GERD Gastroesophageal Reflux Disease | Photo of Woman Holding FlowerWhat Is GERD?

GERD is a digestive disorder where the acid and contents in your stomach flow back through your esophagus (the tube leading down from your throat to your stomach). This acid reflux is known as gastroesophageal reflux (GER) and can lead to irritation of the lining of your esophagus. However, you may receive a diagnosis of GERD from your doctor if you experience heartburn more than two times a week or more (or any of the other symptoms).

What Does GERD Stand For?

GERD is a common medical abbreviation used to refer to Gastroesophageal reflux disease. Doctors may also refer to GERD as Chronic Acid Reflux.

What Are the 4 Stages of Gerd?

Gerd is known to be a chronic and progressive disease. Various treatments can help slow its progression. However, your course of treatment will also depend on what stage you are in. The stage you are in is determined by the severity of reflux you experience in your esophagus. These stages include:

  • Stage 1: Mild GERD
  • Patients experience mild symptoms once or twice a month.
  • Treatments can take the form of lifestyle changes and over-the-counter acid-suppressive medications.
  • Stage 2: Moderate GERD
  • Patients experience mild and more frequent symptoms which require them to take daily prescription acid-suppressive medications.
  • If left untreated, GERD symbols may impact your daily life and activities.
  • Stage 3: Severe GERD
  • Patients have poorly controlled symptoms even if they are on prescription medications.
  • Quality of life is usually lower.
  • They have erosive esophageal inflammation.
  • Evaluation from a GERD expert is highly recommended.
  • A specialist may even suggest the patient have an anti-reflux procedure done to restore the integrity of the lower esophageal sphincter.
  • Stage 4: Reflux induced pre-cancerous lesions or esophageal cancer
  • It results from many years of leaving GERD untreated.
  • 10% of patients reach this stage.
  • Patients develop a pre-cancerous condition known as Barrett’s esophagus. If left untreated, the pre-cancerous lesions can progress into cancer.

Why Does Gerd Happen? 

As of now, there is no known single cause for GERD. Gastroesophageal reflux can occur if the esophageal defenses are overwhelmed by gastric contents that flow back into the esophagus. This common occurrence of acid reflux is usually a result of a weak or relaxed lower esophageal sphincter (LES). The weakened muscles prevent your LES from closing properly/firmly, and your stomach connects leaks back through your esophagus.

What Are The Typical Symptoms of Gerd?

While it is normal to have acid reflux or gastroesophageal reflux once in a while, the condition becomes chronic if you experience it more than twice a week (along with other symptoms). Some common symptoms include:

  • After eating, you feel a burning/painful sensation in your chest (heartburn)
  • Difficulty swallowing or pain while swallowing
  • Regurgitation of food
  • A sour-tasting liquid in your mouth
  • Bad breath
  • Inflammation of the gums
  • Wearing away tooth enamel
  • Vomiting or nausea
  • Sore throat
  • A hoarse voice
  • A sensation of a lump in your throat

If you experience nighttime acid reflux, you may also have:

  • Chronic cough
  • Laryngitis
  • New or worsening asthma
  • Disrupted sleep

Gastroesophageal Reflux Disease Illustration | nside of Stomachsource

Are Gerd and Acid Reflux the Same?

Acid reflux occurs when your lower esophageal sphincter (the valve at the end of your esophagus) does not close properly when the food arrives in the stomach. Because your LES does not close properly, it allows the acidic contents of your stomach to flow back through the esophagus and into your mouth. Acid reflux can occur to many once, which often leads to heartburn. However, GERD is more chronic and serious. When someone has GERD, they experience acid reflux/heartburn more than twice a week for an extended period. No medication they take for heartburn or antacids helps. Therefore, they need to see their healthcare provider to find the best possible treatment to relieve symptoms and prevent their GERD from leading to more serious problems.

Who Treats Gerd? 

We recommend that you first schedule an appointment with your doctor to discuss your symptoms, questions, and issues. If your doctor suspects that you may have GERD, they may refer you to a gastroenterologist. The gastroenterologist may then send you to do specific tests to confirm a diagnosis.

