Gastroesophageal Reflux Disease/Heartburn
What is Gastroesophageal Reflux (GERD)?
GERD is a condition that occurs when stomach contents, including acid, back up into the esophagus. The presence of acid in the esophagus produces the burning sensation called heartburn. Over time, prolonged acid exposure may cause injury that produces inflammation, ulceration, or narrowing of the esophagus, and may increase the risk of developing esophageal cancer.
For additional information about GERD/Heartburn, click here.
How is GERD Diagnosed?
The diagnosis of GERD is suggested by the symptoms it produces. Most often, patients experience a burning sensation below and behind the lower part of the breastbone called heartburn. It may also cause a sensation of regurgitation of food into the esophagus or the sensation of having something stuck in the throat. GERD may also cause less certain symptoms such as hoarseness or chronic cough.
No completely accurate diagnostic test exists for GERD, so several tests may be used to make the diagnosis and identify the best treatment.
· Upper endoscopy examines the lining of the esophagus and looks for evidence of injury.
· Esophogram uses x-rays to identify the presence of hiatal hernia and to look for complications of GERD.
· pH probe may be placed during upper endoscopy to measure the level of acid exposure in the esophagus.
· Esophageal manometry is a study that evaluates how well the esophagus works.
The results of these tests help to determine which treatment can best control the reflux.
For additional information on how GERD is diagnosed, click here.
How is GERD Treated?
Lifestyle modification Changing lifestyle and diet are usually the first steps recommended by healthcare providers to relieve symptoms of GERD. Here are some of the changes you can make:- If you smoke, stop.
- Avoid foods and beverages that worsen symptoms.
- Avoid alcohol, caffeine and chocolate.
- Lose weight if needed.
- Eat small, frequent meals.
- Avoid lying down for three hours after a meal.
- Raise the head of your bed six to eight inches by securing wood blocks under the bedposts. Just using extra pillows will not help.
Medication options include antacids (Rolaids, etc), histamine blockers (Tagament, Pepcid, etc) or proton pump inhibitors (Prilosec, Protonix, etc). Medication is quite effective for most patients, however, long term use of medication (> 6 months) or higher dosages have been recently linked with increased risk of side effect including osteoporosis and heart disease. Prolonged usage of these medications, however, can decrease the effectiveness of the drugs.
Surgical options offered at OSUMC include laparoscopic Nissen fundoplication and EsophyX. A laparoscopic Nissen is the standard surgical treatment for GERD. During a Nissen fundoplication, the upper part of the stomach is wrapped around the lower esophagus to prevent acid reflux. This operation is performed using small incisions in the abdomen, and has been shown to provide excellent long-term control of acid reflux. EsophyX is performed using a device that is passed through the mouth with the guidance of a camera. Small plastic fasteners are used to recreate an effective valve in the lower portion of the esophagus, thus stopping acid reflux. This approach does not require any incisions, and has been shown to reduce acid reflux in patients.
For additional information on treatments for Gastroesophageal Reflux Disease (GERD), click here.
Learn More:
- Related Esophageal Disorders
- Surgical Treatments: Laparoscopic Fundoplication, Incisionless Fundoplication
- GERD FAQ's
- Patient Informational Sessions and Scheduling Appointments