MedlinePlus Medical Encyclopedia: Gastroesophageal reflux disease

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Gastroesophageal reflux disease

Contents of this page:
Illustrations Alternative names Definition Causes, incidence, and risk factors Symptoms Signs and tests	Treatment Expectations (prognosis) Complications Calling your health care provider Prevention

Illustrations

Digestive system

Gastroesophageal reflux disease

Upper gastrointestinal system

Gastroesophageal reflux - series

Alternative names Return to top

Peptic esophagitis; Reflux esophagitis; GERD; Heartburn - chronic

Definition Return to top

Gastroesophageal reflux disease (GERD) is a condition in which food or liquid travels from the stomach back up into the esophagus (the tube from the mouth to the stomach). This partially digested material is usually acidic, and can irritate the esophagus, often causing heartburn and other symptoms.

Causes, incidence, and risk factors Return to top

Gastroesophageal reflux is a common condition that often occurs without symptoms after meals. In some people, the reflux is related to a problem with the lower esophageal sphincter, a band of muscle fibers that usually closes off the esophagus from the stomach. If this sphincter doesn't close properly, food and liquid can move backward into the esophagus and may cause the symptoms.

The risk factors for reflux include hiatal hernia, pregnancy, and scleroderma.

Symptoms Return to top

Heartburn
- Involves a burning pain in the chest (under the breastbone)
- Increased by bending, stooping, lying down, or eating
- Relieved by antacids
- More frequent or worse at night
Belching
Regurgitation of food
Nausea and vomiting
Vomiting blood
Hoarseness or change in voice
Sore throat
Difficulty swallowing
Cough or wheezing

Signs and tests Return to top

A positive stool guaiac
Continuous esophageal pH monitoring showing reflux
Endoscopy showing ulceration or inflammation of the esophagus
Esophageal manometry showing abnormal sphincter pressure
A barium swallow showing reflux
A positive Bernstein test for gastric acid reflux

Treatment Return to top

General measures include:

Weight reduction
Avoiding lying down after meals
Sleeping with the head of the bed elevated
Taking medication with plenty of water
Avoiding dietary fat, chocolate, caffeine, peppermint (they may cause lower esophageal pressure)
Avoiding alcohol and tobacco

Medications that alleviate symptoms include:

Antacids after meals and at bedtime
Histamine H2 receptor blockers
Promotility agents
Proton pump inhibitors

Anti-reflux operations (Nissen fundoplication) may help a small number of patients who have persistent symptoms despite medical treatment. There are also new therapies that can be performed through an endoscope (a flexible tube passed through the mouth into the stomach) for reflux.

Expectations (prognosis) Return to top

The majority of people respond to nonsurgical measures with behavioral modification and medications.

Complications Return to top

Inflammation of the esophagus
Stricture
Esophageal ulcer
Hoarseness, bronchospasm
Chronic pulmonary disease
Barrett's esophagus (a change in the lining of the esophagus that can increase the risk of cancer)

Calling your health care provider Return to top

Call your health care provider if symptoms worsen or do not improve with lifestyle changes or medication.

Prevention Return to top

Avoid foods and activities that worsen symptoms. Maintain a healthy weight.

Update Date: 7/16/2004

Updated by: Christian Stone, M.D., Division of Gastroenterology, Washington University in St. Louis School of Medicine, St. Louis, MO. Review provided by VeriMed Healthcare Network.

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