What is Acid Reflux Disease (GERD)?
Acid reflux disease.(GERD) is a condition in which acid from the stomach escapes and irritates esophagus – the food pipe.
It’s a chronic problem which can be caused by stomach irregularities including: hernias or defects of the esophagus.
Reflux can be explained as the flow back of liquids in the body, in the case of GERD it means stomach acid.
The stomach’s job is to prepare whatever you eat for the intestine to digest. This involves breaking down food with acid. (3)
The esophagus runs through the hiatus, an opening in your diaphragm. A hernia on the hiatus is when a part of the stomach pushes up into the chest.
Hiatal hernias are a known risk factor for the disease.
The esophagus has natural defenses in place to protect itself from stomach acid. If these defenses are compromised, it can become vulnerable to acid reflux.
The lower esophageal sphincter (LES) is the muscle at the bottom of your esophagus. When it relaxes, it opens up so that liquids and foods can travel to your stomach. Once food has gone through it then tightens up and closes.
If it becomes weak or expands at random, acid from your stomach can flow back into the esophagus.
Peristalsis is a type of muscle contraction helping your body process food. Peristaltic waves help food travel through the different stations of digestion.
If these contractions are too slow or jerky, it can provoke acid reflux. Abnormal peristalsis is found in 40-50 percent of people with GERD. (4)
The symptoms of acid reflux disease typically include the following:
After eating a big meal most people have experienced heartburn on occasion. Frequent or severe heartburn is a telltale warning sign of GERD.
Heartburn can be described as a burning feeling in the chest, upper stomach or in the breastbone area of the body
This unpleasant feeling is caused by stomach acid irritating the sensitive lining of the esophagus.
If there is a regular leak of stomach contents into the esophagus, you will experience heartburn more often. If large amounts of digestive fluid escape the stomach, the pain will be more severe. (5)
Belching can happen after drinking a fizzy soda or overloading on food. A burp is simply gas expelled from the stomach.
Normally, excess air from the tummy escapes when the lower esophageal sphincter relaxes.
When gas and stomach juices escape together, burps can taste acidic and burn the throat. On average, people with this disease burp more frequently than usual. (6)
Coughing and Dry Throat
If stomach acid regularly travels up your esophagus, it can affect other areas. Gastric fluids can also be accidentally drawn into the windpipe.
This can cause the sensation of a dry, burning throat making it difficult to swallow. Many GERD patients report feeling like they have a lump in the throat.
This may be accompanied by a harsh, dry cough. In some cases, the cough can be violent enough to wake you up from your sleep.
Your vocal cords are located in the same area as your throat. Exposure to stomach acid can cause them to become inflamed.
This inflammation can make it difficult for you to speak at a normal volume. It can also change your voice frequency, which is your unique voice tone. (7)
Indigestion encompasses a range of different symptoms relating to the stomach.
The occasional bout of indigestion is normal. However, persistent digestive upset is
abnormal and can be a symptom of acid reflux disease (GERD).
This includes abdominal cramps, nausea, and bloating. You may also experience a loud “growling” stomach.
Indigestion due to the disease commonly starts off as burning in the upper abdomen. Sufferers also report feeling pressure in the stomach. (8)
Regurgitation is the unpleasant feeling of acid backing up your throat. It is usually accompanied by a bitter, sour taste in the mouth.
This symptom occurs in 80 percent of patients with GERD.
In mild cases regurgitation can cause you to burp liquid, also known as a “wet” burp.
In more serious instances, regurgitation can cause you to vomit up some of the contents of your stomach. (9)
GERD is measured in stages. Each stage is determined by frequency and severity of the reflux episodes. (10)
At this stage in the process, you’re in the clear. You don’t have to be concerned about acid reflux disease.
Stages #1 – #2
These are the earliest stages of GERD. You will notice the symptoms, but they are not particularly bothersome.
You may experience mild episodes of acid reflux a few times a month. Symptoms are easily relieved with simple lifestyle changes and non-prescription medication.
GERD symptoms occur on a near-daily basis. They may graduate to be more painful or incapacitating. If untreated, they could interfere with your daily activities.
Common symptoms include: heartburn, belching, and indigestion. Depending on your individual condition, you may experience some symptoms more than others.
At this stage the disease is moderately serious.
At this point, the disease is severe. Even with medication, you can still regularly experience symptoms that are painful or very disruptive.
Chronic heartburn and indigestion can interfere with your sleep. In turn, this can impact your ability to function during the day. (11)
Patients with later-stage, untreated GERD report the symptoms report a lower quality of life. (12)
If left entirely untreated, GERD can have serious consequences. Patients at this stage usually develop a condition called Barrett’s esophagus. (13)
GERD is a chronic disease which needs to be managed long-term. Without treatment, acid reflux disease can cause ulcers in your esophagus. (16)
In rare cases, the disease can cause esophageal cancer. Recent research has revealed GERD may increase the risk of certain gastric cancers. (17)
For mild to moderate GERD, changing a few habits can improve your quality of life.
