It’s very common. It affects about 10 to 20% of the US population.
It’s mostly affected in the esophagus area, which most people feel in the chest.
The typical symptoms would be heartburn, which is a sensation of burning in the chest area or regurgitation, the feeling of food coming up into the chest.
Some less typical symptoms that might be related to GERD include chest pain, having a sour taste or lump in the throat, feeling of nausea, coughing, hoarseness of the voice, or even trouble swallowing.
Some of the risk factors that tend to cause GERD include obesity because of the increased pressure on the stomach. Pregnancy is a risk factor in the same way.
Other conditions that might increase the risk are diabetes, asthma, people with connective tissue disorders.
Typically, the triggers include food in particular spicy foods, fatty foods, chocolate, citrus fruits, tomatoes, coffee and alcohol.
Eating too close to bedtime or overeating can be triggers as well. Other triggers include smoking. Episodes can last from minutes to hours.
A hiatal hernia is very common. It’s when part of the stomach is located higher up perhaps by an inch or two and that can cause a weakness of the lower esophagus valve that protects the esophagus from acid reflux.
People with a hiatal hernia have a tendency to have more acid reflux.
We typically would advise patients with GERD to avoid acid forming foods and avoid eating two to three hours before bedtime.
We also encourage weight loss. Losing 10 pounds of weight will take a lot of pressure off the stomach.
Also, there are acid medications that are available and commonly used, including over-the-counter antacids. There are prescription medications that your physician can provide for you that are stronger.
For patients who have more severe acid reflux that’s not responding to medical management, diet changes, there are an increasing number of options including outpatient surgery to tighten the valve or repair a hiatal hernia. Those typically allow patients to return to normal activities in a few days, although they may be on a soft diet for a few weeks.
There are newer surgeries and procedures to repair the esophagus valve, including a laparoscopic procedure that place a ring of magnets in the lower esophagus.
There is also one that can be done by a scope procedure as opposed to surgery where the GI physician places staples to tighten the valve without doing an actual operation.
It can be a chronic condition, but the good news is that diet and lifestyle modifications can make a difference.
It’s not easy to give up that chocolate or the alcohol, but often times by making some diet changes, avoiding late night meals, you can control the acid reflux.
For people who have a hiatal hernia or other conditions that may predispose them to the acid reflux, it may be more difficult to control without medical management.
With more severe GERD, there can be complications, such as acid damage or inflammation of the esophagus.
Sometimes people can get scar tissue in the esophagus that might make it more difficult to eat. It can even cause precancerous changes in the esophagus, such as Barrett’s esophagus, which could increase one’s risk of esophagus cancer.
See your doctor, if you have severe or persistent symptoms that are not responding to antacids or diet changes.
See your doctor if you have new atypical symptoms after the age of 50, or worrisome symptoms, such as vomiting, bleeding, black tarry stools, anemia, or unexpected weight loss, sensation of food getting stuck when you swallow.
GERD is very common. It affects many people, but not everything that presents with discomfort in the chest is GERD. If you do have severe or atypical symptoms, please make sure to discuss with or follow up with your physician or your gastroenterologist to evaluate for any other conditions or any complications that need to be treated.
Watch the San Diego Health video with host Susan Taylor and Dr. Tsai discussing causes and treatments for GERD disease.