How Is Gerd Diagnosed?

You may receive a possible diagnosis from your doctor during your physical examination and when you share your signs and symptoms. To confirm a diagnosis- or check the severity of the disease- your doctor may send you to a gastroenterologist. From there, your gastroenterologist may recommend an:

  • Upper endoscopy and biopsy:During an upper endoscopy, the doctor inserts an endoscope (a long, flexible tube with a light and camera) down your throat. They then look at the lining of your esophagus and stomach. While test results may come out normal- the camera on the tube can show if there is any inflammation or problems in the esophagus. A biopsy (collection of tissue) can also be done during this procedure to test for Barrett’s syndrome.
  • Ambulatory acid (pH) probe test: An pH probe test measures the pH levels of your esophagus. The doctor inserts a tube through your nose/mouth and into your stomach (known as catheter monitoring). You then go home with a monitor, and it measures and records your pH levels as you go about your daily life for 24 hours. There is also another method known as capsule monitoring. In this procedure, your doctor uses an endoscope to place a wireless capsule in the lining of your esophagus to measure your acid reflux for 48 hours. The capsule will then pass through your stool after about 2 days. By keeping a diary that monitors your diet, sleep, and symptoms- your doctor can also figure out how these areas relate to your acid reflux.
  • Esophageal manometry:Esophageal manometry tests the muscle contraction of your lower esophageal sphincter and esophageal muscles. Your doctor will insert a small flexible tube through your nose, and the sensors on the tube measure the strength of your sphincter and muscles as you swallow.
  • X-ray of your upper digestive system: These x-rays will show if you have any problems or complications from GERD. You drink a chalky liquid (barium)- and this will coat and fill the lining of your digestive tract. This coating allows the doctors to get clear x-ray photos of your upper GI tract.

Can Gerd Be Cured?

As of right now, there is no known cure for GERD. However, you can manage/reduce your symptoms. Your doctor will suggest specific lifestyle changes and medications to help manage your GER/GERD symptoms. By following these changes, you could improve your overall quality of life- or prevent your symptoms from progressing. In other cases, your doctor may suggest surgery if you are not responding well to medications or lifestyle changes. Or you may bring up the possibility if you do not want to take long-term medication. However, take note that complications may arise.

Where Is Gerd Pain Felt?

Gerd pain often leads to a painful burning sensation in the middle of your chest. This chest pain is different from what a heart attack feels. Heartburn leads to:

  • A burning sensation that starts around the breastbone area and possibly the upper abdomen
  • Pain after eating, lying down, or bending over
  • Waking up from sleep, especially if you have eaten two hours before going to bed
  • A sour taste in your mouth- especially after lying down
  • Experiencing regurgitation, where some of your stomach contents rise back into your throat
  • The appearance of symptoms after having a large or spicy meal

Meanwhile, with a heart attack, you are most likely to feel:

  • Pressure, tightness, pain, or a squeezing sensation in the center of your chest and arms that may spread to your neck, jaw, or back
  • Irregular or rapid heartbeat
  • Nausea, indigestion, heartburn, vomiting, or abdominal pain
  • Shortness of breath
  • Cold sweat
  • Fatigue
  • Lightheadedness, weakness, or sudden dizziness
  • The appearance of symptoms after physical exertion or having extreme stress

How Long Does It Take To Heal Damage from Gerd?

As mentioned above, GERD is a chronic condition that can be treated but not cured. Most people can see positive results after making lifestyle changes to avoid acid reflux triggers and starting their medications. Healing time and time to see results will also vary from person to person and the severity of symptoms. Some medications may work right away, and other medications may take time. The waiting period can take into effect anytime between 2-12 weeks. Some people who have severe GERD will most likely need to accept that they will have to stick with a long-term management treatment.

Can Gerd Cause Back Pain?

