Gastroesophageal Reflux Disease (GERD): Symptoms, Diagnosis and Treatment

Gastroesophageal reflux goes by many names: heartburn, acid reflux, acid regurgitation or just plain reflux. No matter what it’s called, the cause is the same — stomach acid and stomach contents that flow backward into the esophagus, leading to pain and a burning sensation in the chest.

GERD is chronic, long-lasting heartburn that can have long-term complications.

Your primary care provider can help diagnose and find initial treatments for GERD. Find a provider accepting new patients. If necessary, he or she can refer you to one of our board-certified gastroenterologists.

GERD Symptoms

GERD symptoms are most often caused by problems with the valve between the stomach and the esophagus, called the lower esophageal sphincter. When this valve is weakened or relaxes when it shouldn’t, the acid and contents inside the stomach rise up into the more sensitive tissues of the esophagus.

In addition to heartburn, symptoms of GERD include:

• Bad breath
• Chronic sore throat or hoarseness
• Difficulty swallowing
• Nausea and vomiting
• Weakened tooth enamel

People with asthma are more likely to have GERD, as asthma flare-ups can cause the lower esophageal sphincter to relax. Smoking is also a risk factor, as are pregnancy, obesity and use of certain medications, including antidepressants and pain relievers. If you have a hiatal hernia — an opening in your diaphragm that allows the stomach to rise into the chest — you can also develop GERD.

GERD Diagnosis

Many people have experienced the tell-tale burning and acidic sensation of heartburn. However, if your heartburn happens many times a week, wakes you up at night or interferes with your daily activities, talk to your doctor about GERD. Left untreated, GERD can cause complications such as Barrett’s esophagus, which can increase your risk of esophageal cancer.

To diagnose GERD, your physician may order tests to look inside your upper gastrointestinal tract. These may include an endoscopy (a procedure involving a small, lighted camera to look inside your esophagus), X-rays of your digestive system or esophageal manometry. During esophageal manometry, your doctor will insert a tube through your nose. It then goes down your esophagus and into your stomach, allowing your physician to see if the lower esophageal sphincter opens and closes properly.

The most accurate way to detect a problem with acid reflux is to monitor the amount of acid in your esophagus while eating and sleeping. Called esophageal pH and impedance monitoring, this test requires wearing a wireless monitor for 24 hours.

GERD Treatment

Lifestyle changes can be very helpful in managing GERD. Identify and avoid foods and drinks that trigger acid reflux, such as spicy or acidic foods and alcohol. If you smoke, quitting tobacco can also help with symptoms.

Over-the-counter and prescription medications are available to sooth the burn of GERD if lifestyle changes don’t help. All medications (including those available without a prescription) have side effects, so talk to your physician about the best medication for you.

For GERD that cannot be managed with lifestyle changes or medications, your doctor may recommend a surgical procedure. At Beaufort Memorial, our board-certified general surgeon performs Nissen fundoplication, a procedure in which a small portion of the upper stomach is wrapped around the lower esophagus and supports the lower esophageal sphincter. Nissen fundoplication is often performed laparoscopically, through several small incisions as opposed to one large incision.