Acid
Reflux GERD

What is Acid Reflux – GERD?

Gastroesophageal reflux (or just reflux) happens when your stomach contents like stomach acid and food, backs up out of the stomach and into the esophagus (the tube that links your mouth and stomach). It may also backup all the way into your throat and mouth.

When the acid comes in contact with your esophagus (or your throat), it can cause a burning feeling in your chest or neck, known as heartburn. Most of us will have occasional heartburn, but when your symptoms are frequent and bad enough to impact your sense of well-being, it could be GERD.

Symptoms

The most common symptom of GERD is heartburn, and while this is not life threatening, it can greatly lower your quality of life by impacting your daily activities, your sleep and what you are able to eat. Patients can often avoid heartburn by changing their habits, like how much, how often, and what they eat and drink. Occasional heartburn can be treated with over-the-counter (OTC) medication. However, If symptoms don’t go away or get worse, you should talk to a gastroenterologist as you may need some tests to rule out other health issues.

Each person may not feel gastroesophageal reflux disease (GERD) in the same way.

Common Symptoms

• Heartburn, especially after eating
• Burning pain behind the chest
• Burning pain that is worse when lying down or bending over
• Feeling like food is coming back up into your mouth
• A sore throat that won’t go away
• Scratchy-sounding voice
• A cough that persists
• Sore or burning throat that won’t go away, pain when you swallow
• Feeling like there is a lump in your throat or that food sticks in the throat
• Nausea
• Asthma
• Chest pain
• Frequent burping or throwing up

Alarm Symptoms

Certain symptoms may point to complications or even potential life-threatening problems. If you have any of these alarm-warning symptoms, talk to your doctor right away.

• Losing weight without trying
• Chest pain with activity, such as climbing stairs
• Choking while eating or trouble swallowing food and liquids
• Throwing up blood or material that looks like coffee grounds
• Red or black stools

Treatment

Medications and changes in your habits can put off and control symptoms of gastroesophageal reflux disease. Talk to your doctor about what choices are best for you to try first. Below is a list of things you can do to try to help control symptoms of GERD.

Things To Avoid

Do not eat or drink items that give you heartburn, here is an example of some items:

• Fried/fatty foods
• Alcohol, coffee (including decaf) or carbonated drinks
• Chocolate or peppermint
• Ketchup and mustard
• Vinegar
• Tomato sauce
• Citrus, fruits or juices
• If you are overweight, lose weight
• Stop smoking
• Be careful taking aspirin, anti-inflammatory and pain medications other than acetaminophen (like Tylenol®). These can make heartburn worse.
• Eat smaller portions of food during meals and don’t eat too much.
• Stop eating three hours before lying down to sleep.
• Raise the head of the bed four to six inches
• Pressure on your belly can make reflux worse.
• Sit-ups, leg-lifts or stomach crunches can also make reflux worse

Getting tested

There are many tests for gastroesophageal reflux disease and not all patients with heartburn or GERD need testing. Testing can also help your health-care team guide your treatment.

Endoscopy with or without biopsy

• An endoscopy is done to look inside your esophagus and small intestine, and to do a biopsy (taking small pieces of the tissue to look at under a microscope).
• You will be given medicine to block pain and make you feel relaxed.
• During the endoscopy, your gastroenterologist will use a long, thin (about the width of your little finger), flexible tube with a tiny camera on the end to look inside.
• The tube is passed through the mouth into the small intestine as your gastroenterologist does a careful exam.

Other tests may be performed in special situations or if symptoms are hard to control.

Esophageal Manometry

• Manometry checks if the valve between your stomach and esophagus, that is meant to close after you eat, is weak.
• Manometry also checks to see if the rest of the esophagus is working correctly.
• During the test, a small, thin tube will be put through your nose and down your esophagus. This does not get in the way of your breathing.
• Once the tube is in place, you will be asked to swallow small amounts of water or gel as the machine records esophageal movements.

PH-impedance Monitoring

• This test is to find out if you have abnormal reflux and if it is causing your symptoms.
• The test goes on for 24 hours while you do your normal activities.
• A very thin tube with recording electrodes is put through your nose and down your esophagus. The tube detects reflux and measures the pH (acid levels) in the esophagus and sends the data to a recorder that you need to carry with you.
• Keeping a diary of what you eat and how you feel is important during the test.

Wireless Esophageal pH Monitoring

• This test is like the other pH monitoring test, except there is no tube coming out your nose.
• During an upper GI endoscopy, your doctor will attach a small capsule to the inside of your esophagus.
• The capsule will measure the acid levels in your esophagus and send the data to a receiver that you need to carry with you for 48–96 hours.
• Keeping a diary of what you eat and how you feel is very important during the test.

Barium swallow and upper GI series

• This test is an X-ray that takes pictures of the esophagus, stomach, duodenum and small intestine.
• You will need to drink a chalky liquid called barium while X-ray pictures are taken. The barium makes it easier for the doctor to see.
• These pictures can be used to make a diagnosis and plan more specific treatments.