Heartburn (GERD)

Overview of GERD

Gastro-esophageal reflux disease, or GERD, is one of the most common conditions treated by gastroenterologists. It occurs in about 20% of the US population. Such a high prevalence leads to adverse effects on quality of life as well as significant impacts on our economy in terms of lost time from work and school.

GERD occurs when the contents of the stomach, which are normally highly acidic, enter the esophagus. Under normal circumstances the stomach lining is protected from the acid that is generated there. However, the esophagus is not equipped to handle that degree of acidity and every time the stomach contents enter the esophagus they can produce symptoms that include heartburn and chest pain. The presence of acid in the esophagus can also lead to injury to the esophageal lining, resulting in lesions like erosions, ulcers and even bleeding. There are also less common or “atypical” symptoms ranging from cough, hoarseness, asthma, sore throat and even accelerated decay of the teeth.

Fortunately, most cases of GERD respond to simple measures like acid suppressors and lifestyle modifications including dietary changes, weight loss and elevation of the head of the bed when sleeping. It is important to discuss the symptoms of GERD with your physician because serious complications can occur, especially if the symptoms have been present for many months or years. Sometimes, one can experience difficulty swallowing (known as dysphagia) because a scar can form, causing the esophagus to narrow. This prevents the safe passage of food into the stomach.

Diagnosing GERD

The most effective tool for diagnosing GERD-related injury is upper endoscopy. The procedure allows the gastroenterologist to look directly into the esophagus with the ability to photograph the damage and obtain biopsies for inspection under the microscope. The endoscopist can also perform a dilation to enlarge the narrowing and improve swallowing function. In summary, GERD is very common and usually treated with great success but the potential for injury and complications exist. This is why a consultation with a gastroenterologist can be tremendously helpful.