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GERD or 'reflux'

Gastroesophageal reflux disease (GERD)

Reflux means that stomach acid and juices move back up into your esophagus, the tube that leads from the throat to the stomach. This can cause heartburn, ulcers, and pain and swelling in your esophagus (esophagitis). When you have heartburn that bothers you often, it's called gastroesophageal reflux disease, or GERD.

You can treat GERD with lifestyle changes, like quitting smoking and making changes in your diet to avoid foods that make your heartburn worse. You can also change your eating habits, such as not eating late at night. Your doctor may also suggest medicines.

  • Symptoms

    What are the symptoms of gastroesophageal reflux disease (GERD)?

    The main symptoms of GERD are:

    • Ongoing (persistent) 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.
    • A sour or bitter taste in the mouth. This is caused by the backflow of stomach acid and juices into the esophagus.

    Other symptoms may include:

    • Chest pain. If you have pain in your chest, it is important to make sure that it isn't caused by a problem with your heart.
      • The pain caused by GERD usually happens after you eat. It may occur with heartburn.
      • Pain from the heart usually feels like heaviness, tightness, discomfort, or a dull ache. It occurs most often after you are active.
    • Hoarseness.
    • Trouble swallowing (more common with advanced GERD).
    • A feeling that something is stuck in your throat.
    • A cough.
    • Having extra saliva.
    • Nausea.
  • Causes

    What causes gastroesophageal reflux disease (GERD)?

    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. These include:

    • Foods like peppermint and chocolate.
    • Alcohol, tobacco, and some medicines.

    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.

    Some foods can make GERD worse. These include:

    • Citrus fruits.
    • Tomato-based foods.
    • Fatty and fried foods.
    • Spicy foods.
    • Garlic and onions.
  • Prevention

    How can you prevent gastroesophageal reflux disease (GERD)?

    You may be able to prevent GERD with lifestyle changes, such as eating a healthy diet, not smoking, and staying at a healthy 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.

  • Diagnosis

    How is gastroesophageal reflux disease (GERD) diagnosed?

    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. If you do have heartburn often, your doctor may suggest a medicine that reduces or blocks stomach acid.

    If your heartburn goes away after you take the medicine, your doctor will probably diagnose GERD. You may or may not need any tests.

    If medicines don't help, you may have tests. These tests may include:

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

    How is gastroesophageal reflux disease (GERD) treated?

    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 are important. You can:

    • Eat several small meals instead of three large meals.
    • Wait 2 to 3 hours after eating before lying down.
    • Avoid things that worsen your symptoms. These may include chocolate, mint, alcohol, spicy foods, foods with a lot of acid, and coffee.
    • Raise the head of your bed 6 in. (15 cm) to 8 in. (20 cm) .
    • Lose weight if needed. Losing just 5 lb (2 kg) to 10 lb (5 kg) can help.

    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.

  • When to call

    Gastroesophageal reflux disease (GERD): When to call

    Call your doctor now or seek immediate medical care if:

    • You have new or different belly pain.
    • Your stools are black and tarlike or have streaks of blood.

    Watch closely for changes in your health, and be sure to contact your doctor if:

    • Your symptoms have not improved after 2 days.
    • Food seems to catch in your throat or chest.
  • Self-care

    How can you care for yourself when you have gastroesophageal reflux disease (GERD)?

    • 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, Gaviscon, 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.
    • Change your eating habits.
      • It’s best to eat several small meals instead of two or three large meals.
      • After you eat, wait 2 to 3 hours before you lie down.
      • Chocolate, mint, and alcohol can make GERD worse.
      • Spicy foods, foods that have a lot of acid (like tomatoes and oranges), and coffee can make GERD symptoms worse in some people. If your symptoms are worse after you eat a certain food, you may want to stop eating that food to see if your symptoms get better.
    • Do not smoke or chew tobacco. Smoking can make GERD worse. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
    • If you have GERD symptoms at night, 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.
    • Lose weight if you need to. Losing just 5 to 10 pounds can help.

    Copyrighted material adapted with permission from Healthwise, Incorporated. This information does not replace the advice of a doctor.