What is gerd?

Reflux means that stomach acid and juices flow from the stomach back up into the esophagus, the tube that connects the throat to the stomach. This causes heartburn or regurgitation. Regurgitation happens when food and liquid back up from the stomach into the esophagus and mouth. When you have heartburn or regurgitation that bother you often, it is called gastroesophageal reflux disease, or GERD. This can also cause pain and inflammation in your esophagus (esophagitis). You may also hear GERD called acid reflux.

Eating too much close to bedtime or before lying down sometimes can cause symptoms. But having heartburn or regurgitation from time to time doesn't mean that you have GERD. With GERD, the reflux and heartburn last longer and happen more often.

The main symptoms of GERD are:

• Heartburn. Heartburn is an uncomfortable feeling or burning pain behind the breastbone. It may occur after you eat, soon after you lie down, or when you bend forward. Some people have GERD without heartburn.
• Regurgitation. This happens when food and liquid back up from the stomach into the esophagus and mouth.

Other symptoms may include:

• Chest pain.
• Hoarseness.
• Trouble swallowing.
• A feeling that something is stuck in your throat.
• A cough.
• Having extra saliva.
• Nausea.

To find out if you have GERD, your doctor will do a physical exam and ask you questions about your health. Your doctor may ask about your symptoms, such as whether you often have heartburn or regurgitation. If you do have heartburn or regurgitation often, your doctor may suggest a medicine that reduces or blocks stomach acid.

If your heartburn or regurgitation goes away after you take the medicine, you may not need any tests.

If you have tests, they may include:

• An upper gastrointestinal endoscopy.
• Esophageal tests.
• An upper-gastrointestinal X-ray series.

Treatment aims to reduce reflux, prevent damage to your esophagus, and prevent problems caused by GERD.

For mild symptoms, try over-the-counter medicines such as:

• Antacids (like Tums).
• H2 blockers (like Pepcid).
• Proton pump inhibitors (like Prilosec).

Lifestyle changes can help. You can:

• Stay at a weight that's healthy for you. Extra weight puts a lot of pressure on the valve between the stomach and esophagus. Losing even a few pounds can help. Talk to your doctor if you need help losing weight.
• Change your eating habits:
  • Try to eat several small meals instead of two or three large meals.
  • Wait 2 to 3 hours after eating before lying down. Snacking close to bedtime can make your symptoms worse.
  • Avoid foods that make your symptoms worse. These may include chocolate, mint, alcohol, pepper, spicy foods, high-fat foods, or drinks with caffeine in them, such as tea, coffee, colas, or energy drinks. If your symptoms are worse after you eat a certain food, you may want to stop eating it to see if your symptoms get better.
• Try to quit smoking or chewing tobacco, or cut back as much as you can. If you need help quitting, talk to your doctor about quit-tobacco programs and medicines. These can increase your chances of quitting for good.
• If you have GERD symptoms while trying to sleep, raise the head of your bed 6 to 8 inches by putting the frame on blocks or placing a foam wedge under the head of your mattress. (Adding extra pillows does not work.)
• Do not wear tight clothing around your middle.

If symptoms persist, possible next steps include a change in medicine or testing. Your doctor may recommend surgery to strengthen the valve between your esophagus and stomach.

• Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
• Your doctor may recommend over-the-counter medicine. For mild or occasional indigestion, antacids, such as Tums, Mylanta, or Maalox, may help. Your doctor also may recommend over-the-counter acid reducers, such as famotidine (Pepcid AC), cimetidine (Tagamet HB), or omeprazole (Prilosec). Read and follow all instructions on the label. If you use these medicines often, talk with your doctor.
• Stay at a weight that's healthy for you. Extra weight puts a lot of pressure on the valve between the stomach and esophagus. Losing even a few pounds can help. Talk to your doctor if you need help losing weight.
• Change your eating habits.
  • Try to eat several small meals instead of two or three large meals.
  • After you eat, wait 2 to 3 hours before you lie down. Snacking close to bedtime can make your symptoms worse.
  • Avoid foods that make your symptoms worse. These may include chocolate, mint, alcohol, pepper, spicy foods, high-fat foods, or drinks with caffeine in them, such as tea, coffee, colas, or energy drinks. If your symptoms are worse after you eat a certain food, you may want to stop eating it to see if your symptoms get better.
• Try to quit smoking or chewing tobacco, or cut back as much as you can. If you need help quitting, talk to your doctor about quit-tobacco programs and medicines. These can increase your chances of quitting for good.
• If you have GERD symptoms while trying to sleep, raise the head of your bed 6 to 8 inches by putting the frame on blocks or placing a foam wedge under the head of your mattress. (Adding extra pillows does not work.)
• Do not wear tight clothing around your middle.