A number of people suffer from indigestion and heartburn that is caused by gastroesophageal reflux disease (GERD). While diet and lifestyle change can often improve GERD, sometimes medication or surgery is necessary to find relief.
What is GERD?
GERD is a digestive problem that affects the sphincter between your esophagus and your stomach. With GERD, the lower esophageal sphincter (LES) does not close properly. It is either weak or relaxes at inappropriate times. This allows food and stomach acid to leak into the esophagus. The result is discomfort and irritation of the esophageal lining.
Causes of GERD
Hiatal hernias are a common cause of GERD. It is believed that these hernias can weaken the LES and lead to GERD.
Research shows that both obesity and pregnancy can put stress on the LES and lead to GERD.
Smoking is shown to relax the LES, allowing it to open when it should not.
Consumption of certain foods and beverages, such as fatty foods, coffee or alcohol, can trigger heartburn and reflux.
Symptoms of GERD
The most common symptom of GERD is heartburn, which is also known as acid indigestion. This is felt as a burning pain in the chest that moves up into the throat and neck.
Some people will experience a bitter or acidic taste and a feeling like food is moving back into the mouth.
Other people will feel pressure or pain that is often worse after eating.
Over time, complications may develop as a result of the chronic inflammation of your esophagus that is common with GERD. These can involve esophageal ulcers, a narrowing of the esophagus and precancerous changes known as Barrett's esophagus.
Your doctor will start by discussing your symptoms with you and any triggers you have identified. A test can be performed to monitor the acid levels in your esophagus. This test, performed over a period of 24 hours, involves using a probe to look for acid.
Your doctor may wish to have X-rays of your upper digestive tract. This procedure involves drinking a barium solution, then having X-rays taken that show a silhouette of your esophagus. Esophageal motility testing or endoscopy can also allow closer examination of the area.
The treatment for GERD usually starts with lifestyle changes that can be performed at home. People who have GERD will be instructed to avoid foods that trigger symptoms and to each a number of smaller meals throughout the day instead of three big ones.
Avoiding clothing that constricts the upper abdomen can relieve some of the pressure that causes GERD. Abstaining from eating for a few hours before going to bed can keep food and stomach acid from traveling up the esophagus.
If these measures do not work, medication that controls heartburn may be prescribed. Antacids neutralize stomach acids to produce quick relief. You can also take medication that block or reduce acid production.
If your symptoms are not well controlled with medical therapy or if you are suffering from complications like a narrowing of the esophagus, surgery can help. Surgery may also be needed to help the LES close if a weakness in that sphincter is causing your GERD (performed through small incisions).
Minimally invasive surgery can also be performed to repair a hiatal hernia.
To read further about treatment options for GERD, click here.