|
Heartburn,
Gastroesophageal Reflux (GER), and Gastroesophageal Reflux
Disease (GERD)
On this page:
What is GERD?
Gastroesophageal reflux disease (GERD) is a more serious form
of gastroesophageal reflux (GER), which is common. GER occurs
when the lower esophageal sphincter (LES) opens spontaneously,
for varying periods of time, or does not close properly and
stomach contents rise up into the esophagus. GER is also called
acid reflux or acid regurgitation, because digestive
juices-called acids-rise up with the food. The esophagus is the
tube that carries food from the mouth to the stomach. The LES
is a ring of muscle at the bottom of the esophagus that acts
like a valve between the esophagus and stomach.
When acid reflux occurs, food or fluid can be tasted in the
back of the mouth. When refluxed stomach acid touches the
lining of the esophagus it may cause a burning sensation in the
chest or throat called heartburn or acid indigestion.
Occasional GER is common and does not necessarily mean one has
GERD. Persistent reflux that occurs more than twice a week is
considered GERD, and it can eventually lead to more serious
health problems. People of all ages can have GERD.
[Top]
What are the symptoms of GERD?
The main symptom of GERD in adults is frequent heartburn, also
called acid indigestion-burning-type pain in the lower part of
the mid-chest, behind the breast bone, and in the mid-abdomen.
Most children under 12 years with GERD, and some adults, have
GERD without heartburn. Instead, they may experience a dry
cough, asthma symptoms, or trouble swallowing.
[Top]
What causes GERD?
The reason some people develop GERD is still unclear. However,
research shows that in people with GERD, the LES relaxes while
the rest of the esophagus is working. Anatomical abnormalities
such as a hiatal hernia may also contribute to GERD. A hiatal
hernia occurs when the upper part of the stomach and the LES
move above the diaphragm, the muscle wall that separates the
stomach from the chest. Normally, the diaphragm helps the LES
keep acid from rising up into the esophagus. When a hiatal
hernia is present, acid reflux can occur more easily. A hiatal
hernia can occur in people of any age and is most often a
normal finding in otherwise healthy people over age 50. Most of
the time, a hiatal hernia produces no symptoms.
Other factors that may contribute to GERD include
-
obesity
-
pregnancy
-
smoking
Common foods that can worsen reflux symptoms include
-
citrus fruits
-
chocolate
-
drinks with caffeine or alcohol
-
fatty and fried foods
-
garlic and onions
-
mint flavorings
-
spicy foods
-
tomato-based foods, like spaghetti sauce, salsa, chili, and
pizza
[Top]
What is GERD in children?
Distinguishing between normal, physiologic reflux and GERD in
children is important. Most infants with GER are happy and
healthy even if they frequently spit up or vomit, and babies
usually outgrow GER by their first birthday. Reflux that
continues past 1 year of age may be GERD. Studies show GERD is
common and may be overlooked in infants and children. For
example, GERD can present as repeated regurgitation, nausea,
heartburn, coughing, laryngitis, or respiratory problems like
wheezing, asthma, or pneumonia. Infants and young children may
demonstrate irritability or arching of the back, often during
or immediately after feedings. Infants with GERD may refuse to
feed and experience poor growth.
Talk with your child’s health care provider if reflux-related
symptoms occur regularly and cause your child discomfort. Your
health care provider may recommend simple strategies for
avoiding reflux, such as burping the infant several times
during feeding or keeping the infant in an upright position for
30 minutes after feeding. If your child is older, your health
care provider may recommend that your child eat small, frequent
meals and avoid the following foods:
-
sodas that contain caffeine
-
chocolate
-
peppermint
-
spicy foods
-
acidic foods like oranges, tomatoes, and pizza
-
fried and fatty foods
|