Gastroesophageal Reflux Disease (GERD) – Symptoms, Causes, Diagnosis and Treatment

A Comprehensive Look At Gastroesophageal Reflux

In normal circumstances, the esophagus acts a one way street where food moves from the mouth and into the stomach. However, in dire circumstances, the acids in stomach might overwhelm the muscles surrounding the esophagus and push upwards to the back of the mouth.


This is termed as gastroesophageal reflux or acid reflux and tends to happen sometimes. If it happens too often, then the problem turns into a physiological aberration called gastroesophageal reflux disease (GERD).

GERD – What Is It?

Reflux is generally a term used to define an abnormal, backward movement of body fluid. In that respect, gastroesophageal reflux refers to the unwanted and often distasteful backing up of stomach acids through the food pipe. At the base of the problem lies a muscle called the ‘lower esophageal sphincter (LES)’ which divides the esophagus from the stomach. This is like a valve that keeps the food from moving back into the esophagus.


However, unlike the muscles of the stomach which protect the organ against strong digestive acids, the LES isn’t so well equipped to handle these acids. Therefore, when it is overwhelmed by a large volume of stomach acids, the muscle gives way to the acids to move upwards, thus causing GERD.


What Causes GERD?


It is important to understand that while acid reflux and GERD are used interchangeably, they are not one and the same thing. GERD actually refers to a disease state with acid reflux only being a part of it. GERD can be caused due to a number of reasons including drug interaction and reaction to food. Nevertheless, the major factors are described below:


Malfunctioning LES Muscles – Lack of coordination between smooth muscles and hormones can lead to lowering of efficiency in LES muscles, which in turn will not be able to close off the esophagus opening completely after food has been emptied into the stomach.


Messed Up Stomach Function – Abnormal muscle and nerve functions in the stomach can stop it from contracting normally, thereby increasing the chances of acids being pushed up the esophagus.


Hiatal Hernia – The hiatus is a small opening in the diaphragm (a muscular partition separating the upper organs like the lungs from the stomach) for the esophagus to pass through and connect with the stomach. During a condition called hiatal hernia, the LES muscles can get affected and therefore induce GERD.


Genetic Abnormality – Approximately 30-40% of all GERD cases are hereditary in nature, normally passed on through faulty genes. Such people will be much more susceptible to Barrett’s Esophagus, a precancerous condition producing severe bouts of GERD.


Symptoms Of GERD


The primary symptom of GERD is heartburn where you feel a burning sensation spreading from the stomach regions all the way till your chest and neck. Apart from this, you are also likely to face dyspepsia (feeling of pain, discomfort and nausea right after eating) and regurgitation (vomiting sensation caused due to the acid touching the throat).


Less common GERD symptoms include chest sensations similar to that experienced during heart attacks, coughing, severe nausea, and respiratory as well as throat symptoms.


Diagnosis Of GERD


Besides looking at your medical history, the doctor will also rely on a physical examination of the throat and larynx region to diagnose GERD possibility. Lab tests can include X-rays and biopsies carried out through endoscopy. However, when GERD diagnosis is concerned, esophageal acid testing is taken to be the gold standard.


Treatment Of GERD


GERD alleviation is mainly achieved through life style and diet changes. When that does not work then drug treatment can be employed. However, in the most severe of cases, surgery may become necessary. Drug treatment can be achieved through over the counter medications and then stepped up to more powerful drugs like proton pump inhibitors.
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  1. Cady Haren March 7, 2013 2:01 pm Reply

    Thanks for the comprehensive post. Just had a question though, my doctor has prescribed this medication Nexium for acid reflux but I just wanted second opinion on the same.

    Is it a good medication to treat acid reflux? Would love to hear your answers on the same.

  2. admin March 7, 2013 3:10 pm Reply

    Hi, Cady

    thank you for your comment, Nexium is PPI type drug specially created for relieving acid reflux and is often used for this purpose. It works good in most cases if taken with caution and under the monitoring of your doctor. It can have some side effects sometimes such as: diarrhea, gas, headache, nausea, constipation, dry mouth and stomach pain and this can be a sign for an allergic reaction, so it's recommended to keep close communication with your doctor when taking this drug.

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