What Are the Types of GERD?

Reviewed on 10/21/2021

The two main types of GERD (gastroesophageal reflux disease or heartburn) are 1) recurrent but nonprogressive GERD and 2) progressive GERD.
The two main types of GERD (gastroesophageal reflux disease or heartburn) are 1) recurrent but nonprogressive GERD and 2) progressive GERD.

Acid reflux is a condition in which the acid from the stomach backs up into the esophagus, the tube that brings food from the mouth to the stomach.

When acid reflux happens more than twice weekly, is chronic, or causes uncomfortable symptoms or damage, it is considered to be GERD, which stands for gastroesophageal reflux disease.

There are two main types of GERD:

  • Recurrent but nonprogressive GERD 
    • Affects about 80% of people diagnosed 
    • Usually able to be controlled with medications
  • Progressive GERD
    • Affects the remaining 20% of patients
    • Can result in severe complications, such as strictures or Barrett esophagus
    • Surgery may be needed

There are four stages of GERD: 

  • Stage 1: Mild GERD
    • Mild symptoms once or twice monthly
    • Treatment involves lifestyle changes and over-the-counter (OTC) acid reducers
  • Stage 2: Moderate GERD
    • Symptoms are more frequent
    • Requires daily prescription medication 
    • May affect daily activities 
    • Associated with esophageal inflammation
  • Stage 3: Severe GERD
    • Symptoms are poorly controlled even with prescription medicines
    • Quality of life is affected
    • Erosive esophageal inflammation is likely
    • Surgery may be needed to fix the problem
  • Stage 4: Reflux induced precancerous lesions or esophageal cancer
    • About 10% of patients with chronic GERD will develop stage 4 
    • Is a result of years of untreated severe reflux
    • If untreated, a precancerous condition called Barrett’s esophagus may develop
    • Treatment and close follow-up and management is recommended

What Are Symptoms of GERD?

Symptoms of GERD (gastroesophageal reflux disease) include:

How Is GERD Diagnosed?

GERD (gastroesophageal reflux disease) is diagnosed with a patient history and physical examination. Tests used to diagnose GERD include: 

  • Upper gastrointestinal (GI) endoscopy and biopsy
  • Upper GI series
  • Esophageal pH and impedance monitoring
  • Esophageal manometry 
  • Stool occult blood test

QUESTION

GERD is the back up of stomach acid into the esophagus. See Answer

What Is the Treatment for GERD?

Mild cases of GERD (gastroesophageal reflux disease) may be managed with lifestyle changes or by taking non-prescription medicines. 

Home treatment to relieve symptoms of GERD includes:

  • Avoid foods that worsen symptoms 
  • Lose weight if you are overweight or obese
  • Don’t overeat
  • Don’t eat 2 to 3 hours before bed
    • Lying down with a full stomach can make reflux worse
  • Raise the head of the bed 6 to 8 inches using blocks of wood or rubber under 2 legs of the bed or a foam wedge under the mattress
  • Avoid medications such as aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) including ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn) that may aggravate GERD
  • Take medications with plenty of water
  • Don’t smoke
  • Wear loose clothing around the stomach area

If lifestyle changes do not relieve symptoms of GERD, medications used to treat the condition include: 

  • Antacids
  • Histamine blockers
  • Proton pump inhibitors (PPIs)
  • Prokinetics
  • Antibiotics

In severe cases of GERD, surgery may be recommended when symptoms do not improve with lifestyle changes or medications. 

Surgery used to treat GERD includes: 

  • Fundoplication
  • Endoscopic techniques

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Reviewed on 10/21/2021
References
https://www.uptodate.com/contents/acid-reflux-and-gastroesophageal-reflux-disease-in-adults-the-basics?search=Acid%20Reflux&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2

https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults

https://emedicine.medscape.com/article/176595-treatment#d1

https://houstonheartburn.com/four-stages-of-gerd/