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
- 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