Gastroesophageal (pronounced: gas-tro-ih-sah-fuh- jee -ul) reflux disease is a disorder that results from stomach acid moving backward from the stomach into the esophagus
esophagus. GERD usually happens because the lower esophageal sphincter (LES) — the muscular valve where the esophagus joins the stomach — opens at the wrong time or does not close properly.
When the stomach contents move backward into the esophagus, this is known as gastroesophageal reflux. (Because the stomach makes acid to help a person digest food, gastroesophageal reflux is also known as acid reflux.) Almost everyone has this type of reflux at some time. Often a person isn't even aware that it is happening.
What Causes GERD?
LES works is the main reason why people have gastroesophageal reflux.
The LES is a muscular ring at the bottom of the esophagus where it joins the stomach. As a person swallows, muscles in the esophagus move the food down into the stomach. The LES relaxes just enough to allow food and liquids into the stomach, but then the powerful muscles in the LES contract (tighten) to stop food and liquids from moving back up the esophagus. In other words, the job of the LES is to prevent reflux.
Sometimes, though, the LES might not be able to do its job for various reasons. In some people, the LES doesn't tighten properly. In other cases, the LES doesn't close quickly enough or at the right time, allowing stomach contents to wash back up.
If a person has eaten way too much, the stomach may be so stretched full that the LES can't do its job properly.
Doctors do know that some things can make GERD worse, including obesity, drinking alcohol, and pregnancy. Certain foods and medications can also worsen GERD symptoms; for example, these foods affect some people with GERD:
drinks or foods with caffeine
fatty and fried foods
garlic and onions
tomato-based foods, like spaghetti sauce, chili, and pizza
How Do People Know They Have GERD?
Often, people who have GERD notice that they regularly have the pain of heartburn in the chest or stomach — and their heartburn can last up to a couple of hours. Lots of people who have GERD notice their heartburn is worse after eating.
Other symptoms of GERD include
a sore, raw throat or hoarse voice
a frequent sour taste of acid, especially when lying down
a feeling of burping acid into the mouth
a feeling that food is stuck in the throat
a feeling of choking that may wake someone up
a dry cough
How Doctors Diagnose GERD
A special X-ray called a barium swallow radiograph can help doctors see whether liquid is refluxing into the esophagus. It can also show whether the esophagus is irritated or whether there are other abnormalities in the esophagus. With this test, the person drinks a special solution (barium, a kind of chalky liquid); this liquid then shows up on the X-rays.
An upper endoscopy (pronounced: en- das -ko-pee) allows the doctor to look at the esophagus, stomach, and part of the small intestines using a tiny camera. For this test, the doctor may give the patient a medicine to help him or her relax, and may spray the throat to numb i
In another kind of test, called a 24-hour pH-probe study , the doctor puts a tiny tube into the esophagus that will stay there for 24 hours. The tube is connected to a device that monitors the acid levels in the esophagus as the person goes about normal daily activities. This test is useful for diagnosing people who have symptoms of GERD but no damage to the esophagus. It also can detect whether the reflux triggers respiratory symptoms, such as wheezing and coughing.
How Can GERD Be Treated?
Treatment for GERD depends on how severe symptoms are. For some people, treatment may just include lifestyle changes, such as changing what they eat or drink. Others will need to take medications. In very rare cases, when GERD is particularly severe, a doctor will recommend surgery.
The following lifestyle changes can help the symptoms of GERD or even prevent the condition:
losing weight if you are overweight
eating small meals
wearing loose-fitting clothes
avoiding carbonated beverages
avoiding foods that trigger reflux
It can also help to not lie down for 3 hours after a meal and not eat 2 to 3 hours before going to bed. Doctors sometimes also recommend raising the head of the bed about 6 to 8 inches. Before you start a major bedroom makeover, though, talk to your doctor and your parents about the best sleeping position for you.
doctor may also recommend different medications to relieve symptoms. Over-the-counter antacids, such as Alka-Seltzer or Maalox, work by neutralizing stomach acid and can help with mild symptoms. Other medications called H2 blockers are available over the counter and by prescription and help by blocking the production of stomach acid.
Surgery is a last resort for people with GERD and is rarely needed in healthy teens. The typical surgical treatment for GERD is called fundoplication (pronounced: fun-doh-plih- kay -shun). During the surgery, the upper part of the stomach is wrapped around the lower esophageal sphincter to strengthen the sphincter and prevent reflux. Fundoplication has been used in people of all ages, even babies with severe GERD.
Living With GERD
The key to living with GERD is to not ignore it. Early diagnosis and treatment can help reduce or even eliminate uncomfortable symptoms. Left untreated, however, GERD can cause permanent damage to the esophagus.
You'll probably find that one of the simplest ways to make living with GERD easier is to avoid the things that trigger your symptoms. Some people will have to limit certain foods; others may have to give them up entirely. It all depends on your individual symptoms.
It can be hard to give up sodas or favorite foods at first. But after a while, lots of people discover that they feel so much better that they don't miss the problem foods as much as they thought they would.