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GERD - Gastroesophageal Reflux Disease

(Also Called 'Acid Reflux', 'Gastric Reflux', 'GERD (Gastroesophageal Reflux Disease)', 'Heartburn - GERD ', 'Reflux')

Heartburn is a burning sensation in the center of the chest that often occurs after eating, bending over, with exercise, and sometimes at night when lying down. Approximately one in 10 adults has heartburn at least once a week and one in three monthly. Some pregnant women experience heartburn almost daily as a result of increased pressure on the abdomen and hormonal changes. Although its name implies otherwise, heartburn has nothing to do with your heart. Rather, these symptoms indicate a condition called gastroesophageal reflux disease, or GERD. This fact sheet offers some tips on how to relieve heartburn caused by this condition.

What is GERD?

When you swallow, food passes down your throat and through your esophagus to your stomach. A muscle called the lower esophageal sphincter controls the opening between the esophagus and the stomach, and remains tightly closed except when you swallow food. When this muscle fails to close, the acid-containing contents of the stomach can travel back up into the esophagus. This backward movement is called reflux. When stomach acid enters the lower part of the esophagus, it can produce a burning sensation, commonly referred to as heartburn.

Several factors might explain why this reflux action occurs and might offer some clues for relief. The most important are the following:

  • The position of your body after eating (An upright posture helps prevent reflux.)
  • The size of the meal (Smaller meals reduce reflux.)
  • The nature of foods you consume (Certain substances that irritate the esophagus or weaken the sphincter can cause reflux.)

How is GERD treated?

To treat GERD, we recommend the following:

  • Raise the head of your bed by six inches to allow gravity to help keep the stomach's contents in the stomach. (Do not use piles of pillows because this puts your body into a bent position that actually aggravates the condition by increasing pressure on the abdomen.)
  • Eat meals at least three to four hours before lying down, and avoid bedtime snacks.
  • Eat moderate portions of food and smaller meals.
  • Maintain a healthy weight to eliminate unnecessary intra-abdominal pressure caused by extra pounds.
  • Limit consumption of fatty foods, chocolate, peppermint, coffee, tea, colas, and alcohol — all of which relax the lower esophageal sphincter. Also, avoid tomatoes and citrus fruits or juices, which contribute additional acid that can irritate the esophagus.
  • Give up smoking, which also relaxes the lower esophageal sphincter.
  • Wear loose belts and clothing.
If it persists

Many people will get relief from heartburn and the pressure accompanying esophageal reflux by following the above recommendations. Over-the-counter liquid antacids are also helpful in treating occasional heartburn. If your symptoms persist, do not respond to treatment, or occur frequently, you need to see a doctor for testing and treatment.

A visual examination of the esophagus, known as an endoscopy, might be necessary. Sometimes this test shows that the lining of the esophagus is severely inflamed and irritated by stomach acid. This condition, known as esophagitis, might lead to bleeding and difficulty in swallowing. Medical treatment for this condition might be necessary. This usually involves blocking acid production in the stomach or increasing the strength of the lower esophageal sphincter to help close off the opening to the stomach.

Medicine and the lifestyle changes described above provide relief for most people who suffer from esophageal reflux. Over-the-counter medicines, such as Tums®, Rolaids®, Maalox®, Zantac®, Tagamet®, Pepcid®, and Axid®, can generally relieve esophageal reflux symptoms. Patients with more severe symptoms or those who have been using antacids for more than two weeks should contact their doctors, who can prescribe medicines to control or eliminate acid, such as H2-receptor antagonists and proton pump inhibitors. Only a few people need surgery to correct the disorder.

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 10/22/2009…#7042


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