What You Should Know About GERD

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    Millions of Americans suffer from gastroesophageal reflux disease (GERD), commonly known as chronic acid reflux. While mild cases can be managed with lifestyle changes and over-the-counter medications, if left untreated, recurring GERD symptoms can cause damage to your esophagus and result in more serious digestive disorders like esophageal cancer. In cases where a diagnosis of GERD is uncertain, advanced diagnostic and therapeutic treatment at a comprehensive gastrointestinal motility center is recommended. Dr. Gina Sam, an expert in GERD, discusses what you need to know about symptoms and treatment.

    What causes GERD?

    As you swallow, a circular band of muscle around the bottom part of your esophagus, the lower esophageal sphincter (LES), relaxes, allowing food and liquid to flow into your stomach. It closes again to prevent food juices from returning (refluxing) into the esophagus. GERD occurs when these LES muscles fail to operate properly and the acid in your stomach backs up, irritating the lining of your esophagus.

    What are the signs and symptoms?

    Heartburn, regurgitation of acidic fluid (acid reflux), a sour taste in your mouth, and difficulty swallowing are the most common GERD symptoms. If you experience heartburn two or more days a week on a regular basis, you should be examined by a gastroenterologist.

    Who is at risk?

    There is no hereditary risk for GERD. It's largely due to age and lifestyle factors. High-risk groups include women who are pregnant, individuals with chronic diseases such as asthma and diabetes, those who smoke, and people who are overweight. People who often eat very large meals and consume a lot of caffeine and/or alcohol are also prone to GERD.

    How is GERD detected?

    Unexplained GERD-like symptoms on a chronic basis despite standard treatment is called refractory GERD. Methods of evaluating and conclusively diagnosing this condition include barium swallow radiograph (barium x-ray), endoscopic examination, and a 24-hour pH monitor exam that measures the flow of stomach acid into the lower esophagus and amount of acidity present during a 24-hour period. Another advanced diagnostic tool is esophageal manometry, which measures the muscle pressures in your esophagus when you are resting and swallowing.

    How is GERD treated?

    Over-the-counter antacids are often used to treat mild symptoms. If symptoms persist, a type of drug called a proton-pump inhibitor can be prescribed to decrease acid production. Esophageal strictures can be dilated using a balloon through an endoscope. In certain cases, people with loose lower esophageal sphincters may be candidates for a surgical treatment involving tightening of the sphincter. A new minimally invasive procedure to implant a magnetic band called LINX may be used to control the sphincter. Lifestyle changes such as avoiding trigger foods and beverages, giving up smoking, losing weight if needed, eating small, frequent meals, and wearing loose-fitting clothes are also key to treating GERD.

    Can GERD cause cancer?

    One complication from prolonged reflux is Barrett's esophagus, which is a precancerous lesion that can develop into esophageal adenocarcinoma after many years of reflux. We advise patients with GERD to have an endoscopy to check for Barrett's esophagus. Stony Brook is one of the few centers in Suffolk County providing treatment with radiofrequency ablation to ablate, or burn away, the Barrett's tissue.

    What distinguishes Stony Brook's approach?

    Our team of leading GERD experts uses advanced testing techniques and therapies with a multidisciplinary approach. Stony Brook offers state-of-the-art testing, such as 24-hour pH impedance testing to diagnose refractory GERD and BRAVO 48-hour pH testing. Our experts work with patients and their physicians to determine and provide the most effective, individualized course of treatment.

    For more information or to make an appointment at Stony Brook's Gastrointestinal Motility Center, call (631) 444-5220.

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    All health and health-related information contained in this article is intended to be general and/or educational in nature and should not be used as a substitute for a visit with a healthcare professional for help, diagnosis, guidance, and treatment. The information is intended to offer only general information for individuals to discuss with their healthcare provider. It is not intended to constitute a medical diagnosis or treatment or endorsement of any particular test, treatment, procedure, service, etc. Reliance on information provided is at the user's risk. Your healthcare provider should be consulted regarding matters concerning the medical condition, treatment, and needs of you and your family.

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