Doctors traditionally recommend adopting healthier routines. For example avoiding late-night meals.
A study revealed waiting three hours before lying down after eating significantly lowered symptoms. (18)
Other practices include avoiding types of food and drink which are considered triggers. Consuming alcohol, chocolate and caffeine may worsen GERD.
A high body mass index (BMI) is associated with GERD. Losing weight through diet and exercise can alleviate the condition.
Elevating the head of your bed can also help. Acid reflux can occur at night and make it hard to sleep.
Antacids are over-the-counter medications. This type of treatment aims to lower the acidity of your gastric juices.
They are an ideal option for people suffering with early-stage GERD. However, this may not be sufficient for controlling moderate to severe stage symptoms.
Proton Pump Inhibitors (PPIs)
PPIs decrease production of your stomach’s acidic fluids. They are available without a prescription in most major pharmacies.
PPIs block the enzyme in your stomach responsible for producing acid. Clinical trials have proven they are useful in decreasing symptoms.
They are most successful if taken 30-60 minutes before you eat. One popular PPI is known as dexlansoprazole, this can be taken regardless of when you eat.
A study compared the effectiveness of PPIs versus placebos on GERD patients. 45 out of 100 subjects reported feeling significantly better after two weeks. (19)
PPIs are effective whilst you use them, however once you stop, your symptoms will reappear.
For this reason, most medical professionals advise starting out on a low dose.
Histamine Receptor Antagonists (H2RAs)
H2RAs limit production of excessive levels of stomach acid. They inhibit histamine, a hormone in your stomach.
These drugs are often used alongside PPIs for stubborn nightly symptoms. H2RAs are typically taken before bed time.
As with PPIs, acid production will return to previous levels once you cease taking them.
Baclofen is a drug that treats muscle spasms. It’s beneficial for acid reflux disease because it can reduce relaxations in the lower esophageal muscle.
In turn, this can lower acid reflux episodes. It has also been proven to limit GERD symptoms at night.
Baclofen is prescribed to people who have persistent acid reflux events at night. Subjects taking baclofen report less sleep disturbances due to the disease. (20)
Surgery is for patients are unwilling to take medications permanently or to remove a hiatal hernia.
In obese patients, a gastric bypass to treat obesity may also reduce acid reflux disease.
The optimal patient profile is someone who has “typical” GERD symptoms like heartburn, regurgitation and indigestion.
The procedure involves repairing or strengthening the lower esophageal sphincter – the muscle in the stomach tube.
Surgical intervention is less effective in individuals with symptoms such as coughing and hoarseness.
However, even though surgery can be effective, patients may still have to continue some form of medical treatment. (21)
What is acid reflux disease (GERD)? GERD is a disease in which stomach acid flows into the esophagus and causes irritation.
What are the signs of acid reflux disease (GERD)? Common symptoms of GERD include: frequent, severe heartburn and indigestion. It can also cause excessive burping, coughing, and regurgitation.
How do you develop acid reflux disease (GERD)? The primary cause of GERD is a defect of the lower esophageal sphincter. If this muscle does not function properly, there is no barrier between the stomach and esophagus. The condition can also be caused by a hiatal hernia.
How are you diagnosed with acid reflux disease (GERD)? GERD can be diagnosed based on typical symptoms such as heartburn. Your doctor may examine your esophagus and digestive tract. Alternatively, the acidity of your stomach can be measured with a pH test.
What is the best treatment for acid reflux disease (GERD)? The best treatment for GERD depends on your individual condition. Lifestyle changes can reduce symptoms of mild to moderate GERD. Medications such as PPIs and H2RAs can be a helpful long-term solution. If medications are unsuitable, surgery may be an option.
Is acid reflux disease (GERD) considered a disability? As GERD can be treated with lifestyle changes, medication and surgery it is not usually considered a disability. However, if your symptoms are severely debilitating you may qualify for assistance. (22)
Is there any cure for acid reflux disease (GERD)? As GERD is a chronic disease with no permanent cure. There are a range of medical and non-medical treatments to reduce symptoms.
Is acid reflux disease (GERD) life threatening? 10-20 percent of people affected with GERD can develop Barrett’s Esophagus. This condition causes serious changes to the esophagus.The esophageal tissue becomes so damaged by acid that it starts to resemble intestinal lining. Barrett’s Esophagus raises your risk of esophageal cancer. (23)
GERD is a chronic disease affecting many people with varying levels of intensity. In rare cases, it can cause serious complications.
GERD can impact your sleep and quality of life if untreated. However, symptoms can be managed successfully with various medications and changes to your lifestyle.