GERD (Gastroesophageal Reflux Disease)

The most common symptom of GERD is a chest burning sensation, frequently called "heartburn". There may also be a sour taste in the mouth and even some difficulty swallowing. Other less common symptoms include nausea, cough, and shortness of breath.

There are several methods to diagnose GERD. When there is a strong suspicion for GERD based on symptoms present, the diagnosis can be made without further tests. At this point, therapy can be started with observation.

In cases where the symptoms are not typical for GERD, there are different diagnostic tests that can be performed.

EGD - An EGD (esophagogastroduodenoscopy) is a test where a camera is inserted into the mouth and through the esophagus and stomach to visualize those anamotic regions. This test is not ideal for GERD, but it can detect changes associated with the disease. It can also see if there is inflammation of the esophagus and stomach linings that may point to other diagnoses.

Barium swallow - The barium swallow study involves swallowing barium, a radioactive dye, accompanied by an x-ray. This test permits the visualization of the barium as it passes from the esophagus into the stomach. It can see for narrowings (strictures) along the pathway.

Manometry - Manometry is a test of the pressures caused by the muscle contractions along the esophagus. It can also test the pressure of the sphincter that separates the esophagus and stomach. If the pressure is low, this suggests a diagnosis of GERD. A low sphincter pressure is ineffective at blocking the reflux of stomach contents into the esophagus.

pH probe - The 24-hour pH test measures the amount of acidity (pH) along the lower esophagus. This test can identify the pH at the times when symptoms occur. If the pH is abnormally low during these times, then GERD is likely present. This test can also reveal the pattern of acid reflux throughout the day.

There are many available options to treat GERD. Lifestyle changes is an important step in this process. You should avoid certain foods that increase your stomach acidity or aggravate the symptoms. Remaining upright during and after meals can be helpful. Sometimes, people can decrease symptoms by elevating their head while sleeping. You should also avoid smoking and lose weight (if overweight or obese).

The initial step in medical therapy usually involves a trial on medications for several weeks. These can include antacids, drugs that decrease acid production, or drugs that promote the forward flow of digestion. Oftentimes, the individual may have to be on one or more of these medications in the long term.

In severe cases where medications do not help, there are surgical options. A common operation is the Nissen fundoplication, where the stomach is wrapped around the esophagus to "tighten" the opening between the esophagus and stomach.

The information contained herein is for informational purposes only. It should not replace the expert opinion of your physician or other health care provider. Inclusion of any products in the ads do not represent an endorsement by me, On The Wards (medical blog), or my affiliates. I have not tested or used them and cannot vouch for their accuracy or utility.