Everything You Need to Know About GERD

Learn more about GERD causes, symptoms, diagnosis, and treatment options.

GERD causes

Acid reflux is the main cause of GERD. When you swallow, the lower esophageal sphincter relaxes, allowing foods and drinks to enter your stomach. When all foods enter your stomach, the sphincter closes again. If the sphincter relaxes or weakens, stomach acid might run back up into your esophagus. This continual acid backwash irritates your esophageal lining, causing inflammation.

GERD symptoms

Acid regurgitation and persistent heartburn are the two most common symptoms of GERD. However, some people may have GERD without heartburn. The other symptoms you might experience include hoarseness in the morning, trouble swallowing, and chest pain. You may have a feeling that a piece of food is stuck in your throat or your throat is narrower than normal. GERD may also lead to unpleasant breath, chronic cough, and sleep problems.

GERD risk factors

There are several factors that can increase your risk of GERD. Obesity, pregnancy, conditions like scleroderma, or delayed stomach emptying are several disorders that can make you more prone to GERD. 

Some doctors believe that a hiatal hernia can weaken the LES and increase the risk of GERD. A hiatal hernia develops when the upper half of your stomach goes up into the chest through a tiny hole in your diaphragm. The diaphragm is the muscle that connects the abdomen to the chest. Many patients with a hiatal hernia don’t experience heartburn or reflux. On the other hand, a hiatal hernia may allow stomach contents to reflux more easily into the esophagus.

Other factors that may increase your risk include:

• Diet high in fatty and fried foods

• Smoking

• Eating large meals

• Eating before bed

• Consuming too much alcohol or coffee

• Use of certain medications like antibiotics or aspirin

GERD complications

Untreated GERD can cause a variety of unpleasant complications. Continued inflammation can lead to the development of open sores in your esophagus. Sores can bleed and cause extreme discomfort. The damage to your esophagus can also lead to the formation of scar tissue. The more scar tissue accumulates, the narrower becomes your esophagus. This can lead to problems swallowing. 

Over time, damage from acids can lead to the development of precancerous changes in your esophagus, called Barrett’s esophagus. These changes increase your risk of esophageal cancer significantly.

GERD diagnosis

Based on a physical examination and a history of your symptoms, the doctor may be able to diagnose GERD. The following tests may also be prescribed to confirm a diagnosis or rule out the risk of complications:

• Upper endoscopy. The doctor inserts a thin tube with a camera down to your throat to examine the esophagus and stomach.

• Ambulatory acid (pH) probe test. The doctor places a monitor in your stomach to find out when and for how long reflux occurs. 

• Esophageal manometry. The test used to measure the muscle contractions in your esophagus when you swallow.

• X-ray of your upper digestive system. Used to see the silhouette of your esophagus, stomach, and upper intestine.

GERD treatment

In the beginning, your doctor may recommend lifestyle modifications to improve the symptoms. Lifestyle modifications can be complemented with over-the-counter medications. If the symptoms don’t improve after several weeks of such therapy, prescription medications or surgery may be recommended. It is extremely important to follow all your doctor’s recommendations to relieve the symptoms and prevent complications.