One study found that reflux occurs as frequently in normal individuals as in patients with GERD. In patients with GERD, however, the refluxed liquid contains acid more often, and the acid remains in the esophagus longer.
GERD or acid reflux symptoms are caused by the regurgitation of acidic liquid stomach contents back up into the esophagus. In refractory cases or when complications related to reflux disease are identified (eg, stricture, aspiration, airway disease, Barrett esophagus), surgical treatment (fundoplication) is typically necessary. The prognosis with surgery is considered excellent.
They are useful, however, in diagnosing cancers or causes of esophageal inflammation other than acid reflux, particularly infections. Moreover, biopsies are the only means of diagnosing the cellular changes of Barrett’s esophagus. More recently, it has been suggested that even in patients with GERD whose esophagi appear normal to the eye, biopsies will show widening of the spaces between the lining cells, possibly an indication of damage.
Most people refer to GERD as heartburn, although you can have it without heartburn. Sometimes GERD can cause serious complications including inflammation of the esophagus from stomach acid that causes bleeding or ulcers. In a relatively small number of patients, GERD has been reported to result in a condition called Barrett’s esophagus, which over time can lead to cancer.
3. Eat smaller meals. Large meals fill the stomach and put pressure on the LES, making reflux and GERD more likely. There are potentially injurious agents that can be refluxed other than acid, for example, bile.
The LES acts like a valve, allowing food and liquid to pass through to the stomach. Normally, the LES resists opening to gastric pressures to prevent reflux. In people with GERD, the LES is weak and allows acid and bile to reflux from the stomach into the esophagus, often causing injury to the lining of the esophagus and symptoms such as heartburn, chest pain, regurgitation, sore throat, and cough. The LES is a muscle at the junction of the esophagus and stomach that functions as the bodyâ€™s natural barrier to reflux.
The elevation is accomplished either by putting blocks under the bed’s feet at the head of the bed or, more conveniently, by sleeping with the upper body on a foam rubber wedge. These maneuvers raise the esophagus above the stomach and partially restore the effects of gravity. It is important that the upper body and not just the head be elevated. Elevating only the head does not raise the esophagus and fails to restore the effects of gravity.
- A majority of patients with GERD have hiatal hernias, but many do not.
- into 2 categories (ie, esophageal clearance and mucosal resistance).
- Two of them involve the function of the LES.
- Some other medications and/or supplements may aggravate GERD.
- However, the adequacy of the PPI treatment probably should be evaluated with a 24-hour pH study during treatment with the PPI.
Proper esophageal clearance is an extremely important factor in preventing mucosal injury. Esophageal clearance must be able to neutralize the acid refluxed through the lower esophageal sphincter.
This approach, however, has the same problems as discussed above, that result from using the response to treatment to confirm GERD. effects of gravity, reflux occurs more easily, and acid is returned to the stomach more slowly. Many patients with GERD are awakened from sleep by heartburn. Most reflux during the day occurs after meals.
Obesity is the leading cause of GERD, Dr. Vaezi says. Extra stomach fat places pressure on your abdomen, pushing gastric juices up into your esophagus. “Lose weight if you’re overweight, and don’t gain weight if you’re not,” he says. Surgery is a last resort for people with GERD and is rarely needed in healthy teens. Lots of people who have GERD notice their heartburn is worse after eating.
The reflux of liquid into the lungs (called aspiration) often results in coughing and choking. Aspiration, however, also can occur without producing these symptoms. With or without these symptoms, aspiration may lead to infection of the lungs and result in pneumonia. This type of pneumonia is a serious problem requiring immediate treatment.
Proton pump inhibitors (omeprazole, lansoprazole, pantoprazole, esomeprazole, and rabeprazole) are all highly effective in treating reflux symptoms. These medications act by blocking the final step of acid production in the stomach and are typically taken once or twice daily prior to meals.
In this article, learn more about GERD. Gastroesophageal reflux disease (GERD) occurs when the upper portion of the digestive tract is not functioning properly, causing stomach contents to flow back into the esophagus. The esophagus is a muscular tube linking the mouth to the stomach. In normal digestion, a specialized ring of muscle at the bottom of the esophagus called the lower esophageal sphincter (LES) opens to allow food to pass into the stomach and then quickly closes to prevent backflow into the esophagus.