| Subject | Contents |
| Definition | Gastroesophageal reflux disease (GERD) is when food or liquid travels from the stomach back up into the esophagus (the tube from the mouth to the stomach). This partially digested material is usually acidic and can irritate the esophagus, often causing heartburn and other symptoms.
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| Alternative Names | Peptic esophagitis; Reflux esophagitis; GERD; heartburn - chronic
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| Causes, incidence, and risk factors | Gastroesophageal reflux is a common condition that often occurs without symptoms after meals. In some people, the reflux is related to a problem with the lower esophageal sphincter, a band of muscle fibers that usually closes off the esophagus from the stomach. If this sphincter doesn't close properly, food and liquid can move backward into the esophagus and may cause the symptoms. Some conditions are associated with incompetent esophageal sphincters, including pregnancy , hiatal hernia , obesity , recurrent or persistent vomiting and nasogastric tubes. Risk factors for reflux include previous esophageal surgery or esophageal stricture . |
| Symptoms | Heartburn Involves a burning pain in the chest (under the breastbone) Increased by bending, stooping, lying down, or eating Relieved by milk or antacids More frequent or worse at night Belching Regurgitation of food Nausea and vomitingVomiting bloodHoarseness or change in voice Sore throatDifficulty swallowingCough or wheezing |
| Signs and tests | A positive stool guaiac Continuous esophageal pH monitoring showing refluxEndoscopy showing ulceration or inflammation of the esophagusEsophageal manometry showing abnormal sphincter pressure A barium swallow showing reflux A positive Bernstein test for gastric acid reflux |
| Treatment | General measures include:
Weight reduction Avoiding lying down after meals Sleeping with the head of the bed elevated Taking medication with plenty of water Avoiding dietary fat , chocolate, caffeine , peppermint (they may cause lower esophageal pressure) Avoiding alcohol and tobacco
Medications that alleviate symptoms include:
Antacids after meals and at bedtime Histamine H2 receptor blockers Promotility agents Proton pump inhibitors
Anti-reflux operations ( Nissen fundoplication ) may help a small number of patients who have persistent symptoms despite medical treatment. There are also new therapies that can be performed through an endoscope (a flexible tube passed through the mouth into the stomach) for reflux.
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| Support Groups | |
| Expectations (prognosis) | The majority of people respond to nonsurgical measures with behavioral modification and medications. |
| Complications | Inflammation of the esophagus Stricture Esophageal ulcerHoarseness , bronchospasm Chronicpulmonary diseaseBarrett's esophagus (a change in the lining of the esophagus that can increase the risk of cancer) |
| Calling your health care provider | Call your health care provider if symptoms worsen or do not improve with lifestyle changes and/or medication.
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| Prevention | Avoid foods and activities that worsen symptoms. Maintain a healthy weight.
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