Acid Reflux Disease

Acid Reflux Disease

What is Acid Reflux Disease or Gastroesphageal Reflux Disease (GERD)?
GERD is a condition in which the esophagus becomes irritated or inflamed by stomach contents like acid.  The acid backs up in the esophagus and causes reflux.  The reflux 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 and 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 swallowa liquid is swallowed to coat the inside of your esophagus and stomach, then x-rays of your chest and abdomen are taken.
  • Upper endoscopya 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.  Also, nonprescription antacids such as Maalox, Mylanta, Tums or Rolaids may 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 special circumstances.

What are my options if these treatments don’t work?
Your doctor may recommend a prescription to reduce acid production in the stomach like 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. This procedure, fundoplication, helps tighten the lower esophageal sphincter muscle by tying the stomach, which prevents 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 prior to surgery.