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Gastroesophageal reflux disease

Do you feel a burning in your chest not long after you eat or lie down? Well, if so, you may have Gastroesophageal reflux disease, or GERD, for short. Hi, I'm Dr. Hecht talking today about GERD.When we swallow food, it normally travels down our food pipe, or esophagus, into the stomach, where it's greeted by a rush of Hydrochloric acid secreted by specialized cells that line the stomach. This acid is so powerful, it could actually eat the paint right off your car.Fortunately, there's a band of muscle between the stomach and the esophagus called the Lower Esophageal Sphincter or L-E-S, for short, that clamps down to prevent acid from moving or refluxing upward and burning the lining of the esophagus. If that band of muscle does not adequately clamp down, it allows foods, liquids and strong stomach acid to leak back up into your esophagus causing irritation and burning that's known as heartburn or GERD. Maintaining good, tight L-E-S muscle tone is really the key to preventing heartburn, or GERD. It's as simple as that.So what causes GERD? Well, here are some things that'll cause L-E-S tone to relax and cause GERD. Being overweight or obese, smoking, and drinking too much alcohol can cause GERD. Chocolate and peppermint can cause GERD. This includes eating rich desserts and those mints that you get on the way out of many restaurants. If you’re a woman, pregnancy can bring on GERD.To determine if you have GERD, your doctor may request an upper endoscopy to look inside your esophagus and stomach to diagnose reflux, or look for any damage caused by reflux. Other tests can measure the acid in your esophagus, the amount of pressure in your esophagus, or if you have blood in your stool caused by the irritation in your esophagus.If you do have GERD, lifestyle changes can go a long way to help manage your symptoms. First off, avoid foods that cause problems for you, and don’t drink alcohol. Avoid eating large meals. If you’re a little heavy, try to lose some weight. Even 10 pounds of weight loss will cut down on GERD. And if you smoke, try to stop smoking.If you continue to have GERD symptoms, you should see a Gastroenterologist for evaluation and have an upper endoscopy exam. Your doctor may request you take over-the-counter antacids, or he may prescribe a prescription for stronger medication.You should call your doctor if you’re bleeding, feel like you’re choking, get filled up quickly when you eat, have trouble swallowing, throw up often or experience sudden weight loss.The good news is that most people who have GERD don’t need surgery. For the worst of cases, surgeons may perform a laparoscopic procedure to tighten a weak L-E-S muscle.If you have occasional acid reflux, acid blockers and antacid tablets can be used on an as needed basis. However, if you're having acid reflux symptoms more than 3-4 times a week, it's recommended to take prescribed medications every day to prevent repeated tissue damage to the esophagus.

Gastroesophageal reflux disease

Review Date: 5/20/2019

Reviewed By: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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