GERD or 'reflux'

The main symptoms of GERD are:

• Heartburn. Heartburn is an uncomfortable feeling or burning pain behind the breastbone. It may occur after you eat, soon after you lie down, or when you bend forward. Some people have GERD without heartburn.
• Regurgitation. This happens when food and liquid back up from the stomach into the esophagus and mouth.

Other symptoms may include:

• Chest pain.
• Hoarseness.
• Trouble swallowing.
• A feeling that something is stuck in your throat.
• A cough.
• Having extra saliva.
• Nausea.

GERD happens because of a problem with the ring of muscle at the end of the esophagus called the lower esophageal sphincter. It acts like a one-way valve between the esophagus and the stomach. When you swallow, the valve lets food pass into the stomach. With GERD, the valve doesn't close tightly enough. Stomach acid and juices flow back up (reflux) into the esophagus.

GERD usually happens when the valve relaxes at the wrong time and stays open too long. Some things may relax the valve so it doesn't close tightly or some foods and drinks can make GERD worse. These may include chocolate, mint, alcohol, pepper, spicy foods, high-fat foods, or drinks with caffeine in them, such as tea, coffee, colas, or energy drinks. If your symptoms are worse after you eat a certain food, you may want to stop eating it to see if your symptoms get better.

Other things can make stomach juices back up, such as:

• Hormonal changes during pregnancy.
• A weak lower esophageal sphincter.
• A hiatal hernia.
• Slow digestion.
• An overfull stomach.
• Being overweight or having obesity.

You may be able to prevent GERD with lifestyle changes, such as eating healthy foods, not smoking, and staying at a weight that is healthy for you. Talk to your doctor if you need help losing weight.

Some medicines may cause GERD as a side effect. If any medicines you take seem to be the cause of your heartburn, talk with your doctor. Don't stop taking a prescription medicine until you talk with your doctor.

To find out if you have GERD, your doctor will do a physical exam and ask you questions about your health. Your doctor may ask about your symptoms, such as whether you often have heartburn or regurgitation. If you do have heartburn or regurgitation often, your doctor may suggest a medicine that reduces or blocks stomach acid.

If your heartburn or regurgitation goes away after you take the medicine, you may not need any tests.

If you have tests, they may include:

• An upper gastrointestinal endoscopy.
• Esophageal tests.
• An upper-gastrointestinal X-ray series.

Treatment aims to reduce reflux, prevent damage to your esophagus, and prevent problems caused by GERD.

For mild symptoms, try over-the-counter medicines such as:

• Antacids (like Tums).
• H2 blockers (like Pepcid).
• Proton pump inhibitors (like Prilosec).

Lifestyle changes can help. You can:

• Stay at a weight that's healthy for you. Extra weight puts a lot of pressure on the valve between the stomach and esophagus. Losing even a few pounds can help. Talk to your doctor if you need help losing weight.
• Change your eating habits:
  • Try to eat several small meals instead of two or three large meals.
  • Wait 2 to 3 hours after eating before lying down. Snacking close to bedtime can make your symptoms worse.
  • Avoid foods that make your symptoms worse. These may include chocolate, mint, alcohol, pepper, spicy foods, high-fat foods, or drinks with caffeine in them, such as tea, coffee, colas, or energy drinks. If your symptoms are worse after you eat a certain food, you may want to stop eating it to see if your symptoms get better.
• Try to quit smoking or chewing tobacco, or cut back as much as you can. If you need help quitting, talk to your doctor about quit-tobacco programs and medicines. These can increase your chances of quitting for good.
• If you have GERD symptoms while trying to sleep, raise the head of your bed 6 to 8 inches by putting the frame on blocks or placing a foam wedge under the head of your mattress. (Adding extra pillows does not work.)
• Do not wear tight clothing around your middle.

If symptoms persist, possible next steps include a change in medicine or testing. Your doctor may recommend surgery to strengthen the valve between your esophagus and stomach.

• Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
• Your doctor may recommend over-the-counter medicine. For mild or occasional indigestion, antacids, such as Tums, Mylanta, or Maalox, may help. Your doctor also may recommend over-the-counter acid reducers, such as famotidine (Pepcid AC), cimetidine (Tagamet HB), or omeprazole (Prilosec). Read and follow all instructions on the label. If you use these medicines often, talk with your doctor.
• Stay at a weight that's healthy for you. Extra weight puts a lot of pressure on the valve between the stomach and esophagus. Losing even a few pounds can help. Talk to your doctor if you need help losing weight.
• Change your eating habits.
  • Try to eat several small meals instead of two or three large meals.
  • After you eat, wait 2 to 3 hours before you lie down. Snacking close to bedtime can make your symptoms worse.
  • Avoid foods that make your symptoms worse. These may include chocolate, mint, alcohol, pepper, spicy foods, high-fat foods, or drinks with caffeine in them, such as tea, coffee, colas, or energy drinks. If your symptoms are worse after you eat a certain food, you may want to stop eating it to see if your symptoms get better.
• Try to quit smoking or chewing tobacco, or cut back as much as you can. If you need help quitting, talk to your doctor about quit-tobacco programs and medicines. These can increase your chances of quitting for good.
• If you have GERD symptoms while trying to sleep, raise the head of your bed 6 to 8 inches by putting the frame on blocks or placing a foam wedge under the head of your mattress. (Adding extra pillows does not work.)
• Do not wear tight clothing around your middle.