Acid Reflux (GERD)

Spotting the signs of GERD

The most common sign of GERD is experiencing symptoms of heartburn, regurgitation, chest pain, throat pain, or trouble swallowing more than twice a week. Prolonged exposure to damaging stomach acid can also cause a sour taste in your mouth along with a constant cough, sore throat, or hoarse voice. Symptoms that are often called indigestion are all related to acid reflux.

Other health issues can seem similar to acid reflux, including stomach ulcers, heart disease, inflammation of the stomach lining, and cancer of the esophagus. Symptoms that may be a sign that you have a more serious health condition include difficulty swallowing, shortness of breath, feeling lightheaded or dizzy, black tarry stool, persistent or bloody vomiting, and unexplained weight loss. In particular, it is recommended that older people with reflux symptoms have heart disease ruled out first because GERD and heart disease can cause similar complaints. These are all serious diseases, so if you are experiencing these symptoms see your primary care doctor—even if you think it is GERD.

Main Symptoms of GERD

• Heartburn feels like a burning sensation in the middle of the chest or upper abdomen. It usually happens after eating or when lying down.
• Regurgitation of acidic material leading to an acidic or sour taste in the mouth

Other symptoms you may have with GERD

• Bad breath
• Chest pain. Usually, in the center of your chest.
• Nausea and vomiting
• Constant cough. It usually lasts more than four weeks.
• Sore throat
• Hoarse voice
• Trouble swallowing. It might feel like something is in your throat.
• Teeth erosion. Stomach acid that comes back up toward your throat and mouth can cause teeth to wear away, causing tooth pain or tooth decay.
• Trouble sleeping. Pain may interfere with sleep.
• Breathing issues. If you have a respiratory disease like asthma, acid reflux can cause flare-ups.

Understanding the causes of GERD

Acid reflux disease is usually caused by two things: your body making food stay in your stomach and your eating habits.

When you eat, food travels down your food pipe (the esophagus) into your stomach. Typically, a muscle between the esophagus and stomach—the lower esophageal sphincter (LES)—prevents food from coming back up through the esophagus.

When the LES is too relaxed or you're lying down, food can travel in the wrong direction (up, instead of down) into the esophagus, causing symptoms of acid reflux.

Certain foods and even drinks can trigger GERD. Spicy, high-fat foods, along with drinks like alcohol, carbonated drinks like soda, tea and coffee, should be limited. These can weaken the LES and also slow down digestion, causing the food to sit in the stomach longer than usual.

Lifestyle habits that can make acid reflux symptoms worse:

• Smoking cigarettes
• Eating spicy and fatty foods
• Eating large meals
• Eating right before lying down or going to sleep
• Drinking alcohol, soda, coffee, and tea
• NSAID (nonsteroidal anti-inflammatory drugs, such as ibuprofen)

GERD risk factors

Pressure on your stomach, from being pregnant or overweight, can also push food and acid back up into the esophagus.

Conditions that increase the risk of GERD:

• Being overweight
• Hiatal hernias (part of your stomach pushes up toward your chest)
• Connective tissue disorders (like scleroderma)
• Gastroparesis (your stomach has trouble emptying)
• Pregnancy

If you often have heartburn or symptoms are severe, talk to your primary care doctor. Other reasons to get in touch with your doctor:

• Losing weight
• Pain when you swallow or after you eat. Your doctor may want to rule out other diseases.
• Have a parent, sibling, or another close relative who had cancer of the esophagus, stomach, or intestines
• Symptoms that do not improve despite lifestyle modifications and OTC medications

Go to the ER or call 911 if:

• Having chest pain
• Food gets stuck in your throat
• Blood in stool or vomit

GERD treatment

For many people, changing some habits (especially related to eating) and taking over-the-counter (OTC) antacids, like Tums, relieve symptoms. But you still may need prescription medication to get GERD under control.

Here are some effective over-the-counter (OTC) remedies that can help soothe your symptoms:

• Antacids: These can neutralize stomach acid quickly and provide immediate relief. Options include Tums.
• H2 Blockers: Products like Pepcid can reduce stomach acid production.
• Proton Pump Inhibitors (PPIs): For longer-lasting relief, consider OTC options like Prilosec.

Statistics on GERD

GERD is a fairly common condition found in both children and adults. According to a 2018 study published in the Journal of Neurogastroenterology and Motility, 18% to 27% of people in North America live with GERD.

60% of GERD patients had less than 6 doctor visits: 22% had 1 doctor’s visit, 16% had 2 doctor’s visit, 11% had 3 doctor’s visits

Your doctor may ask about your symptoms and lifestyle; examine your abdomen, chest, and lungs;  run diagnostic and lab tests; and recommend OTC or prescription drugs. Your doctor may schedule a follow-up to monitor your symptoms. If your symptoms improve, they may try to taper you off your medication. Or, if your symptoms do not improve, you may need further testing like an endoscopy and more follow-up visits.

11% of patients with GERD were treated at the ER

While mild GERD usually does not require going to the ER, when you have pain in the chest area, feel like you’re choking, notice blood in your stool, or are forcefully vomiting, you should get immediate medical attention.

45% of GERD patients had an imaging procedure performed

Doctors may order imaging to check for anatomical abnormalities in the esophagus or stomach or to see if there is food in your lungs (due to aspiration). Of the patients that had imaging procedures performed, 58% needed only one imaging procedure.

Methodology

Study conducted using synthetically derived medical claims, pharmacy records, and lab tests. More information available at Humana's Data Exchange program.