Gastroesophageal Reflux Disease (GERD)

The underlying cause of GERD is an incompetent lower esophageal sphincter, allowing the backward flow of acid, bile, and other contents from the stomach into the esophagus. Although there are at least 19 million cases of GERD annually in the U.S., up to 40% of the population in the U.S. has some degree of esophageal reflux. The most obvious symptom is heartburn. Heartburn occurs after eating and can last from a few minutes to a few hours. Additional symptoms may include indigestion, atypical chest pain, vomiting, hoarseness, and cough.

Persons with GERD can have long-term complications. Several GERD symptoms warrant a consultation with a Gl specialist for upper endoscopy:

  • Unintentional weight loss, especially when associated with iron deficiency anemia.
  • Heartburn unresponsive to appropriate treatment or has been problematic for longer than seven years
  • Painful swallowing or vomiting blood require immediate evaluation

GERD can cause esophageal scarring or Barrett’s syndrome, a chronic irritation from acid-bile reflux that causes the normal esophageal lining cells to be replaced by dysplastic (precancerous) cells. Those whos GERD symptoms have lasted for at least five years have three times the risk of developing Barrett’s esophagus as those who have had symptoms for less than a year. When dysplastic cells are present in the esophagus, there is an increased risk for the development of cancer. A small number of BE patients, < 1 % annually, go on to develop esophageal cancer. Over the past 25 years, the incidence of esophageal cancer (adenocarcinoma type) has increased 350%. The increased rate is strongly related to GERD.

In some instances, where people have acid reflux and too much acidity, it really is a result of not having enough acid in the stomach and partially digested food refluxing upĀ into the esophagus, resulting in heartburn.


  • Maintain a reasonable weight. If you are overweight, weight loss can reduci GERD symptoms
  • Nutrition
    • High fiber diet
    • Instead of eating three large meals each day, eat smaller meals mon frequently
    • Foods that promote relaxation of the lower esophagael sphincter includ alcohol, carbonated beverages, citrus juices, caffeinated drinks, chocolate peppermint, tomato-based products and spicy foods
    • Avoid
      • Tomato-based foods
      • Spicy foods, garlic, and onions
      • Pizza
      • Peppermint and mint-flavored items
      • Citrus fruits and juices
      • Fried foods
      • Fatty and oily foods
      • Fried foods
      • Chocolate
      • Coffee, carbonated drinks and tea
      • Alcohol
  • Lifestyle
    • Do not smoke because nicotine relaxes the esophageal sphincter.
    • Furthermore, smokers produce less saliva than nonsmokers. Saliva can neutralize and wash away lingering stomach acid
    • Do not lie down after meals
    • Do not eat for at least 3 hours before bedtime. When going to bed, elevate the head of the bed about 6 inches to facilitate keeping gastric contents in the stomach. Also, sleep on the left side, which causes less pressure on the esophageal sphincter, helping keep gastric contents from backing up.
    • Get plenty of rest
    • Avoid wearing tight clothing around the waist
    • Do not take excessive amounts of aspirin, ibuprofen, and other NSAIDs.
    • Chew gum after meals to stimulate production of saliva and increase swallowing rate to neutralize acid in the esophagus
  • Exercise
    • Get plenty of exercise. However, exercise that increases abdominal pressure, such as bending over, lifting heavy objects, and running may aggravate heartburn, whereas stationary bike riding may be a good