Managing GERD

What is GERD (Acid Reflux)?

Gastroesophogeal reflux disease (GERD), more commonly known as acid reflux is a condition in which stomach contents splash up from the stomach to the esophagus. Acid reflux is sometimes painful and can cause inflammation and ulcerations to the esophageal lining.

Acid reflux contains pepsin, which is an enzyme that starts the process of digestion of proteins in the stomach. Another acid that is sometimes present in reflux is bile, which is backed up into the stomach from the duodenum, the first part of the small intestine. Pepsin and bile can be most injurious to the esophagus.

GERD is usually a life-long problem. Medications are given to stop the excess production of gastric acids, which will allow the esophagus to heal. These medicines are usually prescribed for a lifetime because when the drug is discontinued, injury to the esophagus will happen again in a matter of a few months. In people without GERD, acid reflux is quite normal and no injury or inflammation to the esophagus occurs. However in a patient with GERD, there is much more acid in the stomach contents and the bicarbonate, which is a natural buffer, is unable to neutralize it.

What causes GERD?

The causes of GERD are complex. Some people produce an abnormally large amount of stomach acid, and others have problems with the upper and lower esophageal sphincters. When the esophageal sphincters malfunction, there is a backflow of gastric juices, which are regurgitated up into the esophagus.

If you have a hiatal hernia, you may experience pain and heartburn due to the trapped gastric juices in the hernia itself, which is a portion of the stomach that is squeezed through the opening in the diaphragm. When the sphincter releases, acid reflux will occur. If your stomach empties too slowly, it is more likely that your stomach will be distended and reflux is likely to occur.

Symptoms