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Gastroesophageal Reflux Disease or GERD

What is Gastroesophageal Reflux?

When you normally swallow, food and drink travel down your esophagus and into your stomach, after passing through the lower esophageal sphincter (LES), which is the normal anatomic valve between the esophagus and stomach. The LES relaxes to allow food and liquid to pass into the stomach. The normal LES then tightens again to minimize reflux of fluid and food into the esophagus from the stomach. When the valve or LES is incompetent, GERD develops. Stomach juices reflux from your stomach into the esophagus. Complications can occur including scarring of the esophagus (strictures) and Barrett’s esophagus (see link), dysplasia and esophageal adenocarcinoma.

When you develop GERD, your esophageal sphincter relaxes between swallows, allowing stomach acid to flow into your esophagus. Your stomach creates hydrochloric acid to digest the food you eat. The lining of your stomach produces mucous to protect it against corrosion, but your esophagus does not. When reflux occurs, digestive acid from your stomach irritates the lining of your esophagus.

Treatment of GERD requires an interdisciplinary approach that draws on various medical specialties. At BMC, physicians in our Center for Minimally Invasive Esophageal Therapies provide comprehensive, quality care including medical oncology, radiation oncology, thoracic surgery, gastroenterology, pathology, pulmonary medicine and radiology.

What are the Symptoms?

Although not everybody who develops GERD experiences heartburn, it is the most common symptom. Heartburn is a burning pain in the center of your chest. It often begins in your upper abdomen and then spreads upward to your neck. It can last up to two hours and is usually worse after you eat.

Other GERD symptoms include:

  • Regurgitation
  • A bitter taste in your mouth
  • A persistent cough
  • Hoarseness especially in the morning
  • Wheezing
  • Shortness of breath

What Causes Gastroesophageal Reflux?

The cause of GERD is unknown. There are several factors that can increase your risk for developing GERD, including:

  • Lifestyle factors, such as cigarette smoking, alcohol use, obesity
  • Medications, such as calcium channel blockers, theophylline, nitrates and antihistamines
  • A diet high in fatty and fried foods, chocolate, garlic and onions, caffeinated drinks, acidic foods, such as citrus fruits and spicy foods
  • Eating large meals or eating just before bedtime
  • Having a hiatal hernia, which displaces the LES and moves it into the chest
  • Being pregnant
  • Having diabetes
  • Rapidly gaining weight

How is Gastroesophageal Reflux (GERD) Diagnosed?

There are several procedures your physician may use to diagnose whether you have GERD:

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How is Gastroesophageal Reflux Disease (GERD) Treated?

The goal of GERD treatment is to reduce reflux, relieve symptoms and prevent damage to your esophagus. Depending on the severity of your symptoms, your doctor may first recommend changing your lifestyle, such as not eating within three hours of bedtime, avoiding fatty or fried foods, quitting smoking and/or losing weight. Your doctor may also recommend over-the-counter or prescription medications to control acid production. If non-surgical methods do not take care of your GERD, your doctor may recommend surgery and minimally invasive procedures

Treatments for GERD include

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