Could your frequent heartburn be GERD? How to tell and what to do about it

GERD, which stands for gastroesophageal reflux disease, is a common disease that affects 10-20% of the population. GERD is a frequent cause for doctors’ visits and prescription medications, but often can go undiagnosed if you doesn’t seek adequate care. The good news is this—simple changes to diet and lifestyle can make a big difference in controlling the symptoms and carrying on with normal life.

Vani Konda, MD, medical director for Baylor Scott & White Center for Esophageal Diseases, answers common questions about GERD and what to do if you’re experiencing symptoms.

How do I know if I have GERD or just heartburn?

Gastroesophageal reflux disease (or GERD) is a condition that happens when gastric contents come up from the stomach into the esophagus. These contents can be a combination of acid, bile, food and fluid. A little bit of occasional reflux is to be expected, but it is a problem when symptoms are bothersome, not well controlled or lead to complications.

Typical symptoms are frequent heartburn, which is by far the most common complaint. For people with GERD, symptoms occur more than twice per week. Other symptoms of GERD include:

• Nausea
• Regurgitation (Feeling of food or liquid coming up the chest or into one’s mouth)
• Difficult or painful swallowing
• Pain in the mid-chest or upper abdomen
• Nausea
• Coughing
• Wheezing

What exactly causes GERD?

GERD is caused by the backflow of contents from the stomach back into the esophagus, the muscular tube of swallowing that connects your mouth to your stomach. Stomach acid moving back into the esophagus causes burning and symptoms. Learn more about the causes and symptoms.

What can I do to manage my GERD symptoms?

A combination of diet, lifestyle and medication may address symptoms of GERD for most people. We encourage people to think about ways to optimize reflux symptoms in the following areas: reducing acid, minimizing key trigger foods, decreasing volume, preparing for the night and making it hard for contents to go up.

Below are a few steps that many people find helpful in managing GERD symptoms:

• Identify and limit trigger foods. Sometimes, specific trigger foods bother some people. If a certain food bothers you, you may consider minimizing or avoiding that particular food. Common triggers include tomato-based foods, citrus-based foods, spicy foods, onions, garlic, chocolate, caffeine, alcohol, peppermints, dairy products and carbonated beverages.
• Decrease the overall amount of food. Pay special attention to heavy, greasy and fatty foods, which stay in the stomach longer.
• Eat small, frequent meals.
• Eat dinner earlier. For people who have nighttime symptoms, try eating an earlier and lighter dinner and avoiding eating 3-4 hours prior to bedtime. Sleeping with the head and shoulders elevated can also help.

What about medication or surgery for GERD?     

If symptoms do not improve with lifestyle modifications alone, medications (both over the counter or prescriptions) are very effective. Reducing acid may be done with acid suppression medications called proton pump inhibitors or acid reducers called H2 blockers. There are some over the counter antacids such as calcium carbonate which can provide temporary relief by neutralizing the acidic contents. The goal is to use the least amount of medication needed to control symptoms. Finally, alginate products  can help create a layer above the air-fluid level in the stomach, making it harder for fluid to splash up.

Some people who do not achieve complete resolution or control of all symptoms may explore surgical and minimally invasive therapies to improve the barrier between the stomach and esophagus. Talk to your doctor if you think surgery may be the best next step for you.

How can you tell if it’s something more serious than GERD?

Sometimes people think they have GERD, but they may have another disorder such as a motility disorder or an allergic condition called eosinophilic esophagitis that may mimic symptoms of GERD. In other situations, individuals may be experiencing complications of GERD which may include strictures (narrowings), ulcerations or esophageal cancer.

Symptoms of persistent pain, difficulty swallowing, signs of bleeding and weight loss with no improvement in symptoms with medications are warning signs that something more serious than GERD might be going on. If you’re experiencing these symptoms, consult your doctor to rule out any more serious conditions. If you have multiple risk factors for esophageal cancer including GERD, you may also be asked by your doctor to undergo a screening procedure to check for esophageal cancer or its precursor lesion, Barrett’s esophagus.

Is it possible to avoid GERD?

Strategies to avoid GERD include eating in moderation. This includes portion size as well as food choices—eating smaller meals and avoiding foods most implicated in heartburn.

These are common sense ways of minimizing GERD. Exercise and maintaining a healthy weight are good choices for an overall healthy lifestyle, regardless of whether you have GERD or not. If you have questions about what lifestyle changes to make for your health, talk to your doctor.

Concerned about your GERD symptoms? Consult an expert today.