Gastroesophageal Reflux Disease: a.k.a. GERD

Gastroesophageal Reflux Disease (GERD), also known as acid reflux is a long-term condition in which stomach contents rise up into the esophagus due to failure of the lower esophageal sphincter, resulting in either symptoms or complications.

The most common symptoms are an acidic taste in the mouth, heartburn, and vomiting. Less common symptoms include pain with swallowing/sore throat, nausea, chest pain, and coughing.

Factors that can contribute to GERD:

  • Hiatal hernia
  • Obesity
  • High blood calcium levels

GERD sometimes causes injury to the esophagus which may include one or more of the following:

  • Reflux esophagitis — inflammation of the esophageal epithelium which can cause ulcers near the junction of the stomach and esophagus
  • Esophageal strictures — the persistent narrowing of the esophagus caused by reflux-induced inflammation
  • Barrett’s esophagus — intestinal metaplasia (changes of the epithelial cells from squamous to intestinal columnar epithelium) of the distal esophagus
  • Esophageal adenocarcinoma — a form of cancer

Acid reflux is due to poor closure of the lower esophageal sphincter, which is at the junction between the stomach and the esophagus.

Treatment options include lifestyle changes and medications. Lifestyle changes include not lying down for three hours after eating, raising the head of the bed, losing weight, avoiding foods that result in symptoms, and stopping smoking. Medications include antacids, H2-receptor blockers, proton pump inhibitors, and prokinetics.