It is more common that your pack pain results from some underlying issue that also affects your GERD. However, there is an association between GERD with back pain. Usually, the pain one feels with heartburn can travel to your lower back. If you hunch over while eating a large meal, this could also trigger your back pain since your posture places more pressure on your stomach and diaphragm (which can affect your food digestion).

Can Gerd Cause Chest Pain?

Yes, heartburn or the irritation of the lining of your esophagus from GERD can cause chest pain. These symptoms can trigger nerves in your chest to send pain signals to your brain.

Can Gerd Cause Dizziness?

Dizziness is known to be one of the less common symptoms. As we have discussed, the acid reflux or esophageal reflux you experience with GERD affects your upper GI system. It can also affect the tubes that lead to your inner ear. If these tubes become irritated and swell, this can lead to a loss of balance (aka dizziness). One may also experience dizziness when lying down after eating a meal.

Dizziness can also result from a side effect of your medication. Your pharmacist will let you know (or you could also check the label). If any questions, concerns, or issues arise- we encourage you to talk with your doctor.

Can Gerd Cause Headaches?

Some studies link GERD and headaches, but their correlation still needs to be further investigated. One theory suggests that gastrointestinal disorders such as GERD increase the body’s sensitivity to pain. Studies show that the brain and stomach communicate through the central nervous system, endocrine system, and immune system. If there is any disturbance in the brain or gut, this can lead to a disruption in communication and lead to the development of headaches or even migraines.

Can Gerd Cause Heart Palpitations?

It is highly unlikely that you may experience heart palpitations as a result of GERD. However, heart palpitations are directly related to anxiety. If your symptoms of GERD make you feel anxious or stressed, you can indirectly experience heart palpitations. Heart palpitations and GERD may even share common triggers (such as consumption of alcohol, caffeine, or eating a heavy meal).

Stomach Issues Illustration | Gastroesophageal Reflux Diseasesource

Can Gerd Cause Lower Abdominal Pain?

People with GERD usually experience pain in the upper GI tract due to the irritation one may experience when their stomach acid/content leaks back into their esophagus. Common causes of lower abdominal pain include gas, period pain, UTIs, kidney stones, gastroenteritis, UC, bloating, etc. If you are experiencing any abdominal pain that concerns you, we urge you to see your doctor to get to the bottom of what could be the cause. 

Can Gerd Cause Nausea?

Like the other symptoms above, it is still not clear why GERD causes nausea. Many think that it has to do with the fact that acid reflux results in leaving a person with a sour taste in their mouth, coughing, and/or burping. These symptoms can cause nausea. 

Can Gerd Cause Shortness of Breath?

Yes, GERD can cause shortness of breath. When the stomach acids back up onto the esophagus during acid reflux, the acid can also leak into the lungs and cause the airways to swell (causing difficulties in breathing). Shortness of breath can be more common when sleeping or lying down because it increases the chances for acid reflux to occur. 

Does Drinking Water Help Gerd?

Drinking water can help ease any symptoms of GERD. The pH in water (which is neutral) can help balance the pH of an acidic meal or more acidic stomach fluids. To help lower your risk of acid reflux, you could take small sips of water throughout your meal. However, be wary of how much water you drink all a once when eating a meal. Drinking too much water too fast can worsen your symptoms by distending the stomach and putting more pressure on your lower esophageal sphincter. 

Which Side Should I Sleep on if I Have GERD?

When you have GERD, lying down can be an issue because it can allow your stomach contents to flow back into your esophagus. It is why people commonly experience symptoms of discomfort when sleeping or lying down (especially after eating a heavy meal 2-3 hours before bed). Keeping an upright position allows contents to stay within your stomach. It does not mean that you have to sleep upright to help relieve symptoms. Sleeping on your left side allows gravity to keep your stomach below your esophagus (decreasing the risk of acid reflux). Even if you experience symptoms, they may be more gaseous (which can be less distressing for you).

You could also sleep at an incline (or a combination of sleeping left at an incline). Sleeping at an incline (about 6-8 inches above) limits how often your stomach acid flows back into your esophagus, relieves heartburn, and allows the acid to flow back to your stomach quicker.

