Gastroesophageal Reflux Disease, Adult

• Happens often.
• Causes frequent or severe symptoms.
• Causes problems such as damage to the esophagus.

When stomach acid comes in contact with the esophagus, the acid may cause inflammation in the esophagus. Over time, GERD may create small holes (ulcers) in the lining of the esophagus.

What are the causes?

This condition is caused by a problem with the muscle between the esophagus and the stomach (lower esophageal sphincter, or LES). Normally, the LES muscle closes after food passes through the esophagus to the stomach. When the LES is weakened or abnormal, it does not close properly, and that allows food and stomach acid to go back up into the esophagus.

• Tobacco use.
• Pregnancy.
• Having a hiatal hernia.
• Alcohol use.
• Certain foods and beverages, such as coffee, chocolate, onions, and peppermint.

What increases the risk?

• Have an increased body weight.
• Have a connective tissue disorder.
• Take NSAIDs, such as ibuprofen.

What are the signs or symptoms?

• Heartburn.
• Difficult or painful swallowing and the feeling of having a lump in the throat.
• A bitter taste in the mouth.
• Bad breath and having a large amount of saliva.
• Having an upset or bloated stomach and belching.
• Chest pain. Different conditions can cause chest pain. Make sure you see your health care provider if you experience chest pain.
• Shortness of breath or wheezing.
• Ongoing (chronic) cough or a nighttime cough.
• Wearing away of tooth enamel.
• Weight loss.

How is this diagnosed?

• A test to examine your stomach and esophagus with a small camera (endoscopy).
• A test that measures the acidity level in your esophagus.
• A test that measures how much pressure is on your esophagus.
• A barium swallow or modified barium swallow test to show the shape, size, and functioning of your esophagus.

How is this treated?

• Changes to your diet.
• Medicine.
• Surgery.

The goal of treatment is to help relieve your symptoms and to prevent complications.

Follow these instructions at home:

Eating and drinking

• Follow a diet as recommended by your health care provider. This may involve avoiding foods and drinks such as:
  • Coffee and tea, with or without caffeine.
  • Drinks that contain alcohol.
  • Energy drinks and sports drinks.
  • Carbonated drinks or sodas.
  • Chocolate and cocoa.
  • Peppermint and mint flavorings.
  • Garlic and onions.
  • Horseradish.
  • Spicy and acidic foods, including peppers, chili powder, curry powder, vinegar, hot sauces, and barbecue sauce.
  • Citrus fruit juices and citrus fruits, such as oranges, lemons, and limes.
  • Tomato-based foods, such as red sauce, chili, salsa, and pizza with red sauce.
  • Fried and fatty foods, such as donuts, french fries, potato chips, and high-fat dressings.
  • High-fat meats, such as hot dogs and fatty cuts of red and white meats, such as rib eye steak, sausage, ham, and bacon.
  • High-fat dairy items, such as whole milk, butter, and cream cheese.
• Eat small, frequent meals instead of large meals.
• Avoid drinking large amounts of liquid with your meals.
• Avoid eating meals during the 2–3 hours before bedtime.
• Avoid lying down right after you eat.
• Do not exercise right after you eat.

Lifestyle

• Do not use any products that contain nicotine or tobacco. These products include cigarettes, chewing tobacco, and vaping devices, such as e-cigarettes. If you need help quitting, ask your health care provider.
• Try to reduce your stress by using methods such as yoga or meditation. If you need help reducing stress, ask your health care provider.
• If you are overweight, reduce your weight to an amount that is healthy for you. Ask your health care provider for guidance about a safe weight loss goal.

General instructions

• Pay attention to any changes in your symptoms.
• Take over-the-counter and prescription medicines only as told by your health care provider. Do not take aspirin, ibuprofen, or other NSAIDs unless your health care provider told you to take these medicines.
• Wear loose-fitting clothing. Do not wear anything tight around your waist that causes pressure on your abdomen.
• Raise (elevate) the head of your bed about 6 inches (15 cm). You can use a wedge to do this.
• Avoid bending over if this makes your symptoms worse.
• Keep all follow-up visits. This is important.

Contact a health care provider if:

• You have:
  • New symptoms.
  • Unexplained weight loss.
  • Difficulty swallowing or it hurts to swallow.
  • Wheezing or a persistent cough.
  • A hoarse voice.
• Your symptoms do not improve with treatment.

Get help right away if:

• You have sudden pain in your arms, neck, jaw, teeth, or back.
• You suddenly feel sweaty, dizzy, or light-headed.
• You have chest pain or shortness of breath.
• You vomit and the vomit is green, yellow, or black, or it looks like blood or coffee grounds.
• You faint.
• You have stool that is red, bloody, or black.
• You cannot swallow, drink, or eat.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.

Summary

• Gastroesophageal reflux happens when acid from the stomach flows up into the esophagus. GERD is a disease in which the reflux happens often, causes frequent or severe symptoms, or causes problems such as damage to the esophagus.
• Treatment for this condition may vary depending on how severe your symptoms are. Your health care provider may recommend diet and lifestyle changes, medicine, or surgery.
• Contact a health care provider if you have new or worsening symptoms.
• Take over-the-counter and prescription medicines only as told by your health care provider. Do not take aspirin, ibuprofen, or other NSAIDs unless your health care provider told you to do so.
• Keep all follow-up visits as told by your health care provider. This is important.