GERD - what a funny-sounding word that rhymes with nerd! But
GERD isn't exactly funny. Its letters stand for
gastroesophageal
(say: gas-troh-ih-sa-fuh-
jee
-ul)
reflux
(say:
ree
-fluks)
disease
. You can't catch GERD from someone else, but it's a fairly
common disease. In fact, millions of kids and adults have this
problem. Chances are that you know someone who has GERD.
What Is GERD?
Let's talk about eating for a moment. Chewed-up food slides
down the
esophagus
(say: ih-
sah
-fuh-gus), or swallowing tube, and into the
stomach
. There, acidic
digestive
juices begin to break down the food. A special type of muscle
called a
sphincter
(say:
sfink
-ter) connects the esophagus and the stomach. The sphincter works
like a gate. It opens up so food can get into the stomach, and then
it closes again. This keeps the food and acidic stomach juices from
flowing back into the esophagus.
However, if the sphincter opens at the wrong time, there's a
problem. Whatever's in the stomach goes the wrong way, which is
back up into the esophagus. This is called reflux.
Putting it all together, then, gastroesophageal refers to the
stomach ("gastro" means stomach) and esophagus. Reflux
means to flow back or return. So gastroesophageal reflux is when
the stomach's contents flow back up into the esophagus.
Just about everyone has gastroesophageal reflux once in a while.
Many people don't even feel it happening. Other people might
feel something commonly known as heartburn. Heartburn describes an
uncomfortable burning feeling behind the breastbone. Heartburn has
nothing to do with the heart, but everything to do with your
stomach and esophagus. When stuff from the stomach goes back up
into the esophagus, the esophagus can become irritated because
what's in the stomach is high in acid. That's what causes
the burning feeling.
Heartburn commonly happens after a meal. Eating too much at
Thanksgiving, having extra-spicy salsa, or wolfing down some
pepperoni pizza right before bed can cause heartburn in a lot of
people.
Many people, even newborn babies, have this problem so often or
so severely that it becomes a disease. It's no longer just
reflux. Now it's GERD.
How Do I Know If I Have GERD?
If you have GERD, you have a lot of company because it's
estimated that millions of people in the USA have it. Most are
adults, but kids and even babies can have the disease, too.
Here are some signs and symptoms of GERD:
-
Heartburn
(sometimes called acid indigestion). This is the most common
symptom. The burning feeling can travel from the person's
chest up to the neck and throat. This usually leaves a sour or
bitter taste in the mouth.
-
Wheezing and coughing.
This can happen when acid travels backward up into the throat and
then spills over into the windpipe and down into the
lungs
. A person's chest can hurt, too, and it can be hard or
painful to swallow.
-
Burping or belching
.
This sometimes helps people relieve the buildup of acid, or gas,
in the stomach and can be a symptom of GERD.
These uncomfortable feelings can last as long as 2 hours. Lying
down after eating, wearing tight clothes around the waist, or even
just bending over can make these symptoms worse. So can some
medicines
.
Certain foods can make GERD worse. Here are foods that affect
some but not all people:
- spicy food
- greasy, fried, and fatty foods
- chocolate
- peppermint
- carbonated and caffeinated drinks, such as cola or
coffee
- ketchup and other tomato products
- mustard and vinegar
- citrus fruits and juices
What Will the Doctor Do?
It's possible that a doctor can tell you have GERD just from
hearing about your symptoms. But your doctor may also want you to
have a test to get a better idea of what's going on.
The most common test is called a
barium
(say:
bair
-ee-um)
swallow
or an
upper gastrointestinal X-ray series
. First, you drink a thick liquid containing a substance called
barium. (It can be chalky, but sometimes it's flavored.) Then
the doctor uses a special
X-ray
to track how the barium has gone down the esophagus and into the
stomach. The barium is visible on the X-ray to give a clear picture
of any reflux.
Another test is called a
pH-probe study
. In this study, a thin, flexible tube is inserted into the
esophagus through the mouth or nose. The tube is connected to a
machine that records the pH (or acid level) at the lower end of the
esophagus. If acid refluxes from your stomach into the esophagus,
the machine picks up an increase in acidity. The thin tube is kept
in place for several hours (usually overnight or sometimes for 24
hours). You're probably wondering how this feels. It
doesn't hurt to insert the probe, but it may be a little
uncomfortable. The doctors, nurses, and a parent will be there to
help you feel at ease during this test.
A
milk scan
lets your doctor see if stuff in your stomach refluxes into your
lungs. This test uses a special scan to follow the path of a liquid
after you've swallowed it.
Upper endoscopy
is the name of another test. The doctor also uses a thin, flexible
tube for this test, but now the tube has a light and a tiny video
camera on the end of it. This lets the doctor actually see and take
pictures of the esophagus and stomach. A person getting this test
would receive
anesthesia
, a special medicine that keeps the person from feeling pain or
discomfort.
How Is GERD Treated?
Your doctor can tell you and your parent about diet changes and
medicines to help with GERD. Medicines called antacids can be
helpful for some people who have GERD. These work by lowering the
amount of acid in your stomach. They should only be used for a
short time because they can cause side effects and they may not
control the problem for very long.
For long-term problems, a doctor may give you a prescription for
other medicine. Some medicines work to lower stomach acid. Other
medicines can help make the sphincter muscle stronger and help the
stomach empty more quickly. If nothing else works, a person may
need
surgery
to treat GERD, but this isn't done very often.
How Can I Prevent GERD Symptoms?
If you have GERD, there are ways to help prevent or reduce your
symptoms. Some tips to try:
- Avoid foods that seem to cause problems for you.
- Eat smaller, more frequent meals throughout the day.
- Don't eat right before you go to bed. Wait 2 to 3 hours
between eating and lying down or sleeping.
- Try sleeping on a special wedge-shaped pillow. Or your mom or
dad might be able to elevate the head of your bed on 6-inch
blocks.
- Don't wear tight clothing - like snug jeans or a tight
belt - around your middle.
- Follow your doctor's advice about your weight. In some
cases, losing weight can help GERD. But never start a diet
without consulting with your doctor.
- Keep a diary of GERD symptoms. Record your symptoms and see
if there's a pattern. Do the symptoms happen after eating
certain foods or doing certain activities? If so, you'll know
which foods or activities are OK and which ones to avoid. Soon,
you can be on your way to being GERD-free!
Reviewed by:
Mitchell B. Cohen, MD
Date reviewed: April 2008
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
© 1995-2009 The Nemours Foundation/KidsHealth. All rights reserved.