What is gastroesophageal reflux disease or GERD?

Gastroesophageal reflux disease is a serious, chronic form of gastroesophageal reflux, or GER. Individuals who experience GER more frequently than twice a week for several weeks may have GERD, which can cause more serious complications over time.

Gastroesophageal reflux disease (GERD) occurs when the lower esophageal sphincter becomes weak or relaxed at times when it should not be. This, in turn, causes contents of the stomach to rise into the esophagus.

A hiatal hernia — when the upper part of the stomach moves toward the chest through an opening in the diaphragm — may also cause GERD. Obesity and pregnancy also can induce GERD, as can use of asthma medications, calcium channel blockers, antihistamines, pain killers, sedatives and antidepressants. Smoking or exposure to secondhand smoke are also causes of GERD, which impacts adults and children.

Frequent heartburn is the most common symptom of GERD. However, this symptom fails to occur in some adults. A dry, chronic cough, wheezing, asthma or recurrent pneumonia, nausea, vomiting, a sore throat or laryngitis, difficult or painful swallowing, chest pain, dental erosion or bad breath are also symptoms of this disorder.

GERD is usually diagnosed by a gastroenterologist.

Diet and lifestyle changes are the first treatment strategies for GERD. Decreasing fat intake and eating small frequent meals as opposed to three large meals is a dietary recommendation. If symptoms do not improve with these changes, or if the patient continues to have difficulty swallowing, they should undergo diagnostic testing. However, there is no single test that can accurately diagnose GERD. Instead, clinicians must rely on a series of tests that can confirm diagnosis, including an upper gastrointestinal (GI) series, an upper endoscopy, esophageal pH monitoring or esophageal manometry. The lifestyle changes recommended by clinicians include weight loss if necessary, wearing loose-fitting clothing in the stomach area, remaining upright for several hours after eating, raising the head at least six to eight inches while sleeping and avoiding smoking.

Antacids, H2 blockers, proton pump inhibitors (PPIs), prokinetics and antibiotics are some of the pharmacotherapies that may reduce GERD. If these interventions fail, stronger interventions are available, including fundoplication and endoscopic techniques.

Esophagitis, strictures respiratory problems and Barrett’s esophagus are long-term complications associated with GERD.