Gastroesophageal Reflux Disease (GERD)

Many people develop occasional heartburn or indigestion. If these symptoms become chronic, you may have a more serious condition known as gastroesophageal reflux disease (GERD).

At Henry Ford Health System, our gastrointestinal (GI) physicians and their teams have years of experience in diagnosing and treating GERD. We take a comprehensive approach, offering you expert care at locations throughout southern Michigan.

What is gastroesophageal reflux disease (GERD)?

GERD affects the esophagus, the tube that connects your mouth to your stomach. The muscle at the end of the esophagus (lower esophageal sphincter) normally closes to prevent stomach acid from flowing back from the stomach into the esophagus.

When the lower esophageal sphincter (LES) stops working properly and doesn’t close off the contents of your stomach, stomach acid leaks back (reflux) into the esophagus. If the condition happens at least twice a week, your physician may suspect GERD.

GERD develops when the LES relaxes or weakens because of several possible factors:

  • Increased pressure in your abdomen because of excess weight or pregnancy
  • Certain medications that cause the LES to relax at the wrong times, such as:
    • Antidepressants to treat depression
    • Antihistamines to treat allergies
    • Asthma medications
    • Calcium channel blockers to treat high blood pressure
    • Prescription or over-the-counter painkillers
    • Sedatives to help people sleep
  • Smoking
  • A hiatal hernia, in which the upper part of the stomach moves through an opening in the diaphragm

Symptoms of gastroesophageal reflux disease (GERD)

For people who have GERD, the most common symptom is frequent heartburn, a sharp, burning pain in your chest or abdomen. Other common symptoms include:

  • Regurgitation (backward flow) of partially digested food or stomach acid
  • Chest pain, which can mimic a heart attack
  • Difficulty swallowing
  • Nausea or vomiting
  • Dry cough or hoarseness

Henry Ford: Our diagnostic process for GERD

Your physician may be able to confirm a diagnosis of GERD based on your symptoms, especially if you have heartburn regularly. Other tests that our gastroenterology specialists may recommend for you include:

  • Esophageal pH monitoring to measure the levels of acid in your esophagus over time
  • Manometry test to evaluate how well the muscles in your esophagus are working
  • Barium swallow test using a contrast material and X-rays to produce images of your esophagus
  • Endoscopy using a thin, flexible tube with a tiny camera and instruments to examine the lining of your esophagus

Treatment options for GERD

At Henry Ford, you can expect the latest, most advanced treatment options from our experienced team. Our goal is to:

  • Relieve your symptoms
  • Treat the causes of LES problems
  • Heal the esophagus

Lifestyle changes to manage GERD symptoms

Our GI team brings together many specialties to work with you on lifestyle changes that can relieve your symptoms.

You meet with our registered dietitians and other specialists who discuss your symptoms and provide expert guidance in making long-lasting, effective changes. Learn more about our education and support for people who have GERD and other GI disorders.

Among the lifestyle changes we may recommend are:

  • Weight loss
  • Loose-fitting clothing around your abdomen to avoid pressure on your stomach, which can push acid up into your esophagus
  • Upright posture for 3 hours after meals
  • A slight angle for sleeping, by raising the head of your bed by a few inches
  • Smoking cessation

Medications to treat GERD

Our skilled gastroenterologists (specialists in treating disorders affecting the digestive tract) design a treatment plan that’s best for you. We start with over-the-counter medications and can also prescribe medications that relieve GERD symptoms. We may recommend one or more of the following:

  • Antacids such as Maalox and Rolaids to reduce stomach acid
  • H2 blockers like Tagamet, Zantac or Pepcid to reduce stomach acid production
  • Proton pump inhibitors (PPIs) such as Prilosec and Prevacid that block stomach acid production

Surgery for GERD

If lifestyle adjustments and medication aren’t enough to control your symptoms, or if you cannot take medications for a long time, surgery may be the best treatment option for you.

We offer a minimally invasive procedure called Nissen fundoplication. This laparoscopic surgery involves only 3 to 4 small incisions to tighten the LES. You will need general anesthesia and a brief hospital stay for this procedure.

Complications of GERD

If left untreated, GERD can lead to several serious complications, including:

  • A narrowing of the esophagus: Continued acid reflux into the esophagus can cause scar tissue to develop, which narrows the opening and causes difficulty swallowing.
  • Esophageal ulcers: Stomach acid in the esophagus can cause open sores in the lining of the esophagus, causing bleeding and pain.
  • Barrett’s esophagus: Over time, the lining of the esophagus can change in response to long-term exposure to stomach acid. These tissue changes can lead to cancer of the esophagus.
  • Respiratory problems: People who have GERD may inhale stomach acid into their lungs, causinghoarseness, coughing, asthma, pneumonia and related conditions.
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