Topic Overview What is gastroesophageal reflux disease (GERD)? Gastroesophageal reflux disease (GERD) is caused by the abnormal backflow, or reflux, of stomach acid and juices into the esophagus, the tube that leads from the throat to the stomach. What causes GERD? The backflow of stomach acid and juices into the esophagus occurs when the valve between the lower end of the esophagus and the stomach (the lower esophageal sphincter, or LES) does not close tightly enough. Overeating or bending forward after eating occasionally causes heartburn and a sour taste in the mouth. Occasional heartburn does not mean you have GERD. In GERD, the reflux—and heartburn—last longer and occur more often. What are the symptoms of GERD? The main symptom of GERD is a frequent uncomfortable feeling of burning, warmth, heat, or pain just behind the breastbone, commonly referred to as heartburn. If you have pain behind your breastbone, you need to make sure it is not caused by a problem with your heart. The burning sensation caused by GERD usually occurs after eating. Pain from your heart is usually felt as pressure, heaviness, weight, tightness, squeezing, discomfort, or a dull ache that occurs most often after activity. How is GERD diagnosed? Your health professional will take a medical history and perform a physical exam. If GERD is suspected, your doctor may prescribe medications such as acid reducers to treat symptoms of GERD without performing any tests. If your symptoms respond to these medications, your doctor usually will diagnose you as having GERD. Tests that may be done to diagnose GERD or confirm a diagnosis include: Endoscopy, which allows a health professional to examine the inside of your esophagus and stomach using a thin, flexible, lighted imaging instrument (endoscope).
Esophagus testing, which is made up of a group of tests that evaluates the condition and performance of the esophagus.
Upper gastrointestinal series, which allows a health professional to examine the upper portion of a person's digestive system.
How is GERD treated? Treatment for GERD begins with making lifestyle changes and, if necessary, taking nonprescription antacids or acid reducers. Severe GERD symptoms usually require stronger prescription medications, such as proton pump inhibitors or prokinetic agents, for successful treatment. Lifestyle changes are usually combined with prescription medications to help control the symptoms. Many people who develop GERD have the condition for the rest of their lives. They need to consider long-term lifestyle changes, such as quitting smoking and avoiding foods that make the symptoms worse, and the possibility that they will be taking medications to help control the symptoms for many years. Surgery, such as fundoplication surgery, which strengthens the valve between the esophagus and stomach, may be an option for people for whom medications do not provide adequate relief or who are not able to take medications to control their GERD symptoms because of side effects. However, many people continue to need some medications even after surgery.
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