GERD with Heartburn
Gastroesophageal reflux disease (GERD) occurs when the small valve between the esophagus (throat) and stomach does not close properly and stomach contents go back, or reflux, into the esophagus. When this refluxed stomach acid touches the lining of the esophagus, it causes heartburn. Occasional heartburn is common and is not necessarily related to GERD.
Symptoms
Frequent heartburn (occurring more than twice a week) is the most common symptom of GERD. Heartburn, usually after meals, is experienced as a rising or burning sensation behind the breastbone and sometimes into the throat. Other symptoms can include coughing, bad breath, hoarseness, and a sour taste in the mouth. Studies have shown that asthma and chronic cough may be aggravated or even caused by GERD.
Causes
No one knows why people get GERD. Some factors that may make GERD more likely include:
- tight clothing
- drinking alcohol
- eating right before bed
- being overweight
- pregnancy
- smoking
- exercising too soon after eating
- certain medications
- certain foods (e.g., citrus, mints, caffeine, fatty or spicy foods, tomatoes, garlic, onions, carbonated drinks, chocolate)
Treatment
While the cause of GERD is not known, there are steps a patient can take to control the symptoms.
Lifestyle changes
- Don’t smoke.
- Avoid drinking alcohol.
- Eat small meals.
- Lose weight if needed.
- Wear loose-fitting clothes.
- Avoid lying down for 3 hours after a meal.
- Raise the head of your bed 6 to 8 inches by putting bricks or blocks of wood under the bedposts (extra pillows are not enough).
Medications
The goal of medication is to neutralize stomach acid that may back up into the esophagus. A clinician will recommend either over-the-counter antacids, prescription medications that block acid production in the stomach, or a combination of medicines. Almost everyone will get relief from medication.
For most people, GERD can be treated effectively and does not become a long-term problem. Nevertheless, a small percentage of people with long-standing GERD symptoms may experience complications from inflammation of the esophagus. Because of the potential for complications, it is important to follow the clinician’s advice and to keep follow-up appointments.
When to contact a clinician
Contact a clinician if any of the following occur:
- heartburn returns soon after an antacid wears off
- heartburn that wakes you up at night
- symptoms that persist despite prescription medications and/or lifestyle changes
[HU481: updated 09/08]
