What is GERD?
Gastroesophageal reflux disease (GERD) is a more serious and long-lasting form of GER.
What is the difference between GER and GERD?
GER that occurs more than twice a week for a few weeks could be GERD. GERD can lead to more serious health problems over time. If you think you have GERD, you should see your doctor.
How common is GERD?
GERD affects about 20 percent of the U.S. population.
Who is more likely to have GERD?
Anyone can develop GERD, some for unknown reasons. You are more likely to have GERD if you are
- overweight or obese
- a pregnant woman
- taking certain medicines
- a smoker or regularly exposed to secondhand smoke
Risks of Acid Reflux (GERD)
Without treatment, GERD can sometimes cause serious complications over time, such as:
Esophagitis is inflammation in the esophagus. Adults who have chronic esophagitis over many years are more likely to develop precancerous changes in the esophagus.
An esophageal stricture happens when your esophagus becomes too narrow. Esophageal strictures can lead to problems with swallowing.
With GERD you might breathe stomach acid into your lungs. The stomach acid can then irritate your throat and lungs, causing respiratory problems, such as:
- asthma —a long-lasting disease in your lungs that makes you extra sensitive to things that you’re allergic to
- chest congestion, or extra fluid in your lungs
- a dry, long-lasting cough or a sore throat
- hoarseness—the partial loss of your voice
- laryngitis—the swelling of your voice box that can lead to a short-term loss of your voice
- pneumonia—an infection in one or both of your lungs—that keeps coming back
- wheezing—a high-pitched whistling sound when you breathe
GERD can sometimes cause Barrett’s esophagus. A small number of people with Barrett’s esophagus develop a rare yet often deadly type of cancer of the esophagus.
If you have GERD, talk with your doctor about how to prevent or treat long-term problems.
What are the symptoms of GER and GERD?
If you have gastroesophageal reflux (GER), you may taste food or stomach acid in the back of your mouth.
The most common symptom of gastroesophageal reflux disease (GERD) is regular heartburn, a painful, burning feeling in the middle of your chest, behind your breastbone, and in the middle of your abdomen. Not all adults with GERD have heartburn.
Other common GERD symptoms include:
- bad breath
- pain in your chest or the upper part of your abdomen
- problems swallowing or painful swallowing
- respiratory problems
- the wearing away of your teeth
Some symptoms of GERD come from its complications, including those that affect your lungs.
What causes GER and GERD?
GER and GERD happen when your lower esophageal sphincter becomes weak or relaxes when it shouldn’t, causing stomach contents to rise up into the esophagus. The lower esophageal sphincter becomes weak or relaxes due to certain things, such as:
- increased pressure on your abdomen from being overweight, obese, or pregnant certain medicines, including
- those that doctors use to treat asthma —a long-lasting disease in your lungs that makes you extra sensitive to things that you’re allergic to
- calcium channel blockers—medicines that treat high blood pressure
- antihistamines—medicines that treat allergy symptoms
- sedatives—medicines that help put you to sleep
- antidepressants —medicines that treat depression
- smoking, or inhaling secondhand smoke
A hiatal hernia can also cause GERD. Hiatal hernia is a condition in which the opening in your diaphragm lets the upper part of the stomach move up into your chest, which lowers the pressure in the esophageal sphincter.
When should I seek a doctor’s help?
You should see a doctor if you have persistent GER symptoms that do not get better with over-the-counter medications or change in your diet.
Call a doctor right away if you
- vomit large amounts
- have regular projectile, or forceful, vomiting
- vomit fluid that is
- green or yellow
- looks like coffee grounds
- contains blood
- have problems breathing after vomiting
- have pain in the mouth or throat when you eat
- have problems swallowing or painful swallowing
How do doctors diagnose GER/GERD?
In most cases, your doctor diagnoses gastroesophageal reflux (GER) by reviewing your symptoms and medical history. If your symptoms don’t improve with lifestyle changes and medications, you may need testing.
If your GER symptoms don’t improve, if they come back frequently, or if you have trouble swallowing, your doctor may recommend testing you for gastroesophageal reflux disease (GERD).
What tests do doctors use to diagnose GERD?
Several tests can help a doctor diagnose GERD. Your doctor may order more than one test to make a diagnosis.
Upper gastrointestinal (GI) endoscopy and biopsy
In an upper GI endoscopy, the doctor uses an endoscope (a flexible narrow camera) to see inside your upper GI tract. This procedure takes place at a hospital or an outpatient center.
Upper GI series
An upper GI series uses an xray and looks at the shape of your upper GI tract and can find problems related to GERD, such as
Esophageal pH and impedance monitoring
The most accurate procedure to detect acid reflux is esophageal pH and impedance monitoring. Esophageal pH and impedance monitoring measures the amount of acid in your esophagus while you do normal things, such as eating and sleeping.
Bravo wireless esophageal pH monitoring
Bravo wireless esophageal pH monitoring also measures and records the pH in your esophagus to determine if you have GERD. A doctor temporarily attaches a small capsule to the wall of your esophagus during an upper endoscopy. The capsule measures pH levels in the esophagus and transmits information to a receiver. The receiver is about the size of a pager, which you wear on your belt or waistband.
You will follow your usual daily routine during monitoring, which usually lasts 48 hours. The receiver has several buttons on it that you will press to record symptoms of GERD such as heartburn. The nurse will tell you what symptoms to record. You will be asked to maintain a diary to record certain events such as when you start and stop eating and drinking, when you lie down, and when you get back up.
To prepare for the test talk to your doctor about medicines you are taking. He or she will tell you whether you can eat or drink before the procedure. After about seven to ten days the capsule will fall off the esophageal lining and pass through your digestive tract.
Esophageal manometry measures muscle contractions in your esophagus. We may order this procedure if you’re thinking about anti-reflux surgery.
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