GERD (Chronic Acid Reflux)
What is GERD (chronic acid reflux)?
GERD (gastroesophageal reflux disease, or chronic acid reflux) is a condition in which acid-containing contents in your stomach persistently leak back up into your esophagus, the tube from your throat to your stomach.
Acid reflux happens because a valve at the end of your esophagus, the lower esophageal sphincter, doesn’t close properly when food arrives at your stomach. Acid backwash then flows back up through your esophagus into your throat and mouth, giving you a sour taste.
Acid reflux happens to nearly everyone at some point in life. Having acid reflux and heartburn now and then is totally normal. But, if you have acid reflux/heartburn more than twice a week over a period of several weeks, constantly take heartburn medications and antacids yet your symptoms keep returning, you may have developed GERD. Your GERD should be treated by your healthcare provider. Not just to relieve your symptoms, but because GERD can lead to more serious problems.
What are the main symptoms of GERD (chronic acid reflux)?
The main symptoms are persistent heartburn and acid regurgitation. Some people have GERD without heartburn. Instead, they experience pain in the chest, hoarseness in the morning or trouble swallowing. You may feel like you have food stuck in your throat, or like you are choking or your throat is tight. GERD can also cause a dry cough and bad breath.
What is heartburn?
Heartburn is a symptom of acid reflux. It’s a painful burning sensation in the middle of your chest caused by irritation to the lining of the esophagus caused by stomach acid.
This burning can come on anytime but is often worse after eating. For many people heartburn worsens when they recline or lie in bed, which makes it hard to get a good night’s sleep.
Fortunately, heartburn can usually be managed with over-the-counter (OTC) heartburn/acid indigestion drugs. Your healthcare provider can also prescribe stronger medicines to help tame your heartburn.
What do I do if I think I have GERD (chronic acid reflux)?
With GERD -- when reflux and heartburn happen more than once in a while -- the tissue lining your esophagus is getting battered regularly with stomach acid. Eventually the tissue becomes damaged. If you have this chronic acid reflux and heartburn you can see it’s affecting your daily eating and sleeping habits.
When GERD makes your daily life uncomfortable in this way, call your healthcare provider. Although GERD isn’t life-threatening in itself, its chronic inflammation of the esophagus can lead to something more serious. You may need stronger prescription medications or even surgery to ease your symptoms.
How common is GERD (chronic acid reflux)?
GERD is very common. The condition and its symptoms touch a huge number of people: 20% of the U.S. population.
Anyone of any age can develop GERD, but some may be more at risk for it. For example, the chances you’ll have some form of GERD (mild or severe) increase after age 40.
You’re also more likely to have it if you’re:
- Overweight or obese.
- Smoking or are regularly exposed to second-hand smoke.
- Taking certain medications that may cause acid reflux.
What causes acid reflux?
Acid reflux is caused by weakness or relaxation of the lower esophageal sphincter (valve). Normally this valve closes tightly after food enters your stomach. If it relaxes when it shouldn’t, your stomach contents rise back up into the esophagus.
Stomach acids flow back up into the esophagus, causing reflux.
Factors that can lead to this include:
- Too much pressure on the abdomen. Some pregnant women experience heartburn almost daily because of this increased pressure.
- Particular types of food (for example, dairy, spicy or fried foods) and eating habits.
- Medications that include medicines for asthma, high blood pressure and allergies; as well as painkillers, sedatives and anti-depressants.
- A hiatal hernia. The upper part of the stomach bulges into the diaphragm, getting in the way of normal intake of food.
What are the symptoms of GERD (chronic acid reflux)?
Different people are affected in different ways by GERD. The most common symptoms are:
- Regurgitation (food comes back into your mouth from the esophagus).
- The feeling of food caught in your throat.
- Chest pain.
- Problem swallowing.
- Sore throat and hoarseness.
Infants and children can experience similar symptoms of GERD, as well as:
- Frequent small vomiting episodes.
- Excessive crying, not wanting to eat (in babies and infants).
- Other respiratory (breathing) difficulties.
- Frequent sour taste of acid, especially when lying down.
- Hoarse throat.
- Feeling of choking that may wake the child up.
- Bad breath.
- Difficulty sleeping after eating, especially in infants.
How do I know I’m having heartburn and not a heart attack?
Chest pain caused by heartburn may make you afraid you’re having a heart attack. Heartburn has nothing to do with your heart, but since the discomfort is in your chest it may be hard to know the difference while it’s going on. But symptoms of a heart attack are different than heartburn.
Heartburn is that uncomfortable burning feeling or pain in your chest that can move up to your neck and throat. A heart attack can cause pain in the arms, neck and jaw, shortness of breath, sweating, nausea, dizziness, extreme fatigue and anxiety, among other symptoms.
If your heartburn medication doesn’t help and your chest pain is accompanied by these symptoms, call for medical attention right away.
Can GERD (chronic acid reflux) cause asthma?
We don’t know the exact relationship between GERD and asthma. More than 75% of people with asthma have GERD. They are twice as likely to have GERD as people without asthma. GERD may make asthma symptoms worse, and asthma drugs may make GERD worse. But treating GERD often helps to relieve asthma symptoms.
The symptoms of GERD can injure the lining of the throat, airways and lungs, making breathing difficult and causing a persistent cough, which may suggest a link. Doctors mostly look at GERD as a cause of asthma if:
- Asthma begins in adulthood.
- Asthma symptoms get worse after a meal, exercise, at night and after lying down.
- Asthma doesn’t get better with standard asthma treatments.
If you have asthma and GERD, your healthcare provider can help you find the best ways to handles both conditions -- the right medications and treatments that won’t aggravate symptoms of either disease.
Is GERD (chronic acid reflux) dangerous or life-threatening?
GERD isn’t life-threatening or dangerous in itself. But long-term GERD can lead to more serious health problems:
- Esophagitis: Esophagitis is the irritation and inflammation the stomach acid causes in the lining of the esophagus. Esophagitis can cause ulcers in your esophagus, heartburn, chest pain, bleeding and trouble swallowing.
- Barrett's esophagus: Barrett's esophagus is a condition that develops in some people (about 10%) who have long-term GERD. The damage acid reflux can cause over years can change the cells in the lining of the esophagus. Barrett’s esophagus is a risk factor for cancer of the esophagus.
- Esophageal cancer: Cancer that begins in the esophagus is divided into two major types. Adenocarcinoma usually develops in the lower part of the esophagus. This type can develop from Barrett’s esophagus. Squamous cell carcinoma begins in the cells that line the esophagus. This cancer usually affects the upper and middle part of the esophagus.
- Strictures: Sometimes the damaged lining of the esophagus becomes scarred, causing narrowing of the esophagus. These strictures can interfere with eating and drinking by preventing food and liquid from reaching the stomach.