Gastroesophageal Reflux Disease (GERD)
GERD, gastroesophageal reflux disease or simply reflux, is a common condition that affects up to 20% of the population. The most common reflux symptom is chronic heartburn, but it's not the only symptom.
Other symptoms of GERD include:
- Chronic sore throat
- Difficulty or pain when swallowing
- Waterbrash (sudden excess of saliva)
- Sour taste in the mouth (due to regurgitatin)
- Bad breath
- Inflammation of the gums
- Erosion of tooth enamel (the surface of the teeth)
- Nausea (less frequently)
NOTE: Chest pain is also a symptom of heartburn. However, it is often difficult to differentiate chest pain due to heartburn/GERD and chest pain due to heart disease. Therefore, be sure to get all chest pain evaluated IMMEDIATELY by a health care professional.
Sometimes, there are no symptoms, and reflux is only diagnosed when complications (see below) arise.
How Is Reflux Diagnosed?
First, your doctor will review your symptoms of reflux with you and do a complete physical exam.
If he or she believes that you have GERD, usually you will be given a trial run of GERD medications (most often, proton pump inhibitors such as Rabeprazole [Aciphex], Dexlansoprazole [Dexilant], Esomeprazole [Nexium) Lansoprazole [Prevacid], Omeprazole [Prilosec, Zegerid], and Pantoprazole [Protonix]), for a minimum of for two weeks to see if you experience relief.
In some instances, further testing, such as an upper endoscopy or pH testing, may be needed to aid in a GERD diagnosis.
What Causes Reflux?
There is no known single cause of reflux. What we know is that it occurs when the normal defenses of the esophagus are overwhelmed by acid refluxing into it from the stomach.
Normally, stomach acid is kept in the stomach by a muscular valve between it and the esophagus called the lower esophageal sphincter. If that valve is faulty for any reason, reflux occurs.
Factors that may contribute to GERD include smoking, alcohol, being overweight or pregnant, the use of certain medications, chronic constipation, and consumption of GERD-aggravating foods (which vary on an individual basis but may include fatty or spicy foods, caffeine, and peppermint).
The symptoms of reflux are a result of the damage caused by stomach acid that has entered the esophagus (heartburn, belching), higher into the throat (hoarseness, sore throat), or even into the mouth (sour taste in the mouth, regurgitation, erosion of tooth enamel) or lungs (causing cough or asthma).
How Is Reflux Treated?
Reflux is usually treated with a combination of prescription medications and lifestyle changes. More serious cases can require surgery.
What Happens if Reflux Goes Untreated?
Besides the obvious effect on quality of life, untreated reflux can lead to some serious complications. They include:
- Esophagitis. This is an irritation and inflammation of the lining of the esophagus caused by stomach acid.
- Dysphagia. Over time, untreated GERD causes difficulty swallowing. This may be a result of peptic stricture (narrowing), which is the result of the healing process of ulcerative esophagitis.
- Barrett's esophagus. The chronic exposure to stomach acid can cause changes in the cells of the esophagus that may be precancerous.
- Esophageal cancer. Years of exposure to stomach acid may cause cancer of the esophagus.