ACID REFLUX (GASTROESOPHAGEAL REFLUX DISEASE(GERD) Symptoms, Causes & Treatments OVERVIEW Gastroesophageal reflux disease (GERD) occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus. Many people experience acid reflux from time to time. GERD is mild acid reflux that occurs at least twice a week, or moderate to severe acid reflux that occurs at least once a week. Most people can manage the discomfort of GERD with lifestyle changes and over-the-counter medications. But some people with GERD may need stronger medications or surgery to ease symptoms. SYMPTOMS Common signs and symptoms of GERD include: A burning sensation in your chest (heartburn), usually after eating, which might be worse at night • Chest pain • Difficulty swallowing • Regurgitation of food or sour liquid • Sensation of a lump in your throat If you have nighttime acid reflux, you might also experience: • Chronic cough • Laryngitis • New or worsening asthma • Disrupted sleep CAUSES GERD is caused by frequent acid reflux. When you swallow, a circular band of muscle around the bottom of your esophagus (lower esophageal sphincter) relaxes to allow food and liquid to flow into your stomach. Then the sphincter closes again. If the sphincter relaxes abnormally or weakens, stomach acid can flow back up into your esophagus. This constant backwash of acid irritates the lining of your esophagus, often causing it to become inflamed. TREATMENTS Your doctor is likely to recommend that you first try lifestyle modifications and over-the-counter medications. If you don't experience relief within a few weeks, your doctor might recommend prescription medication or surgery. Over-the-counter medications The options include: • Antacids that neutralize stomach acid. • Medications to reduce acid production. • Medications that block acid production and heal the esophagus. Prescription medications Prescription-strength treatments for GERD include: • Prescription-strength H-2-receptor blockers • Prescription-strength proton pump inhibitors. • Medication to strengthen the lower esophageal sphincter. Surgery and other procedures GERD can usually be controlled with medication. But if medications don't help or you wish to avoid long-term medication use, your doctor might recommend: Fundoplication. The surgeon wraps the top of your stomach around the lower esophageal sphincter, to tighten the muscle and prevent reflux. Fundoplication is usually done with a minimally invasive (laparoscopic) procedure. The wrapping of the top part of the stomach can be partial or complete. LINX device. A ring of tiny magnetic beads is wrapped around the junction of the stomach and esophagus. The magnetic attraction between the beads is strong enough to keep the junction closed to refluxing acid, but weak enough to allow food to pass through. The Linx device can be implanted using minimally invasive surgery.