Gastroesophageal Reflux Disease, known in shortened form as GERD and sometimes as acid reflux, is a condition in which the esophagus opens or fails to close, allowing stomach acids and contents to rise into the esophagus. It´s a chronic and more serious form of Gastroesophageal Reflux (GER), a common condition in millions of adults and especially common in children under the age of twelve.
GER and GERD often take the shape of a variety of painful symptoms, ranging from heartburn to trouble sleeping and chronic chest pain and even difficulty swallowing. Patients diagnosed with GERD often struggle with symptoms or outbreaks at various times for the rest of their lives. While a new generation of drug treatments has shown success, other means of prevention – including modifications to diet and exercise – routinely provide a more comfortable means of managing symptoms.
What causes Gastroesophageal Reflux?
GER occurs when a valve in the top of the stomach fails to close or opens spontaneously. This valve, known as the Lower Esophageal Sphincter (LES), allows mucosal fluids to rise into the esophagus, which connects the throat to the stomach. The contents of the stomach, including stomach acids, rise into the mouth and throat with painful results.
While there is no one single cause of GERD, some research points to otherwise benign physical abnormalities such as a hiatal hernia, in which the lower esophageal sphincter and the upper part of the stomach move above the diaphragm - the muscle wall separating the stomach from the chest. GER can also happen when the LES fails to close tightly after absorbing food.
The condition is considered Gastroesophageal Reflux Disease when symptoms occur more than twice a week. The symptoms are usually more severe and last longer, as well.
The symptoms of GERD
The most common result of this backflow is a pain or pressure, for example the burning gassy feeling of heartburn, occurring behind the breastbone or the mid-abdomen region.
A wide range of discomfiting symptoms also linked with GERD includes chronic earache, a hoarse of rasping voice, frequent nausea, and inflammation of some sinus tissues. Pain may continue off and on for days or weeks, depending on the severity of the attack.
Making the diagnosis
Doctors are able to diagnose GERD by asking questions about diet and the patient´s discomfort. They will then evaluate the patient´s diet and lifestyle patterns that may foster susceptibility for GERD.
For more severe cases, doctors will sometimes examine the patient´s esophagus with a small camera extended via tube into the throat, in a procedure known as endoscopy. In other cases doctors may order that a set of X-rays be taken of the esophagus, stomach, and the part of the small intestine known as the duodenum. This Upper Gastrointestinal Series test (made famous as an "upper GI series" on countless television hospital dramas) will determine if other problems in the digestive system are contributing to GERD conditions.
Several different medications, procedures for GERD treatment
Many doctors arrive at a diagnosis simply by prescribing H2 blockers (sold commercially as brands including Pepcid) or proton pump inhibitor drugs (such as Prilosec) that work to block stomach acids. If heartburn conditions disappear after the drugs are taken, doctors may diagnose GERD.
In many cases, mild to moderate symptoms can be treated with over the counter medicines such as antacid tablets and digestive aids. Doctors may also prefer to schedule fundoplication surgery to repair the lower esophageal sphincter in cases where no other option seems potentially effective. In fundoplication, the stomach is actually wrapped around the LES, strengthening it and preventing acid reflux. Today the surgery is often performed with a minimum of invasion into the body.
Two recent surgeries approved by the FDA work to treat symptoms by managing the operation of the LES. The first, known as Endocinch, puts pleats into the muscle to help strengthen its workings and operation. Another procedure, called the Stretta Procedure, uses radio frequency energy to treat the LES. The lasting benefits of both procedures are still being determined.
Other medications include foaming agents, for example Gaviscon, that cover the stomach contents with foam and render them less acidic.
The drugs known collectively as prokinetics help strengthen the Lower Esophageal Sphincter and help the stomach to faster empty its contents through the digestive system.
How to manage and even prevent symptoms
Doctors also recommend changes to patient lifestyles, including avoiding tobacco and alcohol and switching to a diet with less fatty or fried foods. However, a 2006 Stanford University study revealed no tangible, universal link between dietary changes and improvement of symptoms.
