acid reflux/gerd

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Acid Reflux/GERD



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Overview

Gastroesophageal reflux disease (GERD) happens when a muscle at the end of your esophagus does not close properly. This allows stomach contents to leak back, or reflux, into the esophagus and irritate it.





Overview

You may feel a burning in the chest or throat called heartburn. Sometimes, you can taste stomach fluid in the back of the mouth. This is acid indigestion. If you have these symptoms more than twice a week, you may have GERD.





Overview

Anyone, including infants and children, can have GERD. If not treated, it can lead to more serious health problems. In some cases, you might need medicines or surgery. However, many people can improve their symptoms by:

-- Avoiding alcohol and spicy, fatty or acidic foods that trigger heartburn

-- Eating smaller meals





Overview

-- Not eating close to bedtime

-- Losing weight if needed

-- Wearing loose-fitting clothes





Symptoms

Common symptoms of GERD include heartburn, regurgitation and dyspepsia.

Heartburn is a feeling of burning pain that can arise when acid from the stomach makes its way up the esophagus. This pain can sometimes occur in the throat. While heart is in its name this pain does not affect the heart.





Symptoms

Regurgitation is the feeling of stomach acid being brought up to the mouth. This can often feel like a small amount of vomit in the mouth, a wet burp or a sour taste in the mouth.

Dyspepsia is a medical term for general stomach pain. This can include nausea after meals, burping, bloating, a feeling of fullness and abdominal pain.





Symptoms

Acid reflex and GERD is very common and generally can be controlled with dietary changes and the use of prescribed and over the counter medicines. However, this does not mean you should ignore your symptoms.





Diagnosis

People usually decide to see a doctor because they have symptoms like severe heartburn or regurgitation. Sometimes an inflamed food pipe is discovered by chance during an examination that is being done because of other symptoms, but that is less common.





Diagnosis

Symptoms play an important role in the diagnosis of GERD, so it can be helpful if you describe your symptoms in as much detail as possible:

•What symptoms do you have?

•Where exactly are they?

•How often do you have them?





Diagnosis

•Do you have the symptoms after eating or when your stomach is empty?

•Do they get worse when you lie down?

This information can help your doctor to find out whether you have GERD or whether it is more likely that your symptoms are being caused by something else.





Diagnosis

The symptoms caused by GERD are not always the typical ones. For instance, someone might have GERD without having heartburn or regurgitation, or these symptoms may only be very mild. Or they might have different or more symptoms, such as problems swallowing, a sore throat or a cough.





Diagnosis

If it is thought that someone might have GERD, doctors sometimes suggest that they have a “trial treatment” for GERD to see if they respond. In what is known as a “PPI test”, the patient takes proton pump inhibitors (PPIs) for about two weeks. Proton pump inhibitors are drugs that reduce the production of acidic stomach juices. If the medication relieves the symptoms, then it is very likely that GERD is causing the symptoms. In that case the treatment with proton pump inhibitors is typic





Treatment

You may need to make changes to your lifestyle such as maintaining a healthy weight, quitting smoking, drinking less alcohol, or not eating foods that make GERD worse.

Treatment options for GERD may be different for each person.

-- Medicine





Treatment

Taking medicine for GERD is the option most people choose first.

-- Surgery

For some people, surgery can improve GERD symptoms and lower the amount of medicine they need.

Endoscopic Treatments





Treatment

Endoscopic treatments for GERD are newer and are still being studied, so less is known about how well they work or how safe they are.

In the next few pages, you can find more information about these types of treatment.

Medicine





Treatment

Different medicines can help control problems caused by GERD.

Some relieve heartburn symptoms when they happen, and some help keep heartburn and other problems from happening.

Some medicines are taken only when needed and some are taken every day for a few weeks or months. Others must be taken every day for years.





Treatment

Some medicines can be bought over the counter without a prescription, and others need a prescription. Some are available both over the counter and by prescription.

The three main types of medicines to treat GERD are antacids, H2RAs (histamine type 2 receptor antagonists), and PPIs (proton pump inhibitors).

Antacids





Treatment

Antacids stop heartburn by neutralizing (weakening) the acid in your stomach.

