Gastroesophageal Reflux Disease (GERD)

Gastroesophageal reflux disease (GERD) is a condition in which the stomach contents (food or liquid) leak backwards from the stomach into the esophagus (the tube from the mouth to the stomach). This action can irritate the esophagus, causing heartburn and other symptoms.

When you eat, food passes from the throat to the stomach through the esophagus (also called the food pipe or swallowing tube). Once food in the stomach, a ring of muscle fibers prevents food from moving backward into the esophagus. These muscle fibers are called the lower esophageal sphincter, or LES.

If this sphincter muscle doesn’t close well, food, liquid, and stomach acid can leak back into the esophagus. This is called reflux or gastroesophageal reflux. This reflux may cause symptoms, or can even damage the esophagus.

The risk factors for reflux include hiatal hernia (a condition in which part of the stomach moves above the diaphragm, which is the muscle that separates the chest and abdominal cavities), scleroderma, and esophageal cancer.

Obesity, cigarettes, and possibly alcohol also increase the change of GERD. Heartburn and gastroesophageal reflux can be brought on or worsened by pregnancy and many different medications. Such drugs include:

  • Anticholinergics (e.g., for seasickness)
  • Beta-blockers for high blood pressure or heart disease
  • Bronchodilators for asthma
  • Calcium channel blockers for high blood pressure
  • Dopamine-active drugs for Parkinson’s disease
  • Progestin for abnormal menstrual bleeding or birth control
  • Sedatives for insomnia or anxiety
  • Tricyclic antidepressants

If you suspect that one of your medications may be causing heartburn, talk to one of our board certified physicians. NEVER change or stop a medication you take regularly without talking to your physician.

Individuals with Barrett’s esophagus may not have any symptoms. However, most patients diagnosed with Barrett’s esophagus have a history of longstanding gastro-esophageal reflux disease (GERD).

Typical symptoms of GERD include:

Heartburn – a burning sensation in the chest
Increased by bending, stooping, lying down, or eating
More likely or increased at night
Relieved by antacids
Regurgitation – sensation of food or gastric acid backing up into the esophagus or throat
Nausea after eating
Dysphagia – difficulty swallowing (Note: this symptom requires immediate medical attention)

You may not need any tests if your symptoms are not severe. Over-the-counter antacids may be used after meals and at bedtime, although they do not last very long. Talk with your board certified physician if antacids are not providing enough relief.If your symptoms are severe or they return after you have been treated, one or more tests may help diagnose reflux or any complications:

  • Esophagogastroduodenoscopy (EGD) is often used to identify the cause and examine the esophagus for damage. The doctor inserts a thin tube with a camera on the end through your mouth. The tube is then passed into your esophagus, stomach, and small intestine.
  • Barium swallow
  • Continuous esophageal pH monitoring
  • Esophageal manometry

A positive stool occult blood test may diagnose bleeding from the irritation in the esophagus.