Patient Education
ACID REFLUX (GERD)
Acid reflux is also called gastroesophageal reflux disease (GERD). Reflux develops when gastric or duodenal contents flow back into the esophagus. Your stomach makes acid to help digest food. Your stomach is protected from the acid but your esophagus is not. When acid gets into the esophagus, it may cause a burning feeling in the chest (heartburn).
There are two types of reflux.
- Non Acid Reflux occurs when you have reflux but it does not cause changes in the lining of the esophagus. You may have symptoms which correlate with reflux but no damage to the esophagus.
- Acid Reflux is when the gastric contents flow back into the esophagus and injure the lining of the esophagus.
All adults and children normally have some amount of reflux, particularly after eating. It is considered a pathological condition when it causes undesirable symptoms such as pain or respiratory distress. Studies show 15 million Americans suffer from symptoms of heartburn daily and 60 million experience heartburn once a month.
CAUSES OF GERD:
1. Abnormal Function of the lower esophageal sphincter
2. Hiatal Hernia
3. Esophageal Contractions
4. Abnormally slow emptying of stomach
5. Foods
6. Medications
7. Hormonal Changes
8. Overfull Stomach
9. Smoking
10. Being overweight
11. Alcohol
12. Late evening meals
SIGNS AND SYMPTOMS OF GERD
1. Heartburn – burning sensation in the middle of chest
2. Regurgitation – food or liquid refluxing up into the mouth
3. Difficulty swallowing
4. Nausea
5. Ear, nose and throat problems
6. Coughing
7. Hoarseness
8. Frequent belching
9. Anemia – due to blood loss from ulcers in the esophagus
10. Aspiration pneumonia
11. Abdominal pain
COMPLICATIONS OF REFLUX
1. Esophagitis – inflammation
2. Esophageal ulcerations
3. Esophageal Stricture – narrowing
4. Barrett’s Esophagus – change of normal squamous epithelium due to chronic irritation from gastric reflux
DIAGNOSIS OF GERD:
1. Physical Exam
2. Upper GI
3. EGD or Gastroscopy – visualization and biopsy
4. Manometry and pH
5. Gastric Emptying Study
TREATMENT
1. Lifestyle changes – simplest form of treatment
2. Elevate head of bed 6 inches
3. Avoid lying down for 2-3 hours after eating
4. Smaller and more frequent meals
5. Stop smoking
6. Limit alcohol use
7. Foods to avoid – fatty foods, chocolate, peppermint, spearmint, caffeine
8. Medications to avoid – NSAIDS, Aspirin, Quinidine, Ca Channel Blockers, Tetracycline , Potassium, Theophylline (do not stop any medications unless you check with your doctor)
9. Weight control
10. Stress
11. Avoid stooping or bending
MEDICAL TREATMENT:
1. H2 receptor antagonists – inhibits gastric acid secretions – EX. Zantac
2. Prokinetic agents- speeds the motility of the GI tract – Reglan
3. Proton Pump Inhibitors (PPI’S) – shuts off acid production –Ex. Prilosec , Nexium, Prevacid, and Aciphex
4. Surgery if medications prove to be ineffective
If you have persistent heartburn talk to your doctor about it and decide if you need to be screened.
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