They work quickly to treat mild GERD symptoms.

Antacids go by many names, such as Mylanta®, Rolaids®, or Tums®, and they are available without a prescription.

They are taken as pills or liquids.





Treatment

You may need to continue taking antacids along with an H2RA or PPI to control symptoms.

H2RAs and PPIs work for a longer time than fast-acting antacids, but they do not start working as fast.

Histamine type 2 receptor antagonists (H2RAs)





Treatment

H2RAs cause your stomach to produce less acid. Less acid in your stomach lowers your chance of getting heartburn.

All H2RAs are available both by prescription and over the counter.

They are taken as pills.

Surgery





Treatment

For some people, surgery to strengthen the barrier between the stomach and esophagus may be a treatment option for acid reflux. This surgery to treat GERD is called a “fundoplication” (pronounced fun-doe-ply-KAY-shun). Your doctor can tell you if surgery might help you.

How does surgery for GERD work?





Treatment

In a fundoplication, the top part of your stomach is wrapped around the bottom of your esophagus and attached there.

This helps strengthen the muscle at the bottom of your esophagus that closes to keep food and acid from coming back up.





Treatment

The surgeon may be able to do the surgery with a tool called a “laparoscope” (pronounced LAH-pruh-skohp). A laparoscope is a thin tube with a tiny camera that the surgeon puts through small cuts in your belly along with other small tools to do the surgery.

It usually takes less time to recover from surgery with a laporascope than if the surgeon has to make a large cut in your belly to do the surgery.





Treatment

There are two types of surgery: total fundoplication and partial fundoplication

What are the side effects?

Fundoplication surgery can cause you to feel bloated and make it hard to swallow. These side effects may last for 30 days or longer, and some side effects may require a second surgery to fix.





Treatment

Serious side effects, such as infection and heart attack, may be more common with surgery than with medicine. These side effects are rare.

Endoscopic treatments





Treatment

Endoscopic (pronounced en-doh-SKAHP-ik) treatments help strengthen the muscle that keeps food and acid from going up into your esophagus. These treatments are not considered surgery because no cuts are made in your belly. Instead, a doctor puts a thin tube called an endoscope through your mouth and down your esophagus to do the treatment.





Treatment

Three types of endoscopic treatments are EndoCinch™, Stretta®, and EsophyX™. These treatments are very new and are not as common as medicines or surgery to treat GERD. People receiving one of these treatments may be in a study to see how well it works.

What does research say about endoscopic treatments?





Treatment

There are not enough studies to say how well endoscopic treatments (EndoCinch™, Stretta®, and EsophyX™) work to control the symptoms of GERD.

What are the side effects of endoscopic treatments?

Endoscopic treatments can cause pain in your chest or abdomen (belly) and bleeding.





Treatment

They can also cause you to feel bloated and make it hard to swallow. These side effects may last for 30 days or longer.

Because these treatments are new, not enough research has been done to know how safe they are.

Lifestyle changes





Treatment

Your doctor may suggest some lifestyle changes that can help control your GERD symptoms. These include:

Maintain a healthy weight.

Quit smoking.

Limit alcohol.

Avoid eating 3 hours before lying down.





Treatment

Raise the head of your bed.

Avoid foods that can make GERD symptoms worse (spicy foods, fatty foods, mint, chocolate, tomato-based foods, coffee, and citrus fruits).





Causes

Acid reflux / GERD is the result of the weakening or unusual relaxing of the lower esophageal sphincter. This is the band of muscle around the bottom of the esophagus that normally prevents a backflow of stomach acid into the esophagus. When esophageal sphincter doesn’t close properly a constant flow of acid can move freely up the esophagus and over time erode tissues.





Prevention

Prevention often involves making simple healthy choices. If you smoke, quitting now will reduce reflux. Alcohol, caffeinated beverages, fatty foods, chocolate, and mint relax the lower sphincter. Avoid these foods to reduce reflux. Citrus fruits and juices, spicy food, tomato sauce and carbonated drinks can irritate the esophageal lining. Some are able to reduce reflux by wearing loose fitting clothes and eating smaller meals. Other methods include not lying down after eating, sleeping with a we





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acid reflux/gerd

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