Some patients find symptoms eased after they raised the head of their bed six to eight inches off the floor and began sleeping on the inclined mattress. A 2006 study published in the Archives of Internal Medicine lends credence to its reported effectiveness. The bed must be raised, however – just adding pillows is not sufficient. Other research shows sleeping on the left side of the body will also help reduce symptoms.
Experts also suggest GERD sufferers wear loose-fitting clothes around the waist and midsection, to give the stomach and digestive tract unrestricted room to move and breathe. Losing even a small amount of weight is also believed to ease or remove symptoms.
Patients should also not eat for at least two hours before bedtime. In particular, patients should not eat or drink foods high in acidic materials. These include milk and milk based products, which include high amounts of calcium and fat; foods high in Vitamin C such as oranges; and cruciferous vegetables such as onions, spinach, and Brussels sprouts. They should also avoid chocolates and peppermint candies, as well as carbonated soft drinks. Smoking before bedtime also increases the risk of heartburn.
In some cases maintaining good posture will prevent spasms in the muscles around the esophagus that can trap stomach acid and gases. Good posture will also help reduce the coughing and asthma-like symptoms sometimes associated with acid reflux.
Some patients have also found relief from symptoms by frequently using chewing gum to increase the amount of saliva present in the mouth and esophagus. Others drink club soda or club soda mixed with Angostura bitters as a way to cure heartburn or nausea.
GERD and long-term complications
When left untreated or ignored, GERD can cause bleeding ulcers in the stomach and esophagus. It may also contribute to asthma and persistent cough.
In certain rare cases, GERD may lead to a condition known as Bartlett´s Esophagus, in which the very lining of the esophagus changes into tissue more closely resembling the lining of the intestine. Bartlett´s Esophagus patients are considered at a high risk for carcinoma.
Gastroesophageal reflux in children
Children with GER may not suffer heartburn symptoms but instead struggle with dry cough, asthma symptoms, or trouble swallowing. Babies and smaller children may also struggle with vomiting, constant crying, failure to gain wait, and incessant burping or belching.
Unfortunately, treatment of GERD is stymied somewhat because children may have all the symptoms of Gastroesophageal reflux or none at all: each set of symptoms is unique to the child. Complicating matters even more, some acid reflux is a normal occurrence in babies, so identifying problem cases is especially difficult.
Parents helping their babies deal with GER can manage the babies´ symptoms by burping them several times during each meal, keeping the child upright for a half hour after each feeding, and avoid giving too much food at one time. Parents should check the warning labels of all over the counter medications such as antacids or stomach soothers before giving them to children.
It´s estimated that up to thirty-five percent of all children struggle with some degree of GER but outgrow it around their first birthday. Children struggling with chronic GERD may suffer with the problem into their teens. Parents who believe their children are suffering from excessive or chronic heartburn should consult their family pediatrician.
The National Digestive Diseases Information Clearinghouse recommends older children with GERD eat smaller, more frequent meals and avoid the following in their diet: sodas with caffeine, peppermints, chocolate, spicy foods, foods high in acidic content such as oranges and lemons, and fried or fatty foods. Children should also have their last daily meal between two and three hours before going to bed, to give the stomach time to digest the food before lying down.
GERD in pregnant women
GERD is a common condition for pregnant women, as their body´s systems adapt to the growing fetus inside them. Women who are pregnant can take antacids to treatsymptoms, but should consult their doctor before taking any more serious medications.
In most instances symptoms lessen or disappear entirely after the baby is born.
When to seek medical assistance
Gastroesophageal Reflux Disease is believed to be present whenever heartburn or other symptoms occur more than twice a week. Just the same, it´s important for patients who find themselves at high risk to seek professional diagnosis. They may be able to catch symptoms in their early stages, making management of pain and discomfort that much easier.
