Most people have experienced heartburn or indigestion at one time or the other. If you have heartburn several times a week you may have Gastroesophageal Reflux Disease (GERD) or acid reflux disease.

GERD is a condition that affects millions of Americans. It occurs as the result of a malfunctioning muscle at the junction between the esophagus and stomach. This muscle, known as the lower esophageal sphincter (LES), opens to allow food to pass from your mouth into your stomach. When you are not eating the muscle remains closed. If the sphincter becomes weak or relaxes too frequently, acid from your stomach refluxes into your esophagus. Repeated exposure of the esophagus to stomach acid can cause irritation, damage and even predispose you to cancer.
The most common symptom of acid reflux disease is heartburn. Other symptoms include belching, acidic or sour taste in the mouth, chest pain not related to your heart, nausea, difficulty or pain with swallowing, hoarseness, sore throat, and coughing.

It is not known what causes GERD. We do know that it is affected by diet, lifestyle and medications. Certain foods cause the muscle to be even more incompetent. These foods include:
• Spicy foods
• Onions Garlic  
• Fried foods
• Caffeine
 • Chocolate   
 • Peppermint
• Acidic foods  
• Juices
• Alcohol

Smoking, obesity and certain medications can also make GERD symptoms worse. Symptoms are often worse after meals and at bedtime.

Diagnosis of GERD is usually made based on symptoms and a response to medical therapy. Often upper endoscopy or EGD (esophagogastroduodenoscopy) is performed to confirm diagnosis or to assess for injury or damage to the esophagus. It also examines the stomach for ulcer disease or the presence of cancers. A small flexible tube equipped with a video camera is place into the mouth and advanced into the esophagus, stomach and small intestine. It is performed in an outpatient setting with the use of a mild sedative. EGD is recommended for people requiring chronic therapy for acid reflux disease
as well as patients with worrisome symptoms such as bleeding, weight loss, anemia and difficulty swallowing.

Treatment involves lifestyle modifications, medications and occasionally surgery.
Modifying your eating habits will usually result in a 25% improvement in symptoms.
Lifestyle modifications include:
• Weight loss   
• Elevate the head of your bed 6 inches
• Smoking cessation
• Avoid eating several hours prior to lying down 
• Avoid alcohol       
• Avoid foods mentioned above
• Eat smaller meals

Most of the time patients require medications to control their symptoms. Over the counter medications include antacids such as Tums, Rolaids and Mylanta. These may provide some initial relief but typically wear off quickly. Medications known as H2 Blockers help by reducing the amount of acid the stomach produces. Examples include Pepcid, Tagamet and Zantac. They are stronger than antacids but often require frequent dosing. Prilosec OTC or omeprozole is the only over the counter medicine known as a proton pump inhibitor (PPI). This class of drugs is the strongest in blocking acid production. PPIs are taken once or twice daily.

Anti-reflux surgery is not for everyone. The surgery reconstructs your GE junction by wrapping the LES with the top part of the  stomach. This procedure  recreates the tightness the LES muscle has lost. Untreated acid reflux disease can lead to serious problems. Erosive esophagitis is injury of the mucosal lining of the esophagus as a result of repeated exposure to acid. The ulcerations are painful can also cause difficulty with swallowing. Bleeding may occur.
Esophageal strictures occur as the lining of the esophagus heals esophagus. Similar to a burn, the area of injury is replaced by scar tissue. The fibrous tissue causes narrowing of the esophagus. Barrett's esophagus is a permanent change it the lining of the lower esophagus. The normal cells are replaced by gastric mucosa. The cells can develop into cancer over time. Esophageal Cancer is the most dangerous complication of untreated acid reflux disease.
Chronic use of medications to control acid reflux warrants a trip to your doctor.

Evaluation for GERD should include an appointment with our staff at Atlantic Gastroenterology, PA. Please call us today at 252-758-2424.