Gastroesophageal Reflux Disease (GERD, Acid Reflux, Heartburn)

Patients looking for medical information about GERD can find out about signs and symptoms, self help (dietary advice, life style modifications, over-the-counter medications), treatment options, endoscopic and surgical treatments, GERD during pregnancy, GERD in elderly, GERD in infants and children, etc. by choosing one of the links to the left.

GERD stands for Gastroesophageal Reflux Disease. Gastroesophageal reflux describes a backflow of acid from the stomach into the swallowing tube or esophagus. This acid can irritate and sometimes damage the delicate lining on the inside of the esophagus. Almost everyone experiences gastroesophageal reflux at some time. The usual symptom is heartburn, an uncomfortable burning sensation behind the breastbone, most commonly occurring after a meal. In some individuals this reflux is frequent or severe enough to cause more significant problems, that is a disease. Thus, gastroesophageal reflux disease is a clinical condition that occurs when reflux of stomach acid into the esophagus is severe enough to impact the patient’s life and/or damage the esophagus.

The difference between heartburn, acid reflux and GERD:

Heartburn is the most typical symptom that patients with gastroesophageal reflux disease, or acid reflux, complain of -- typically described as a burning sensation in the mid-chest but there are also other symptoms that can manifest as acid reflux or GERD. Those symptoms include: regurgitation, cough, shortness of breath and chest pain. Acid reflux and GERD are often used interchangeably and refers to the actual process of gastro content, such as acidic juices, coming up from the stomach into the lower esophagus.

Treatment for GERD

Surgery is an alternative that is generally applied when long-term medical treatment is either ineffective or undesirable, or when certain complications of GERD are present. When considering surgery as a treatment for GERD a thorough review of all aspects of the procedure with a gastroenterologist (a physician who specializes in these disorders) and a surgeon is advised.

Side-effects or complications associated with the surgery occur in 5-20% of patients. The most common are difficulty swallowing or impairment of the ability to belch or vomit. Side-effects are usually temporary, but they sometimes persist.

Anti-reflux surgery can breakdown, similar to hernia repairs in other parts of the body. The recurrence rate is not well defined but may be in the range of 10-30% over 20 years. A number of factors can contribute to this breakdown. In some individuals, even after surgery, reflux symptoms may persist and the use of medication may need to continue.

Endoscopic Treatments

The effectiveness and side effects or risks associated with medical and surgical therapy for GERD have been well studied. Newer endoscopic treatments are not yet as well studied. Some individuals who are helped by pharmacologic (drug) therapy, but who require long-term therapy, would prefer a non-surgical, non-pharmacologic option for treatment of their symptoms. This has led to research and development of newer endoscopic procedures designed to treat GERD.

Foods That Cause Heartburn

Alcohol can irritate the esophageal lining and loosen the lower esophageal sphincter, as can coffee and other caffeine-containing products. Diet can contribute to LES dysfunction. Coffee, tea, cocoa, and cola drinks are all powerful stimulants of gastric acids. Mints and chocolate, often served to cap off a meal to aid in digestion, can actually make things worse. Both relax the LES and can induce heartburn, as can fried and fatty foods. Some people say that onions and garlic give them heartburn. Others have trouble with citrus fruits or tomato products. If you notice that a particular food leads to episodes of heartburn, by all means stay away from it.

The difference between heartburn and a heart attack

Symptoms associated with the digestive condition called gastroesophageal reflux disease (GERD), or reflux, can mimic the pain of heart attack or angina - which is chest pain caused by diminished blood flow through the coronary arteries - especially when the sensation is constricting rather than burning in nature. But it can be dangerous to assume that any chest pain is caused by acid reflux. Even people with known reflux disease should always seek medical attention if they experience chest discomfort brought on by exercise, which may signal either angina or a heart attack.

The main thing to determine is the severity and length of your chest pain. If the sensation is a severe, pressing, or squeezing discomfort, it may be a heart attack. Also, heart attack pain lasts a while. If the pain goes away in 5-10 minutes, it's probably not a heart attack. It could be angina, however, which does require a visit to the doctor - and treatment. So it's important not to dismiss chest tightness, especially if it follows physical exertion.