Gastroesophageal reflux disease, or GERD is characterized by repeated bouts of heartburn (a burning feeling in the chest) and sour-tasting fluid in the throat. Additional symptoms may include belching, pain in the upper abdomen, or chronic cough or hoarseness. This heartburn can begin after eating a large meal or lying down, especially after eating.
When you eat, food travels from the mouth, down the esophagus and to the stomach. Where the esophagus meets the stomach is a one-way valve called the lower esophageal sphincter (LES). Normally, the LES opens when you swallow, allowing food to enter the stomach, and then closes quickly. In patients with GERD, the LES improperly functions, allowing food and stomach acid to travel back (reflux) into the esophagus.
GERD is diagnosed through a combination of modalities:
GERD is a serious condition and if left untreated, can lead to serious problems. Exposing sensitive tissue in the esophagus to stomach acid over prolonged periods can lead to inflammation of the esophagus (esophagitis), esophageal ulcer, or esophageal stricture (scarring causing a narrowing of the esophagus). In severe cases, GERD can even lead to cancer.
In some cases, GERD can be controlled by making lifestyle changes, changing your diet, and/or through medication. If your condition does not respond to any of these methods, surgical intervention may be necessary.
Lifestyle and dietary changes include restricting alcohol and caffeine from the diet as well as limiting fried or fatty foods, spicy foods, citrus fruits and tomatoes, onions, peppermint and chocolate. Also of great benefit is quitting smoking, regular exercise and weight loss, as well as raising the head of the bed or avoiding foods close to bedtime (two to three hours prior). Over the counter or prescription antacids, acid blockers, or proton pump inhibitors (PPIs) may be recommended by your physician.
If surgery becomes necessary for GERD, laparoscopic fundoplication may be performed. This surgery, done using a laparoscope (a small telescope attached to a camera), allows the surgeon to recreate the lower esophageal sphincter (LES) as well as make any necessary additional repairs. Dilation, or stretching, of the esophagus may be necessary in cases of esophageal stricture.
Gastroesophageal reflux disease not only impacts your comfort and quality of life, it is a serious condition that requires medical intervention. Your surgeon will help you to determine the treatments that are best suited to your individual condition.