Gastroesophageal reflux disease (patient information)

For the WikiDoc page for this topic, click here

WikiDoc Resources for Gastroesophageal reflux disease (patient information)
Articles
Most recent articles on Gastroesophageal reflux disease (patient information) Most cited articles on Gastroesophageal reflux disease (patient information) Review articles on Gastroesophageal reflux disease (patient information) Articles on Gastroesophageal reflux disease (patient information) in N Eng J Med, Lancet, BMJ
Media
Powerpoint slides on Gastroesophageal reflux disease (patient information) Images of Gastroesophageal reflux disease (patient information) Photos of Gastroesophageal reflux disease (patient information) Podcasts & MP3s on Gastroesophageal reflux disease (patient information) Videos on Gastroesophageal reflux disease (patient information)
Evidence Based Medicine
Cochrane Collaboration on Gastroesophageal reflux disease (patient information) Bandolier on Gastroesophageal reflux disease (patient information) TRIP on Gastroesophageal reflux disease (patient information)
Clinical Trials
Ongoing Trials on Gastroesophageal reflux disease (patient information) at Clinical Trials.gov Trial results on Gastroesophageal reflux disease (patient information) Clinical Trials on Gastroesophageal reflux disease (patient information) at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on Gastroesophageal reflux disease (patient information) NICE Guidance on Gastroesophageal reflux disease (patient information) NHS PRODIGY Guidance FDA on Gastroesophageal reflux disease (patient information) CDC on Gastroesophageal reflux disease (patient information)
Books
Books on Gastroesophageal reflux disease (patient information)
News
Gastroesophageal reflux disease (patient information) in the news Be alerted to news on Gastroesophageal reflux disease (patient information) News trends on Gastroesophageal reflux disease (patient information)
Commentary
Blogs on Gastroesophageal reflux disease (patient information)
Definitions
Definitions of Gastroesophageal reflux disease (patient information)
Patient Resources / Community
Patient resources on Gastroesophageal reflux disease (patient information) Discussion groups on Gastroesophageal reflux disease (patient information) Patient Handouts on Gastroesophageal reflux disease (patient information) Directions to Hospitals Treating Gastroesophageal reflux disease (patient information) Risk calculators and risk factors for Gastroesophageal reflux disease (patient information)
Healthcare Provider Resources
Symptoms of Gastroesophageal reflux disease (patient information) Causes & Risk Factors for Gastroesophageal reflux disease (patient information) Diagnostic studies for Gastroesophageal reflux disease (patient information) Treatment of Gastroesophageal reflux disease (patient information)
Continuing Medical Education (CME)
CME Programs on Gastroesophageal reflux disease (patient information)
International
Gastroesophageal reflux disease (patient information) en Espanol Gastroesophageal reflux disease (patient information) en Francais
Business
Gastroesophageal reflux disease (patient information) in the Marketplace Patents on Gastroesophageal reflux disease (patient information)
Experimental / Informatics
List of terms related to Gastroesophageal reflux disease (patient information)

Editor-in-Chief: Meagan E. Doherty

Please Join in Editing This Page and Apply to be an Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [1] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.

What is Gastroesophageal reflux disease (GERD)?

Gastroesophageal reflux disease (GERD) is a more serious form of gastroesophageal reflux (GER), which is common. GER occurs when the lower esophageal sphincter (LES) opens spontaneously, for varying periods of time, or does not close properly and stomach contents rise up into the esophagus. GER is also called acid reflux or acid regurgitation, because digestive juices—called acids—rise up with the food. The esophagus is the tube that carries food from the mouth to the stomach. The LES is a ring of muscle at the bottom of the esophagus that acts like a valve between the esophagus and stomach.

When acid reflux occurs, food or fluid can be tasted in the back of the mouth. When refluxed stomach acid touches the lining of the esophagus it may cause a burning sensation in the chest or throat called heartburn or acid indigestion. Occasional GER is common and does not necessarily mean one has GERD. Persistent reflux that occurs more than twice a week is considered GERD, and it can eventually lead to more serious health problems. People of all ages can have GERD.

What are the symptoms of Gastroesophageal reflux disease (GERD)?

