Am Fam Physician. 1999;59(5):1172
See related article on gastroesophageal reflux disease.
What is gastroesophageal reflux disease?
Gastroesophageal reflux disease (also called GERD) is the medical term for chronic heartburn. Many people have heartburn at times. It's caused by irriration from stomach acid that backs up into the esophagus. The esophagus is the tube that carries food from your mouth to your stomach. Sometimes stomach acid backs all the way up to the throat or into the mouth. This acid has a sour taste.
When heartburn keeps happening over a long period of time, it's called GERD. In some people, the stomach acid can hurt the esophagus. If you have this kind of heartburn, you may find it hard to swallow, or it may hurt to swallow. You may feel chest pain or pressure, and you may cough a lot. Your esophagus may become narrow in places, making it hard for food and liquids to get down into your stomach.
How does my doctor know I have GERD?
If you have bad heartburn and acid backing up into your esophagus, you probably have GERD. If your only symptoms are cough, chest pain, trouble swallowing or painful swallowing, you may need to have tests.
Your doctor may want to take x-rays or look at your esophagus through a narrow tube called an endoscope. Your doctor can use x-rays or an endoscope to see if your esophagus is hurt or has gotten narrow.
Your doctor may want you to have a pH monitoring test. This test will find out how much acid is in your esophagus. A small probe (a tool) measures how much acid gets into your esophagus during 24 hours.
If I have GERD, what treatment will I need?
To feel better, you may need to change the way you eat, drink and sleep. Your doctor may want you to make some of these changes:
Stop smoking, if you smoke.
Stop drinking alcohol, if you drink.
Don't drink coffee or sodas that have caffeine in them.
Don't eat foods that have acid in them, like oranges, grapefruit and tomatoes.
Don't eat foods or drink liquids that have chocolate, spearmint or peppermint in them.
Don't eat large meals. Instead, eat smaller meals and eat more often.
Don't eat anything for three to four hours before you go to bed or before you lie down.
Don't lie on your side when you go to sleep.
Your doctor may ask you to raise the head of your bed about 6 inches by putting blockes under the bed frame.
Are there medicines that can help me?
You may need to take an antacid or another over-the-counter medicine. If you have very bad heartburn, your doctor may have you take a medicine that causes your stomach to make less acid. Another medicine helps food move more quickly through your stomach. Your doctor will decide if your heartburn is bad enough that you need to take these special medicines.
If medicines and changes in your eating and drinking don't help, you may need surgery. Your doctor will tell you if you need surgery.