top of page

Gastroesophageal Reflux Disease (GERD)

WHAT IS GASTROESOPHAGEAL REFLUX DISEASE?

Gastroesophageal reflux (GERD) develops when contents in the stomach flow back into the food pipe called the esophagus. This occurs when the valve called the lower esophageal sphincter (LES), between the esophagus and stomach, cannot close properly. The LES would normally open when you swallow food or liquids to allow the contents to enter the stomach. The LES will close once the contents enter the stomach. When the LES does not close properly, the contents in the stomach back up into the esophagus, this reverse flow can damage the esophagus lining and cause discomfort.

SYMPTOMS

​Symptoms of GERD can vary from person to person. Common symptoms include:

  • Heartburn (i.e. Burning or acid-like sensation around the chest area)

  • Regurgitation

  • Difficulty swallowing

  • Painful swallowing

 

It is important you see your healthcare provider if the symptoms worsen. If GERD is left untreated, it can damage the esophagus. Continued acid exposure may cause scarring and narrowing of the esophagus.

RISK FACTORS

  • Obesity

  • Smoking 

  • Pregnancy

  • Long-term use of nonsteroidal anti-inflammatory (NSAID) medications (for example: aspirin, ibuprofen)

  • Excessive alcohol or coffee consumption

  • Delayed stomach emptying

  • Eating a large meal or eating late at night

DIAGNOSIS

Your healthcare provider can often diagnose GERD by asking you a few questions about your symptoms. If you respond to treatment, it will confirm the diagnosis of GERD.

 

Tests to diagnose GERD:
These tests can be done separately or together.

​

Intraesophageal pH and Impedance Monitoring:
This test measures the amount of acid that flows into your esophagus. This test is done using a catheter that is inserted through your nose. This catheter will stay in place for 24 hours. You would eat and drink normally during the test. When the test is complete, the recorder is returned to the Motility Lab so the results can be transferred for your doctor to review.
 

Common side effects include: throat irritation/sore throat and a small amount of bleeding. Side effects are usually well tolerated and minor.

 

Esophageal Manometry Study:
This test is used to assess the contractions (squeezes) of your esophagus and if the LES is closing properly. When swallowing food or liquid, the muscles lining your esophagus squeeze to move the contents down. 
 

During an esophageal manometry test, a catheter with multiple sensors is passed into your nose and down your esophagus. You will be asked to take a couple of swallows and the sensors will measure the strength of your contractions.

LIFESTYLE MANAGEMENT

Treatment of GERD can range from short-term to long-term and this depends on your symptoms. Medications are an important part of managing your symptoms, but changes to your lifestyles can also help.

 

  • Avoid or lessen intake of foods & beverages that can worsen your symptoms. This may include alcohol beverages, tomatoes, spicy foods, citrus fruits, chocolate, peppermint, caffeine, and carbonated drinks.

  • Weight loss

  • Quit smoking

  • Avoid eating or drinking 2-3 hours before bedtime

  • Elevate the head of the bed with a wedge underneath the mattress if symptoms occur during sleep

TREATMENT

Medications to treat GERD can reduce the amount of acid production and improve your symptoms. They work in different ways and it is common for people to combine therapies to improve their symptoms. These medications can be purchased over-the-counter at your pharmacy or your healthcare provider may give you a prescription for stronger acid-reducing medications.

 

Always speak with your healthcare provider before trying any treatment to see if they are right for you. It is always important to review potential harmful effects. These medications can also affect the way your other medications work, so it is important to also speak with your pharmacist to see if they can be taken together.

 

The following recommendations are general guidelines for the treatment of GERD and may not be suitable for everyone.

Always consult your healthcare provider before starting any new therapies.

Assorted medication blister packs

ANTACIDS

These medications are mostly found over-the-counter and do not require a prescription. Antacids coat the esophagus and stomach lining, neutralize stomach acid, and alleviate GERD symptoms. Antacids are available in tablet or liquid forms and effects typically last for a short period of time.

​

Examples: Gaviscon®, Tums®, Rolaids®, Maalox®, Milk of Magnesia 

PROTON PUMP INHIBITORS

These medications also stop acid production by blocking an enzyme called the proton pump that controls acid production in the stomach.

These medications require a prescription from a healthcare provider.

​

Examples: omeprazole (Losec®), pantoprazole (Pantoloc®, Tecta®), esomeprazole (Nexium®), lansoprazole (Prevacid®), rabeprazole (Pariet®), dexlansoprazole (Dexilant®)

H2 BLOCKERS

Histamine is found in the lining of your stomach and is responsible for acid production. These medications block histamine production to lower the amount of acid in your stomach. Most H2 antagonist medications can be purchased over-the-counter, while others will require a prescription.

​

Example: Pepcid® (famotidine)

bottom of page