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Gastroesophageal Reflux Disease (GERD) Information

By D Ruplinger

Gastroesophageal Reflux Disease, or GERD, is the medical term for what most people refer to as acid reflux disease.

Gastroesophageal is a relatively new term for acid reflux disease. It has been used for approximately the past 20 years. Before that it was just referred to as heartburn. But heartburn is just one of the symptoms of GERD. Some of the other symptoms of GERD are regurgitation, hoarseness or laryngitis, the feeling of a lump in the throat, coughing, bad breath, asthma, difficulty swallowing, and water brash. Some people with GERD do not have any symptoms at all.

What happens to cause GERD? It starts with acid in the stomach washing back up into the esophagus repeatedly, which happens if the lower esophageal sphincter becomes relaxed.

Some foods and beverages can cause the lower esophageal sphincter to relax. This is not an all-inclusive list but some of the most common are: chocolate, licorice, peppermint, fatty foods, caffeinated beverages, and alcohol. Barbiturates, calcium-channel blockers, Diazepam and Sumitriptan are some of the medications that cause the lower esophageal sphincter to relax and allow acid back in to the esophagus.

Lifestyle changes can be very effective in helping to control GERD although over- the-counter medications, prescription medications, and possibly surgery, may also be necessary. Some of the lifestyle changes that may help control GERD include: losing weight if you are overweight, avoiding high-fat foods, not lying down right after eating, not eating large heavy meals (i.e. don't overstuff yourself"especially on fatty foods), and stopping smoking if you are a smoker.

GERD can be a difficult disease to diagnosis. That is because of the wide range of symptoms people can experience and the complication of some people not experiencing any symptoms at all. It is easier to diagnosis if a person is experiencing the classic symptoms of GERD which are heartburn and regurgitation. In some cases a physician will not do tests right away but will first prescribe over-the-counter or prescription medications to see if they clear up the symptoms.

If the medications do not take care of the symptoms then a physician will likely do one or more of the following diagnostic tests: x-rays with a barium swallow, an upper gastrointestinal x-ray series, an upper endoscopy, an esophageal manometry, or a 24-hour pH probe. The reason physicians may try over-the-counter or prescription medications before running tests is because some of the tests, such as the upper endoscopy and pH probe are invasive, and because of the costs of some of the tests.

After diagnosing GERD, a physician will recommend lifestyle changes such as the ones mentioned earlier in this article to help control the GERD, and depending on the severity will recommend over-the-counter medications or will prescribe a stronger medication by prescription. The medications may need to be continued indefinitely because over half of all people who stop taking their medications after getting their symptoms under control have a recurrence within a year.

If the medications do not alleviate the symptoms, surgery may be needed. Surgery is also an alternative to having to take medications indefinitely. A procedure called a "Nissen fundoplication is the type of surgery typically done to relieve GERD. In the surgery the upper part of the stomach located near the esophagus, called the "fundus, is wrapped around the lower esophagus. Doing this strengthens the barrier function of the lower esophagus, thus preventing gastreosophageal reflux and repairing the main irregularity that occurs in people suffering from GERD. The surgery is usually done laparoscopically. It is considered a safe surgery (but remember any surgery carries risks) that typically gives good results.

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