Gastroesophageal reflux disease (GERD) is a condition in which the stomach contents, either food or liquid, leak backwards from the stomach into the esophagus. It is no stranger to physicians.
“Related symptoms are complaining of heartburn, burning in the chest or throat and chest pain,” said Dr. Nathan Massey of Colorectal, Surgical and Gastroenterology Associates. It can be a scary experience for some patients. “GERD is actually one of the most common reasons people go to the emergency room thinking they are having a heart attack,” Massey said.
GERD is more common in patients who are overweight or eat large meals or high-fat content foods, which sit in the stomach longer and have more opportunity to reflux. Caffeinated or carbonated beverages are other causes of GERD. The patient may wake up in the middle of the night with GERD or experience it while lying down. If patients have nighttime symptoms, a wedge pillow that elevates the head and neck can provide relief.
“It is common for people to have one of the symptoms on rare occasions, like once every couple of weeks,” Massey said. “But when a patient has reflux for two or more days a week, it can lead to esophagitis and permanent damage to the esophagus.”
A diagnosis of GERD can be made in several different ways. “You can do an endoscopy exam, or EGD, where you examine the esophagus and stomach with a light while the patient is sedated,” said Massey. That test looks for damage from acid reflux or the consequences of having it for a period of time, such as a hiatal hernia, but it is not required to diagnose the problem most of the time.
A second way to diagnose GERD is with a barium swallow under fluoroscopy. “You want to discuss the symptoms with the patient to make sure they are not covering up symptoms of an ulcer, cancer or some other major problem,” Massey said.
Patients with GERD may need further evaluation and medicine on a regular basis to control the symptoms and prevent complications. “You can now get the three main, strong antacids over the counter without a prescription: Prilosec, Prevacid and a newer one called Zegerid,” said Massey.
GERD is a fairly chronic problem, but the severity of the disease determines whether the patient requires lifelong medication. “If the symptoms are easily controlled with medicine and the patient follows lifestyle recommendations, often they can get off medicines after several months of use and only require it on an as-needed basis,” said Massey.
The main thing doctors should look out for is esophageal damage and risk of cancer of the esophagus. Cancer of the esophagus is a rare but possible complication. “It affects about one out of 10 thousand to 12 thousand people,” Massey said. “Untreated, in a small percentage of people it can lead to complications like precancerous tissue and scarring that can cause a narrowing of the esophagus. This prevents people from being able to swallow food and requires us to stretch the esophagus. It is better to be proactive instead of waiting until a complication has developed.”
By Jamie Lober, Staff Writer