However, you might want to avoid sleeping on your back because this can increase the amount of acid reflux that occurs during the night. Sleeping straight on your back allows stomach acid to flow easily into your esophagus and remain there. You may also want to avoid sleeping on your right side. Laying on your right side places your stomach above your esophagus. This position allows stomach acid to flow back into your esophagus. Studies also show that reflux symptoms tend to be more liquid-based when sleeping on your right side. Therefore, you may experience an increase in regurgitation, coughing, and choking. 

Is Milk Good for Acid Reflux?

The answer to this question can be very suggestive because it can vary from person to person. Some people believe that milk (mainly nonfat or plant-based) helps relieve their heartburn. Others find that milk and dairy products high in fat make heartburn worse. If you feel like milk and dairy products could be a possible trigger for you, don’t hesitate to bring it up to your doctor. 

Is Yogurt Good for Acid Reflux?

As cautioned above, dairy products high in fat may worsen symptoms. However, low-fat yogurt and its probiotics can be beneficial for some people (as well as aid in digestion). 

Which Foods Cause Gerd?

The foods that trigger GERD symptoms will vary from person to person. Some common foods to look out for include:

  • Fried food
  • Fast food
  • Pizza
  • Potato chips or other similarly processed snacks
  • Chili powder or pepper
  • Fatty meats like bacon and sausage
  • Cheese
  • Tomato-based sauces
  • Citrus fruits
  • Chocolates
  • Peppermint
  • Carbonated beverages
  • High-fat foods in general (french fries, ice cream, full-fat dairy products, etc.)
  • Garlic and onion
  • Mint 

Is Gerd Life Threatening? 

GERD itself is not considered to be life-threatening. However, if left untreated for a long time, it can lead to serious health problems or cancer. These health issues may include:

  • Esophagitis: Esophagitis is the irritation and inflammation of the lining of the esophagus caused by constant/frequent acid reflux. If left untreated, it can lead to ulcers and strictures in the esophagus, heartburn, sore throat, hoarse voice, chest pain, bleeding, and trouble swallowing. Also, be aware that ulcers and strictures of the esophagus may increase your risk of developing esophageal cancer.
  • Esophageal ulcers: Esophageal ulcers result from damage to the esophagus. People with an ulcer may have a burning sensation in the chest, indigestion, pain when swallowing, nausea, heartburn, or bloody stools. Some people may not be aware that they have an ulcer. If left untreated, the ulcer can lead to esophageal perforation (a hole in your esophagus) or a bleeding ulcer.
  • Esophageal stricture: Untreated GERC can lead to the build-up of inflammation, scarring, and abnormal tissue growth in your esophagus. It can lead to a narrower and tighter esophagus. If it gets to that point, it can interfere with eating and drinking because it becomes harder for foods or liquids to pass from your esophagus to your stomach. You may also experience difficulty or pain with swallowing or constricted breathing.
  • Aspiration pneumonia: There is a possibility that the stomach acid that backs up into your esophagus can be inhaled into your lungs. This occurrence can lead to an infection known as aspiration pneumonia. In this case, you may experience fever, deep cough, chest pain, shortness of breath, wheezing, fatigue, or blue discoloration of the skin. Worst case scenario, the infection can be fatal if left untreated.
  • Barrett’s esophagus: Barrett’s esophagus is a condition that develops in about 10-15% of people who have long-term GERD. At this stage, damage from acid reflux can lead to changes in the cells lining the esophagus. These changes can eventually lead to the possibility of these abnormal cells becoming cancerous.
  • Esophageal cancer: Esophageal cancer starts at the esophagus and can be divided into Adenocarcinoma or Squamous cell carcinoma. Adenocarcinoma occurs in the lower part of the esophagus. Squamous cell carcinoma affects the upper and middle part of the esophagus and begins in the cells that line your esophagus. Most people don’t feel any symptoms until the cancer has reached a more advanced stage.

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