GERD causes and risk factors
A muscle at the end of your esophagus called the lower esophageal sphincter (LES) normally opens to allow food to enter the stomach and closes to prevent food and stomach acid from flowing back into the esophagus. When the LES doesn’t work properly, it can allow stomach acid and partially digested food to reflux, or leak backward, into the esophagus.
GERD can develop when your LES relaxes or weakens. This can happen for several reasons, including:
- Certain medications, such as antidepressants, antihistamines, asthma medications, calcium channel blockers to treat high blood pressure, painkillers (either prescription or over-the-counter) and sedatives to help you sleep
- Hiatal hernia, in which the upper part of your stomach bulges through an opening in your diaphragm (a thin muscle that separates the chest from the abdomen)
- Increased pressure in your abdomen (belly) because of excess weight or pregnancy
The most common symptom of GERD is heartburn — a burning pain in your upper or middle chest that often develops or gets worse after eating. Other common GERD symptoms include:
- Backward flow of partially digested food or stomach acid
- Chest pain that may seem similar to a heart attack
- Trouble swallowing
- Nausea or vomiting
- Dry cough or hoarseness
It’s important to talk to your doctor if you think you may have GERD. Without proper treatment, GERD can lead to several serious complications, such as:
- Narrowing of the esophagus: Repeated exposure to stomach acid can cause your esophagus to develop scar tissue, which narrows the opening and can make it hard to swallow.
- Esophageal ulcers: Stomach acid can cause your esophagus to develop sores in its lining, which can bleed and be painful.
- Barrett’s esophagus: Over time, the lining of the esophagus can change because of repeated, long-term exposure to stomach acid. This is called Barrett’s esophagus, which can increase your risk for esophageal cancer.
- Lung and breathing problems: You may inhale stomach acid into your lungs as a result of GERD. This can lead to coughing, hoarseness, asthma, pneumonia and other lung conditions.
How we diagnose GERD
Your doctor may confirm a diagnosis of GERD based on your symptoms, especially if you have heartburn regularly. Other tests your doctor may recommend include:
- Barium swallow test: You’ll swallow a substance called barium, which shows up well on X-rays, so we can see detailed images of the inside of your esophagus
- Endoscopy: Your doctor will use an endoscope (a thin, flexible tube with a light and camera) to examine the lining of your esophagus
- Esophageal pH monitoring: We can measure the levels of acid in your esophagus over time
- Manometry test: This lets us measure how well the muscles in your esophagus work
Our options for treating GERD
We use the most advanced treatment options to relieve your symptoms, treat the causes of your LES problems and heal damage to your esophagus as a result of GERD. You and your doctor will create a personalized treatment plan based on your unique needs and concerns. Your treatment plan may include:
Lifestyle changes for GERD
You’ll work with our registered dietitians and other specialists, who can give you expert guidance on making changes to reduce and manage your symptoms. The lifestyle changes we may recommend include:
- Eating three meals a day and avoiding snacks
- Exercising regularly
- Losing weight
- Quitting smoking
- Raising the head of your bed six to eight inches
- Staying away from fatty foods
- Staying away from caffeinated, carbonated or alcoholic dinks
- Staying upright for at least three hours after meals
- Wearing loose-fitting clothing around your belly to lower pressure on your stomach
Medication therapy for GERD
There are several medications that can relieve your GERD symptoms. Your doctor may prescribe:
- Antacids, such as Maalox and Rolaids, to reduce stomach acid
- H2 blockers, such as Tagamet, Zantac or Pepcid, to reduce the production of stomach acid
- Proton-pump inhibitors (PPIs), such as Prilosec and Prevacid, that block the production of stomach acid
If lifestyle changes and medications don’t do enough to control your symptoms, or if you can’t take medications for a long time, surgery may be your best treatment option.
One surgery we offer is Nissen fundoplication, in which your surgeon wraps the top of your stomach around the lower esophagus. This helps lower the risk of stomach acid backing up into your esophagus.
Another surgical option we provide is called LINX device surgery. In this procedure, your surgeon will implant a small band of titanium beads around your lower esophagus. This helps reinforce the LES and prevents stomach acid from traveling backward into the stomach. Learn about one patient’s success with LINX device surgery.
Additional questions about GERD
It’s natural to have questions if you have GERD or you think you may be at risk. Find answers to common questions about GERD.