Michael Kabel is senior staff writer for Corner Stork Baby Gifts.com. Stop by for parenting and baby resources, unique baby gifts, baby gift baskets and baby shower favors.
GER and GERD often take the shape of a variety of painful symptoms, ranging from heartburn to trouble sleeping and chronic chest pain and even difficulty swallowing. Patients diagnosed with GERD often struggle with symptoms or outbreaks at various times for the rest of their lives. While a new generation of drug treatments has shown success, other means of prevention – including modifications to diet and exercise – routinely provide a more comfortable means of managing symptoms.
What causes Gastroesophageal Reflux?
GER occurs when a valve in the top of the stomach fails to close or opens spontaneously. This valve, known as the Lower Esophageal Sphincter (LES), allows mucosal fluids to rise into the esophagus, which connects the throat to the stomach. The contents of the stomach, including stomach acids, rise into the mouth and throat with painful results.
While there is no one single cause of GERD, some research points to otherwise benign physical abnormalities such as a hiatal hernia, in which the lower esophageal sphincter and the upper part of the stomach move above the diaphragm - the muscle wall separating the stomach from the chest. GER can also happen when the LES fails to close tightly after absorbing food.
The condition is considered Gastroesophageal Reflux Disease when symptoms occur more than twice a week. The symptoms are usually more severe and last longer, as well.
The symptoms of GERD
The most common result of this backflow is a pain or pressure, for example the burning gassy feeling of heartburn, occurring behind the breastbone or the mid-abdomen region.
A wide range of discomfiting symptoms also linked with GERD includes chronic earache, a hoarse of rasping voice, frequent nausea, and inflammation of some sinus tissues. Pain may continue off and on for days or weeks, depending on the severity of the attack.
Making the diagnosis
Doctors are able to diagnose GERD by asking questions about diet and the patient´s discomfort. They will then evaluate the patient´s diet and lifestyle patterns that may foster susceptibility for GERD.
For more severe cases, doctors will sometimes examine the patient´s esophagus with a small camera extended via tube into the throat, in a procedure known as endoscopy. In other cases doctors may order that a set of X-rays be taken of the esophagus, stomach, and the part of the small intestine known as the duodenum. This Upper Gastrointestinal Series test (made famous as an "upper GI series" on countless television hospital dramas) will determine if other problems in the digestive system are contributing to GERD conditions.
Several different medications, procedures for GERD treatment
Many doctors arrive at a diagnosis simply by prescribing H2 blockers (sold commercially as brands including Pepcid) or proton pump inhibitor drugs (such as Prilosec) that work to block stomach acids. If heartburn conditions disappear after the drugs are taken, doctors may diagnose GERD.
In many cases, mild to moderate symptoms can be treated with over the counter medicines such as antacid tablets and digestive aids. Doctors may also prefer to schedule fundoplication surgery to repair the lower esophageal sphincter in cases where no other option seems potentially effective. In fundoplication, the stomach is actually wrapped around the LES, strengthening it and preventing acid reflux. Today the surgery is often performed with a minimum of invasion into the body.
Two recent surgeries approved by the FDA work to treat symptoms by managing the operation of the LES. The first, known as Endocinch, puts pleats into the muscle to help strengthen its workings and operation. Another procedure, called the Stretta Procedure, uses radio frequency energy to treat the LES. The lasting benefits of both procedures are still being determined.
Other medications include foaming agents, for example Gaviscon, that cover the stomach contents with foam and render them less acidic.
The drugs known collectively as prokinetics help strengthen the Lower Esophageal Sphincter and help the stomach to faster empty its contents through the digestive system.
How to manage and even prevent symptoms
Doctors also recommend changes to patient lifestyles, including avoiding tobacco and alcohol and switching to a diet with less fatty or fried foods. However, a 2006 Stanford University study revealed no tangible, universal link between dietary changes and improvement of symptoms.
