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.
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
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.
25% to 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:
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.
Chronic acid reflux leads to uncomplicated GERD, but not everyone with GERD
has heartburn. The primary symptoms of GERD are heartburn, regurgitation, and
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.