Acid Reflux Disease

What is Acid Reflux Disease or Gastroesophageal Reflux Disease (GERD)?
GERD is a condition in which the esophagus becomes irritated or inflamed by stomach contents, such as acid. The acid backs up in the esophagus and causes reflux, which is the main symptom of heartburn.

  • Heartburn usually starts 30-60 minutes after eating, causing a burning pain in the center of the chest.
  • Most reflux occurs due to inappropriate relaxation of the lower esophageal sphincter muscle.  This muscle generally relaxes in response to a swallow and is supposed to close to keep food and acid in the stomach. Reflux happens when it relaxes, not in response to the swallow.

What causes GERD?
The exact cause of GERD is unknown.  Common factors that can make GERD worse:

  • Lifestyle: Alcohol, smoking, obesity, and poor posture
  • Medications: Blood pressure and antihistamines
  • Diet: Fatty and fried foods, chocolate, garlic, onions, caffeine, citrus and spicy foods
  • Carbonated drinks
  • Late-night meals

What are the symptoms of GERD?

  • Heartburn
  • Regurgitation of bitter acid in the throat
  • Bitter taste in the mouth
  • Persistent dry cough
  • Wheezing
  • Chest pain

What tests are performed to diagnose GERD?

  • Upper GI Series, barium swallow: A liquid is swallowed to coat the inside of your esophagus and stomach, and then x-rays of your chest and abdomen are taken.
  • Upper endoscopy: A thin tube with a tiny camera is passed down your esophagus to see if stomach acid is damaging the esophagus.
  • pH testing

What is the treatment for GERD?
Simple lifestyle modifications may be enough for mild symptoms. Nonprescription antacids such as Maalox, Mylanta, Tums, or Rolaids may also help. If lifestyle changes and antacids are not enough to relieve symptoms, other treatments like acid blockers are usually needed. Since surgical solutions have limitations, they are usually reserved for particular circumstances.

What are my options if these treatments don’t work?
Your doctor may recommend a prescription for a stomach acid reducer, such as Prilosec, Prevacid, Aciphex, Protonix, Nexium, Zantac, or Dexilant. 

When is surgery needed for GERD?
If prescription drugs are not relieving symptoms, or if you have serious complications, you may need surgery. Fundoplication helps tighten the lower esophageal sphincter muscle by tying the stomach, preventing acid from flowing back into the esophagus.   However, studies show that many patients still require acid-lowering medications and may develop new symptoms not noted before surgery.