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What is GERD (acid reflux)? - Gastroesophageal reflux disease,
commonly referred to as GERD or acid reflux, is a condition in which
the liquid content of the stomach regurgitates (backs up or refluxes)
into the esophagus. The liquid can inflame and damage the lining
(cause, cause esophagitis) of the esophagus although visible signs of
inflammation occur in a minority of patients. The regurgitated liquid
usually contains acid and pepsin that are produced by the stomach.
(Pepsin is an enzyme that begins the digestion of proteins in the
stomach.) The refluxed liquid also may contain bile that has backed-up
into the stomach from the duodenum. (The duodenum is the first part of
the small intestine that attaches to the stomach.) Acid is believed to
be the most injurious component of the refluxed liquid. Pepsin and
bile also may injure the esophagus, but their role in the production
of esophageal inflammation and damage is not as clear as the role of
acid. Read More
Video: What Is Gastrointestinal Reflux Disease?
Video: Heartburn and Acid Reflux Testing - Endoscopy
What causes GERD? - The cause of GERD is complex. There probably are
multiple causes, and different causes may be operative in different
individuals, or even in the same individual at different times. A
small number of patients with GERD produce abnormally large amounts of
acid, but this is uncommon and not a contributing factor in the vast
majority of patients. The factors that contribute to GERD are the
lower esophageal sphincter, hiatal hernias, esophageal contractions,
and emptying of the stomach. Read More
What are the symptoms of uncomplicated GERD? - The symptoms of
uncomplicated GERD are primarily heartburn, regurgitation, and nausea.
Other symptoms occur when there are complications of GERD and will be
discussed with the complications. Read More
How is GERD diagnosed and evaluated? — The usual way that GERD is
diagnosed—or at least suspected—is by its characteristic symptom,
heartburn. Heartburn is most frequently described as a sub-sternal
(under the middle of the chest) burning that occurs after meals and
often worsens when lying down. To confirm the diagnosis, physicians
often treat patients with medications to suppress the production of
acid by the stomach. If the heartburn then is diminished to a large
extent, the diagnosis of GERD is considered confirmed. This approach
of making a diagnosis on the basis of a response of the symptoms to
treatment is commonly called a therapeutic trial. Read More
How is GERD treated? — One of the simplest treatments for GERD is
referred to as life-style changes, a combination of several changes in
habit, particularly related to eating. Read More
What is a reasonable approach to the management of GERD? — There are
several ways to approach the evaluation and management of GERD. The
approach depends primarily on the frequency and severity of symptoms,
the adequacy of the response to treatment, and the presence of
complications. Read More
What are the unresolved issues in GERD? - The cause of GERD is
complex. There probably are multiple causes, and different causes may
be operative in different individuals, or even in the same individual
at different times. A small number of patients with GERD produce
abnormally large amounts of acid, but this is uncommon and not a
contributing factor in the vast majority of patients. The factors that
contribute to GERD are the lower esophageal sphincter, hiatal hernias,
esophageal contractions, and emptying of the stomach. Read More
What are the unresolved issues in GERD? - The cause of GERD is
complex. There probably are multiple causes, and different causes may
be operative in different individuals, or even in the same individual
at different times. A small number of patients with GERD produce
abnormally large amounts of acid, but this is uncommon and not a
contributing factor in the vast majority of patients. The factors that
contribute to GERD are the lower esophageal sphincter, hiatal hernias,
esophageal contractions, and emptying of the stomach. Read More