standing. Constant irritation of the esophagus by stomach acid can lead to inflammation, ulcers, and bleeding. Over time, scarring and narrowing of the esophagus can also develop, making it difficult to swallow foods and even result in an obstruction. This narrowing is called a stricture. Some patients develop a condition called Barrett’s esophagus, which is a precancerous condition.

Does my hiatal hernia need to be repaired?

Some patients with GERD may need surgery to strengthen the LES. This procedure is called fundoplication. This surgery is now usually done by laparoscopy. This is a newer type of minimally invasive surgery, performed with a tiny incision at the naval and a few needle points in the upper abdomen. The patient usually returns home 1-2 days after surgery, with few problems. Surgery, however, should not be considered until all medical treatments have been tried. Surgery is often seriously considered for an otherwise healthy patient when the disease is severe, or the patient wants to avoid the expense or regimen of long-term treatment with medications.

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