What is it and what are its risks?
Gastroesophageal reflux disease (also called GERD)
is the medical term for chronic heartburn. GERD occurs when a small valve (the lower
esophageal sphincter) between the stomach and esophagus leaks, causing digestive fluids,
bile and stomach acid to back up" from the stomach into the esophagus.
As many as 10 percent of Americans have episodes of
heartburn every day, and 44 percent have symptoms at least once a month. In all, GERD
affects an estimated 25 to 35 percent of the U.S. population.
Esophagitis (inflammation of the esophagus), a
complication of GERD, tends to become a recurring, chronic condition. Other complications
of GERD include strictures (narrowing of the esophagus due to scar tissue), ulceration and
Barrett's esophagus (a severe, chronic inflammation of the lower esophagus). Patients with
Barrett's esophagus have a greater risk of developing esophageal cancer (even though the
overall risk remains quite low). Younger age at onset of GERD and longer duration of
symptoms seem to increase the risk of esophageal cancer.
The contribution of hiatal hernia to GERD is another source of
controversy. Although the incidence of prolonged reflux appears to be increased with
hiatal hernia, patients may have a hiatal hernia without reflux or reflux without a hiatal
What are the common signs of GERD?
Frequent heartburn is the most common symptom of GERD and often
occurs after meals. Heartburn is a pain in the middle of your chest. It is often described
as an uncomfortable, rising, burning sensation behind the breastbone. Sometimes the pain
can be so strong that you think you're having a heart attack. GERD is the most common
cause of non-cardiac chest pain (pain that is not found to be originating from the heart).
Other major symptoms of GERD include;
regurgitation of gastric acid into the mouth; difficult and/or painful swallowing; nausea;
cough, and worsening of asthma.
GERD can cause other signs, too.
You can have GERD without even having heartburn. It
can cause throat problems like a sore throat or a lump in your throat or feeling like you
always have to clear your throat. GERD can also cause hoarseness or a burning feeling in
your mouth. You might be more hoarse when you first get up in the morning (the acidic
juices and bile from your stomach can more freely flow up the esophagus and into your
throat when you are lying down). You may feel like food is sticking in your throat. GERD
may also make you feel like you're choking or that your throat is tight. A dry cough is
another sign. GERD can also cause bad breath and even a pain in your ears.