Some patients find symptoms eased after they raised the head of their bed six to eight inches off the floor and began sleeping on the inclined mattress. A 2006 study published in the Archives of Internal Medicine lends credence to its reported effectiveness. The bed must be raised, however – just adding pillows is not sufficient. Other research shows sleeping on the left side of the body will also help reduce symptoms.
Experts also suggest GERD sufferers wear loose-fitting clothes around the waist and midsection, to give the stomach and digestive tract unrestricted room to move and breathe. Losing even a small amount of weight is also believed to ease or remove symptoms.
Patients should also not eat for at least two hours before bedtime. In particular, patients should not eat or drink foods high in acidic materials. These include milk and milk based products, which include high amounts of calcium and fat; foods high in Vitamin C such as oranges; and cruciferous vegetables such as onions, spinach, and Brussels sprouts. They should also avoid chocolates and peppermint candies, as well as carbonated soft drinks. Smoking before bedtime also increases the risk of heartburn.
In some cases maintaining good posture will prevent spasms in the muscles around the esophagus that can trap stomach acid and gases. Good posture will also help reduce the coughing and asthma-like symptoms sometimes associated with acid reflux.
Some patients have also found relief from symptoms by frequently using chewing gum to increase the amount of saliva present in the mouth and esophagus. Others drink club soda or club soda mixed with Angostura bitters as a way to cure heartburn or nausea.
GERD and long-term complications
When left untreated or ignored, GERD can cause bleeding ulcers in the stomach and esophagus. It may also contribute to asthma and persistent cough.
In certain rare cases, GERD may lead to a condition known as Bartlett´s Esophagus, in which the very lining of the esophagus changes into tissue more closely resembling the lining of the intestine. Bartlett´s Esophagus patients are considered at a high risk for carcinoma.
Gastroesophageal reflux in children
Children with GER may not suffer heartburn symptoms but instead struggle with dry cough, asthma symptoms, or trouble swallowing. Babies and smaller children may also struggle with vomiting, constant crying, failure to gain wait, and incessant burping or belching.
Unfortunately, treatment of GERD is stymied somewhat because children may have all the symptoms of Gastroesophageal reflux or none at all: each set of symptoms is unique to the child. Complicating matters even more, some acid reflux is a normal occurrence in babies, so identifying problem cases is especially difficult.
Parents helping their babies deal with GER can manage the babies´ symptoms by burping them several times during each meal, keeping the child upright for a half hour after each feeding, and avoid giving too much food at one time. Parents should check the warning labels of all over the counter medications such as antacids or stomach soothers before giving them to children.
It´s estimated that up to thirty-five percent of all children struggle with some degree of GER but outgrow it around their first birthday. Children struggling with chronic GERD may suffer with the problem into their teens. Parents who believe their children are suffering from excessive or chronic heartburn should consult their family pediatrician.
The National Digestive Diseases Information Clearinghouse recommends older children with GERD eat smaller, more frequent meals and avoid the following in their diet: sodas with caffeine, peppermints, chocolate, spicy foods, foods high in acidic content such as oranges and lemons, and fried or fatty foods. Children should also have their last daily meal between two and three hours before going to bed, to give the stomach time to digest the food before lying down.
GERD in pregnant women
GERD is a common condition for pregnant women, as their body´s systems adapt to the growing fetus inside them. Women who are pregnant can take antacids to treatsymptoms, but should consult their doctor before taking any more serious medications.
In most instances symptoms lessen or disappear entirely after the baby is born.
When to seek medical assistance
Gastroesophageal Reflux Disease is believed to be present whenever heartburn or other symptoms occur more than twice a week. Just the same, it´s important for patients who find themselves at high risk to seek professional diagnosis. They may be able to catch symptoms in their early stages, making management of pain and discomfort that much easier.
Michael Kabel is senior staff writer for Corner Stork Baby Gifts.com. Stop by for parenting and baby resources, unique baby gifts, baby gift baskets and baby shower favors.
