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February 3, 2012
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Acid Reflux (GERD)

Medical Author:
P John Simic, MD
Coauthor:
Vincent W Yang, MD, PhD
Medical Editor:
John P. Cunha, DO, FACOEP
John P. Cunha, DO, FACOEP
John P. Cunha, DO, FACOEP

John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

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GERD Symptoms

What Are the Symptoms of GERD?

Chronic acid reflux leads to uncomplicated GERD, but not everyone with GERD has heartburn. The primary symptoms of GERD are heartburn, regurgitation, and nausea.

Heartburn usually is described as a burning pain in the middle of the chest. It may start high in the abdomen or may extend up into the neck. Sometimes the pain may be sharp or pressure-like, rather than burning. Such pain can mimic heart pain (angina). In other patients, the pain may extend to the back. Typically heartburn related to GERD is seen more commonly after a meal. Other symptoms of GERD include:

Hoarseness. If acid reflux gets past the upper esophageal sphincter, it can enter the throat (pharynx) and even the voice box (larynx), causing hoarseness or a sore throat.

SOURCE:
WebMD.com. Understanding GERD -- Symptoms.

Read more about GERD symptoms »

Acid Reflux (GERD) Overview

Gastroesophageal reflux disease (GERD) is a condition in which the esophagus becomes irritated or inflamed because of acid backing up from the stomach. The esophagus or food pipe is the tube stretching from the throat to the stomach. When food is swallowed, it travels down the esophagus.

The stomach produces hydrochloric acid after a meal to aid in the digestion of food.

  • The inner lining of the stomach resists corrosion by this acid. The cells that line the stomach secrete large amounts of protective mucus.
  • The lining of the esophagus does not share these resistant features and stomach acid can damage it.
  • The esophagus lies just behind the heart, so the term heartburn was coined to describe the sensation of acid burning the esophagus.

Normally, a ring of muscle at the bottom of the esophagus, called the lower esophageal sphincter, prevents reflux (or backing up) of acid.

  • This sphincter relaxes during swallowing to allow food to pass. It then tightens to prevent flow in the opposite direction.
  • With GERD, however, the sphincter relaxes between swallows, allowing stomach contents and corrosive acid to well up and damage the lining of the esophagus.

GERD affects 25%-40% of the adult population of the United States to some degree at some point. About 10% of adults experience GERD weekly or daily. Not just adults are affected; even infants and children can have GERD.

Acid Reflux (GERD) Causes

No one knows the exact cause of gastroesophageal reflux. The following are contributing factors that weaken or relax the lower esophageal sphincter, making reflux worse:

  • Lifestyle: Use of alcohol or cigarettes, obesity, poor posture (slouching)
  • Medications: Calcium channel blockers, theophylline (Tedral, Hydrophed, Marax, Bronchial, Quibron), nitrates, antihistamines
  • Diet: Fatty and fried foods, chocolate, garlic and onions, drinks with caffeine, acid foods such as citrus fruits and tomatoes, spicy foods, mint flavorings
  • Eating habits: - Eating large meals, eating soon before bedtime
  • Other medical conditions:  Hiatal hernia, pregnancy, diabetes, rapid weight gain

Hiatal hernia is a condition when the upper part of the stomach protrudes up above the diaphragm (the strong muscle that separates the organs of the chest from those of the abdomen).

  • Normally, the diaphragm acts as an additional barrier, helping the lower esophageal sphincter keep acid from backing up into the esophagus.
  • Hiatal hernia can be caused by persistent coughing, vomiting, straining, or sudden physical exertion. Obesity and pregnancy can make the condition worse.
  • A hiatal hernia makes it easier for the acid to back up.
  • Hiatal hernia is very common in people older than 50 years.
  • Hiatal hernia usually requires no treatment. In rare cases when the hernia becomes twisted or is making GERD worse, surgery may be required.
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Viewer Comments & Reviews

GERD - Proton Pump Inhibitors

The eMedicineHealth physician editors ask:

Heartburn symptoms caused by GERD are usually relieved by drugs called proton pump inhibitors (Prilosec, Prevacid, Aciphex, Protonix, Nexium, Zegerid); however, proton pump inhibitors sometimes do not work well. If your symptoms were not relieved by treatment with proton pump inhibitors, can you please describe your GERD symptoms that did not improve? If you have other treatments that have been effective, please comment on those.

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GERD - Symptoms and Signs

The eMedicineHealth physician editors ask:

What were your GERD symptoms and signs?

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GI Disorders

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Acid Reflux (GERD)

Chest Pain »

Chest Pain Overview

If you are having severe pain, crushing, squeezing, or pressure in your chest that lasts more than a few minutes, or if the pain moves into your neck, left shoulder, arm, or jaw, go immediately to a hospital emergency department. Do not drive yourself. Call 911 for emergency transport.

Chest pain is one of the most frightening symptoms a person can have. It is sometimes difficult even for a doctor or other medical professional to tell what is causing chest pain and whether it is life-threatening.

  • Any part of the chest can be the cause of the pain including the heart, lungs, esophagus, muscle, bone, and skin.

  • Because of the complex nerve distribution in the body, chest pain may actually originate from another part of the body.

  • The stomach or other organs in the belly (abdomen), for example, can cause chest pain.

Potentially life-threatening causes of c...

Read the Chest Pain article »


Read What Your Physician is Reading on Medscape

Gastroesophageal Reflux Disease »

Gastroesophageal reflux is a normal physiological phenomenon experienced intermittently by most people, particularly after a meal.

Read More on Medscape Reference »

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