Learn About Gastroesophageal Reflux Disease

Gastroesophageal reflux disease (GERD), also known as acid reflux, is a condition where stomach contents come back up into the esophagus resulting in a variety of problems. The classic is heartburn, but symptoms can include: acidic taste in the mouth, cough, chest pain, breathing issues, nausea, intolerance of certain foods, pain after eating, bloating, belching, flatulence, hiccups, hoarseness, and sore throat In the United States, GERD affects more than 40% of the population at least once per month, 20% once per week, and 7% daily. Medical treatment of GERD results in costs of at least $6 billion per year.

GERD is caused by a weak lower esophageal sphincter (LES), the junction between the stomach and the stomach.

Because of its weakness, the LES is unable to close properly and, as a result, stomach contents are able to reflux back into the esophagus. Certain risk factors are associated with the development of GERD, including: obesity, pregnancy, smoking, hiatal hernia, and advanced age. It can be worsened by drinking certain beverages, such as alcohol, carbonated drinks, coffee, or tea; or by eating certain foods, such as citrus, tomato, chocolate, mint, garlic, onions, spicy foods, or fatty foods. Some medications, such as aspirin, ibuprofen, certain muscle relaxers, or certain blood pressure medications can also provoke symptoms.

GERD can also be associated with various complications. Patients can develop chronic cough, asthma, laryngitis, and dental erosions. Over time, due to exposure to stomach acid, esophagitis, a painful inflammation of the esophagus, can also develop. This can lead to bleeding, scarring, or ulcers. In addition, a condition known as Barrett’s esophagus can affect about 1% of GERD patients. Barrett’s esophagus occurs when cells in the lower esophagus become damaged and change in character and composition. This leads to an increased risk of developing esophageal cancer.

If you are concerned that you may have GERD, please consult your primary care physician. GERD should only be diagnosed by a physician. For those whose symptoms do not improve with simple measures, further testing may be necessary in order to confirm a diagnosis of GERD. These tests include esophagogastroduodenoscopy (EGD), upper gastrointestinal series, esophageal pH monitoring, or esophageal manometry.

Treatment of GERD can include lifestyle changes, dietary modification, medical management, and surgical intervention.

Patients with GERD are encouraged to eat smaller meals more frequently throughout the day, quit smoking, putting blocks under the head of their bed to raise their head, avoid eating 3-4 hours before lying down, avoid wearing tight clothes or tight belts, and to lose weight. Medications currently being used to treat GERD include H2 blockers and proton pump inhibitors. Some of these medications should not be used long-term since they are associated with osteoporosis (weakening of the bones) and other side effects.

Surgical intervention, also known as anti-reflux surgery, can be performed using an open, laparoscopic, or robotic technique. There are a variety of new surgical approaches to treating reflux. If you have GERD schedule an appointment with your doctor and ask about your treatment options.

Dr Irene Lo is a Board Certified General Surgeon who has completed a fellowship in Advanced Minimally Invasive and Bariatric Surgery, is a Fellow of the American College of Surgeons, and is part of the 680Bariatrics Team at Walnut Creek Surgical Associates, with offices in Walnut Creek, San Ramon, and Concord. Call 925- 933-0984 to schedule an appointment or find her on www.wcsurgeons.com