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Gastroesophageal Reflux Disease (GERD)


Dr. Mansfield
Research suggests that gastroesophageal reflux disease, or GERD, affects around one in five adults in the United States. Dr. Malone, can you tell us about GERD?

Dr. Malone
Sure, Dr. Mansfield. You may hear others refer to gastroesophageal reflux as acid indigestion, acid reflux, heartburn, or reflux. When gastroesophageal reflux happens more than twice a week for a few weeks, it could be GERD.

Gastroesophageal reflux happens when the lower esophageal sphincter, or LES, becomes weak or relaxed. The contents of the stomach can then come back up into the esophagus, which doesn't have the same protective lining as the stomach. Stomach acid that touches the lining of the esophagus can cause a painful, burning sensation or other symptoms. However, up to 50 percent of patients with GERD have no symptoms.

The LES naturally relaxes during meals to let food into the stomach. It can stay relaxed for up to three hours after eating, and lying down during this time can cause acid reflux symptoms. The LES becomes unnaturally weak or relaxed due to several things, such as:

  • Increased pressure on the abdomen from being overweight, obese, or pregnant
  • Certain medicines, including asthma medications, antihistamines, calcium channel blockers, painkillers, sedatives, and antidepressants
  • Smoking or inhaling secondhand smoke, and
  • Ingestion of caffeine, chocolate, or mint

GERD can cause serious complications over time if it's left untreated. Some potential complications include:

  • Esophagitis, or inflammation and ulceration of the esophagus. Chronic esophagitis can lead to precancerous changes in the esophagus.
  • Barrett's esophagus, which is a condition in which tissue that is similar to the lining of the intestine replaces the tissue lining the esophagus. In some cases, Barrett's esophagus can lead to the development of a rare but often deadly type of esophageal cancer.
  • Esophageal stricture, meaning the esophagus becomes scarred and too narrow. This can lead to problems with swallowing. (and)
  • Respiratory problems, which can result from stomach acid getting into the lungs.