Acid Reflux and GERD

What are Acid Reflux and GERD?

Acid reflux is the flow of stomach acid into the esophagus. During acid reflux, you may taste regurgitated food or a sour liquid at the back of your mouth and you may feel a burning sensation in your chest (heartburn).

When acid reflux causes symptoms like regurgitation and heartburn, patients are diagnosed as having gastroesophageal reflux disease (GERD).

The most common symptoms of acid reflux and GERD are:

  • A burning sensation in the chest or throat (heartburn)
  • Chest pain
  • Difficulty swallowing (dysphagia)
  • Dry cough
  • Hoarseness or sore throat
  • Regurgitation of food or sour liquid
  • The sensation of a lump in your throat

The lower esophageal sphincter is the muscle that controls the entry of food into the stomach. When you swallow food, it opens then closes. On occasion, this muscle can relax too often throughout the day. When this happens, stomach acid can flow back into your esophagus and cause heartburn.

When this happens frequently, more than twice a week, patients may be diagnosed with GERD. If the condition persists it can cause inflammation of the esophagus, known as esophagitis. Esophagitis can wear down the lining of your esophagus over time. This can lead to complications such as:

Your chances of acid reflux and GERD can increase from:

  • Obesity
  • Hiatal Hernia
  • Pregnancy
  • Smoking
  • Dry mouth
  • Asthma
  • Diabetes
  • Delayed stomach emptying
  • Connective tissue disorders

 

Acid reflux and GERD can be diagnosed from evaluation of your symptoms and by using specific tests. Some tests include:

  • Tests that monitor the amount of acid in the esophagus, such as a 24-Hour Esophageal pH Test
  • An X-ray of your esophagus involving ingestion of barium
  • Endoscopy to look for complications from reflux, such as esophagus Barrett’s esophagus
  • Esophageal motility testing (manometry), which measures movement and pressure in the esophagus. The test involves placing a catheter through your nose and into your esophagus

Treatment for acid reflux and GERD begin with over-the-counter medications that attempt to control the stomach acid.

Possible over-the-counter treatments include:

  • Antacids, such as:
    • Maalox
    • Mylanta
    • Gelusil
    • Gaviscon
    • Rolaids
    • Tums
  • H-2-receptor blockers to reduce acid production. These include:
    • Nizatidine (Axid AR)
    • Ranitidine (Zantac)
  • Proton pump inhibitors, which act as stronger blockers of acid production. Over-the-counter proton pump inhibitors include:
    • Lansoprazole (Prevacid 24 HR)
    • Omeprazole (Prilosec, Zegerid OTC)
  • Esomeprazole (Nexium)

If over-the-counter options are not effective, your doctor may recommend prescription medications, such as:

  • Prescription-strength H-2-receptor blockers, including:
    • Prescription-strength cimetidine (Tagamet)
    • Prescription-strength Famotidine (Pepcid)
    • Prescription-strength Nizatidine (Axid)
    • Prescription-strength Ranitidine (Zantac)
  • Prescription-strength proton pump inhibitors, including:
    • Esomeprazole (Nexium)
    • Lansoprazole (Prevacid)
    • Omeprazole (Prilosec, Zegerid)
    • Pantoprazole (Protonix)
    • Rabeprazole (Aciphex)
    • Dexlansoprazole (Dexilant)
  • Medications to strengthen the relaxation of the lower esophageal sphincter, such as:
    • Baclofen

Your doctor may recommend that you combine GERD medications to increase their effectiveness.

In situations where medications are not helpful, your doctor may recommend surgery to strengthen the lower esophageal sphincter. The name of the surgery for GERD is Nissen fundoplication.

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