Gastroesophageal Reflux Disease (GERD)/Heartburn

What is GERD?

GERD
(gastroesophageal reflux disease) is a digestive disorder. It’s caused when gastric acid
from your stomach flows back up into your food pipe (esophagus).

Heartburn is the most common symptom of GERD.

What causes GERD?

GERD happens when gastric acid from your stomach backs up into your food pipe (esophagus). 

A muscle at the bottom of the esophagus opens to let food in. And it closes to keep food in the stomach. This muscle is called the lower esophageal sphincter (LES). When your LES relaxes too often or for too long, acid backs up into your esophagus. This causes heartburn and may cause damage.

Some lifestyle issues that can cause GERD may include:

  • Being overweight
  • Overeating
  • Eating foods such as citrus, chocolate, and fatty or spicy foods
  • Having caffeine
  • Having alcohol
  • Smoking
  • Using aspirin and over-the-counter pain and fever medicines. These include nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen. 

Some health problems that may cause heartburn may include:

  • Swelling of your stomach lining (gastritis)
  • Painful sores (ulcers) on the lining of your stomach or esophagus, or the first part of your small intestine (duodenum)
  • An allergic condition in the esophagus (eosinophilic esophagitis)

Who is at risk for GERD?

You may be more at risk for GERD if you:

  • Have a
    part of your stomach slide up out of the belly cavity next to your esophagus (hiatal
    hernia)
  • Have a weak lower esophageal sphincter or LES
  • Are obese
  • Are pregnant
  • Use
    some medicines, such as aspirin or over-the-counter pain and fever medicines such as
    NSAIDs
  • Smoke or are around secondhand smoke
  • Drink alcohol
  • Are older

What are the symptoms of GERD?

Heartburn, also called acid indigestion, or acid reflux, is the most common symptom of
GERD. Heartburn is a burning chest pain that starts behind your breastbone and moves up
to your neck and throat. It can last as long as 2 hours. It often feels worse after you
eat. Lying down or bending over can also cause heartburn. Another common symptom of GERD
is bringing swallowed food up again to the mouth (regurgitation). Some people can have
trouble swallowing.

Heartburn is not a GERD symptom for most children younger than 12 years old, and for
some adults. They may have a dry cough, asthma symptoms, or trouble swallowing
instead.

Each
person’s symptoms may vary. GERD symptoms may seem like other health problems. Always
see your healthcare provider to be sure.

How is GERD diagnosed?

To
see if you have GERD, your healthcare provider will give you a physical exam and ask
about your past health. Some people with typical symptoms may be treated without more
testing.

Other
tests for GERD may include:

  • Upper GI (gastrointestinal) series, also called a barium swallow. This test looks at the organs of the top part of your digestive system. It checks your food pipe (esophagus), stomach, and the first part of your small intestine (duodenum). You will swallow a metallic fluid called barium. Barium coats the organs so that they can be seen on an X-ray. 
  • Upper
    endoscopy or EGD (esophagogastroduodenoscopy).
    This test looks at the lining
    or inside of your esophagus, stomach, and duodenum. This test uses a thin, lighted
    tube (endoscope). The tube has a camera at one end. The tube is put into your mouth
    and throat. Then it goes into your esophagus, stomach, and duodenum. Your healthcare
    provider can see the inside of these organs. He or she can also take a small tissue
    sample (biopsy) if needed.
  • Bernstein
    test.
    This test helps to see if your symptoms are caused by acid in your
    esophagus. The test is done by dripping a mild acid through a tube placed in your
    esophagus.
  • Esophageal manometry. This test checks the strength of your esophagus muscles. It can see if you have any problems with backward flow of fluid (reflux) or swallowing. A small tube is put into your nostril, then down your throat and into your esophagus. The tube checks how much pressure your esophageal muscles make when they are at rest.
  • pH
    monitoring.
    This test checks the pH (acid level) in your esophagus. A thin,
    plastic tube is placed into your nostril, down your throat, and into your esophagus.
    The tube has a sensor that measures pH level. The other end of the tube outside your
    body is attached to a small monitor that records your pH levels for 24 to 48 hours.
    During this time you can go home and do your normal activities. You will need to keep
    a diary of any symptoms you feel, and also of the food you eat. Your pH readings are
    checked and compared to your activity for that time period.
  • Impedance testing. This test is able
    to see reflux of acid, plus nonacid liquid and air. It is combined with pH
    monitoring.