Chronic acid reflux (Gastroesophageal reflux disease)

There’s nothing pleasant about that burning feeling in your chest caused by acid reflux. But is it something you should be concerned about? If it happens occasionally, acid reflux can be treated at home.

When acid reflux starts to happen frequently and you have other symptoms, you may have developed gastroesophageal reflux disease (GERD).

What is acid reflux?

Acid reflux can feel like a burning sensation that happens when acid from your stomach backs up into your esophagus (the tube between your mouth and your stomach). It's sometimes called heartburn.

Acid reflux is caused by a problem with a muscle at the bottom of the esophagus (the esophageal sphincter). Normally, the muscle relaxes to let food and liquid into the stomach, then it closes. When the muscle doesn’t close correctly, stomach acid can back up through the partial opening leading to acid reflux symptoms.

Frequent, long-term heartburn can allow acid to wear away the lining of the esophagus and cause problems such as scar tissue that narrows the esophagus, sores (peptic ulcers) in the esophagus or even precancerous changes to the esophagus (Barrett's esophagus).

GERD symptoms

Symptoms of GERD start with frequent heartburn and may also include:

• A sour taste in the mouth
• Regurgitation (when stomach contents back up into the mouth)
• Nausea
• Burping
• Bloating
• Dry cough or throat clearing repeatedly
• Sore throat, hoarseness or laryngitis
• Shortness of breath
• Asthma
• Wearing away of tooth enamel
• Trouble swallowing or feeling like there’s a lump in the throat
• Chest pain (severe chest pain could be something more serious than gastroesophageal reflux disease and requires immediate medical help)

When babies have acid reflux or gastroesophageal reflux disease, they may be fussy or arch their backs during feedings. They may spit up more than normal and even vomit. They may not gain weight well. If your child has these acid reflux or GERD symptoms – especially if they aren’t gaining as much weight as they should – they should be evaluated by their pediatrician.

Consult your doctor for frequent heartburn, or if acid reflux symptoms don’t get better with over-the-counter medications.

Call your doctor right away if you have severe chest pain, bloody or dark stools or emesis (vomit), unexplained weight loss, trouble swallowing or a feeling that food is trapped, or a sensation of acid refluxed into the windpipe causing shortness of breath, coughing or hoarseness of the voice.

Risk factors for GERD

Having some of the factors listed below can mean you’re at increased risk for gastroesophageal reflux disease.

• Being overweight
• Eating large meals or overeating
• Consuming citrus fruits, chocolate, caffeine, alcohol, carbonated drinks, peppermint, or fatty or spicy foods
• Smoking
• Pregnancy
• Having a hiatal hernia
• Using nonsteroidal anti-inflammatory drugs such as aspirin and ibuprofen

Getting a GERD diagnosis

To receive a diagnosis for GERD, you’ll meet with your doctor to talk about your symptoms. Your doctor will also perform a physical exam and may order tests, including:

• Endoscopy: A flexible tube equipped with a light and a tiny camera (endoscope) is inserted down the throat to see inside the esophagus and stomach. If needed, a tissue sample (biopsy) can be done during an endoscopy.
• pH monitoring: This test checks for stomach acid in the esophagus.
• Motility testing: This measures if the esophagus is working properly. A thin, flexible tube (catheter) is inserted into the nose, down the esophagus and into the stomach.

Services & treatment for GERD

If you have gastroesophageal reflux disease, your Aurora team will work with you to determine the best GERD treatment options for relief.

Dietary and lifestyle changes for acid reflux

GERD and acid reflux may be treated successfully with dietary and lifestyle changes like these:

• Maintain healthy weight

• Eat smaller more frequent meals

• Avoid citrus fruits, fatty or spicy foods, chocolate, caffeine, alcohol, carbonated drinks, and peppermint

• Don't smoke

• Avoid lying down for two to three hours after eating

• When lying down, elevate your head by six inches with a pillow wedge

Medications

Your doctor may also recommend over-the-counter acid reflux medicines such as:

• Antacids. These will address symptoms but won't fix any damage stomach acid has caused in the esophagus.

• H-2 receptor blockers. This heartburn medication reduces the amount of acid the body makes. They can help relieve symptoms for longer periods of time.

• Proton-pump inhibitors. These block the acid the body makes, which allows the esophagus to heal.

If over-the-counter acid reflux medicines don't work, your doctor may recommend prescription medications for GERD treatment such as:

• Prescription-strength H-2 receptor blockers
• Prescription-strength proton-pump inhibitors
• Prokinetic agents to tighten the muscle between the stomach and esophagus (esophageal sphincter) and help the stomach empty faster

Surgery for GERD

Medications will reduce symptoms for most people, but not all. And they don’t repair the damage done by gastroesophageal reflux disease over the long term. Surgery may be a good choice for GERD treatment for you if you:

• Still have persistent acid reflux or other symptoms while taking medication
• Develop side effects from taking medication
• Notice your symptoms return when you stop taking medication
• Have damage to your esophagus such as bleeding or narrowing (stricture)
• Can’t afford medication or prefer not to take lifelong medication

The most common surgery for GERD is called fundoplication. It can be done as an open procedure or as a laparoscopic procedure. During the surgery, the top of the stomach is wrapped around the end of the esophagus. This creates pressure that helps keep stomach acid and food from flowing up the esophagus.

If your condition has progressed to complications such as Barrett’s esophagus, other procedures may be recommended.

Do you suffer from acid reflux?

Millions of people suffer from acid reflux, more commonly known as heartburn. Our acid reflux quiz helps evaluate your symptoms, identify your risk factors and give you an idea what to do next based on your results.

Take the acid reflux quiz