The main symptom of GERD in adults is frequent heartburn, also called acid indigestion—burning-type pain in the lower part of the mid-chest, behind the breast bone, and in the mid-abdomen. Most children under 12 years with GERD, and some adults, have GERD without heartburn. Instead, they may experience a dry cough, asthma symptoms, or trouble swallowing.

What are the causes of Gastroesophageal reflux disease (GERD)?

The reason some people develop GERD is still unclear. However, research shows that in people with GERD, the LES relaxes while the rest of the esophagus is working. Anatomical abnormalities such as a hiatal hernia may also contribute to GERD. A hiatal hernia occurs when the upper part of the stomach and the LES move above the diaphragm, the muscle wall that separates the stomach from the chest. Normally, the diaphragm helps the LES keep acid from rising up into the esophagus. When a hiatal hernia is present, acid reflux can occur more easily. A hiatal hernia can occur in people of any age and is most often a normal finding in otherwise healthy people over age 50. Most of the time, a hiatal hernia produces no symptoms.

Other factors that may contribute to GERD include:

• obesity
• pregnancy
• smoking

Common foods that can worsen reflux symptoms include:

• citrus fruits
• chocolate
• drinks with caffeine or alcohol
• fatty and fried foods
• garlic and onions
• mint flavorings
• spicy foods
• tomato-based foods, like spaghetti sauce, salsa, chili, and pizza

Treatment options

See your health care provider if you have had symptoms of GERD and have been using antacids or other over-the-counter reflux medications for more than 2 weeks. Your health care provider may refer you to a gastroenterologist, a doctor who treats diseases of the stomach and intestines. Depending on the severity of your GERD, treatment may involve one or more of the following lifestyle changes, medications, or surgery.

Lifestyle Changes

• If you smoke, stop.
• Avoid foods and beverages that worsen symptoms.
• Lose weight if needed.
• Eat small, frequent meals.
• Wear loose-fitting clothes.
• Avoid lying down for 3 hours after a meal.
• Raise the head of your bed 6 to 8 inches by securing wood blocks under the bedposts. Just using extra pillows will not help.

Medications

Your health care provider may recommend over-the-counter antacids or medications that stop acid production or help the muscles that empty your stomach. You can buy many of these medications without a prescription. However, see your health care provider before starting or adding a medication.

Antacids, such as Alka-Seltzer, Maalox, Mylanta, Rolaids, and Riopan, are usually the first drugs recommended to relieve heartburn and other mild GERD symptoms. Many brands on the market use different combinations of three basic salts—magnesium, calcium, and aluminum—with hydroxide or bicarbonate ions to neutralize the acid in your stomach. Antacids, however, can have side effects. Magnesium salt can lead to diarrhea, and aluminum salt may cause constipation. Aluminum and magnesium salts are often combined in a single product to balance these effects.

Calcium carbonate antacids, such as Tums, Titralac, and Alka-2, can also be a supplemental source of calcium. They can cause constipation as well.

Foaming agents, such as Gaviscon, work by covering your stomach contents with foam to prevent reflux.

H2 blockers, such as cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR), and ranitidine (Zantac 75), decrease acid production. They are available in prescription strength and over-the-counter strength. These drugs provide short-term relief and are effective for about half of those who have GERD symptoms.

Proton pump inhibitors include omeprazole (Prilosec, Zegerid), lansoprazole (Prevacid), pantoprazole (Protonix), rabeprazole (Aciphex), and esomeprazole (Nexium), which are available by prescription. Prilosec is also available in over-the-counter strength. Proton pump inhibitors are more effective than H2 blockers and can relieve symptoms and heal the esophageal lining in almost everyone who has GERD.

Prokinetics help strengthen the LES and make the stomach empty faster. This group includes bethanechol (Urecholine) and metoclopramide (Reglan). Metoclopramide also improves muscle action in the digestive tract. Prokinetics have frequent side effects that limit their usefulness—fatigue, sleepiness, depression, anxiety, and problems with physical movement.

Because drugs work in different ways, combinations of medications may help control symptoms. People who get heartburn after eating may take both antacids and H2 blockers. The antacids work first to neutralize the acid in the stomach, and then the H2 blockers act on acid production. By the time the antacid stops working, the H2 blocker will have stopped acid production. Your health care provider is the best source of information about how to use medications for GERD.

Where to find medical care for yourdisease

Directions to Hospitals Treating Gastroesophageal reflux disease (GERD)