Gastroesophageal reflux is a backward flow or reflux of stomach contents into the esophagus. Everybody has some reflux, often not associated with any symptoms. Abnormal amounts of gastroesophageal reflux can cause gastroesophageal reflux disease (GERD). This occurs when the valve of smooth muscle between the esophagus and the stomach does not function properly, allowing excessive reflux of acidic stomach contents into the esophagus. This muscle band is called the lower esophageal sphincter.
What are signs and symptoms of gastroesophageal reflux?
Signs and symptoms of GERD include:
- Heartburn or a sour taste in the mouth.
- Pain occurring in the middle of the chest.
- Coughing and/or choking while lying down.
- Increased trouble breathing while asleep.
How is GERD diagnosed?
A physician diagnoses gastroesophageal reflux from a history of signs and symptoms. He or she may order tests such as a barium swallow or an esophageal pH probe to help diagnose this condition.
What causes gastroesophageal reflux disease?
Each time you eat, stomach acids are released. Normally the lower esophageal sphincter acts as a guard to prevent stomach acids from backing up into the esophagus. An increase of the pressure in the stomach (for example, from excessive coughing), and/or relaxation of the muscle tone of the valve may cause reflux to occur.
Factors that may cause an increase in pressure include:
- Full stomach from a large meal
- Obesity
- Lying down
- Bending forward
- Lifting heavy objects
- Pregnancy
Factors that loosen the muscle tone of the valve can be caused by:
- Medications such as theophylline and calcium channel blockers.
- Nicotine
- Alcohol, Coffee
- Chocolate
- Mint
- Fatty foods
What is the treatment for GERD?
The following treatments may be recommended:
Lifestyle changes:
If you are overweight, talk with your health care provider about losing weight.
- If you smoke, quitting smoking is important. Your health care provider may have ideas to help you quit.
- Limit acidic foods, caffeine, strong spices, carbonated drinks, fatty foods, chocolate, mint, alcohol or nicotine.
- Eat smaller, more frequent meals.
- Avoid food or liquids for 2-3 hours before bedtime.
- Elevate the head of the bed 6-8 inches.
- Avoid lifting heavy objects.
- Avoid bending forward at the waist.
- Avoid wearing clothing which fits tightly around the waist.
If simple lifestyle changes don't offer relief, medications which reduce or neutralize the acid production in the stomach may be recommended or prescribed by your physician.
