Overview

.” Or, you may notice a bad taste in your mouth, sore throat, voice changes, cough, wheezing, or swallowing problems. However up to 10% of patients feel no symptoms at all, they have “silent reflux”.

What Causes GERD?

Acid can move into the swallowing tube if the muscle at the top of the stomach opens or relaxes. Many foods and medicines can cause the muscle to relax. Acid can also move into the swallowing tube if there is increased pressure in the belly or if the stomach has slid up into the chest over time (a hiatal hernia). This is caused by:

Overweight
Pregnancy
Heavy lifting
Bending over with full stomach
Lying down after eating
Wearing clothes too tight around the belly

How is GERD Diagnosed?

Often GERD is diagnosed by your symptoms. Your doctor may give you a trial of medicine to see if your symptoms go away. At other times, the only way and most accurate way to diagnose GERD is with a pH probe test. The pH probe is a tiny wire that is threaded into the nose to the lower swallowing tube. It measures the acid in the swallowing tube. After 24 hours it is taken out, and the readings are checked. If acid levels are high (GERD), then medicine is started. A more recent development is the use of a wireless pH probe for acid testing that eliminates the discomfort of a wire placed through the nose for 24 hours.

How is GERD Treated?

Change your “lifestyle”:

Lose weight if you are overweight.
Do not lie down for 3 hours after you eat.
Do not eat large meals.
Put 6 inch blocks under the legs at the head of your bed.
Do not wear tight clothes around your belly.
Bend at your knees instead of bending over at the waist.
Do not smoke.

Do not eat foods or drink liquids that relax the stomach muscle or stimulate acid:

Caffeine
Peppermint
Spearmint
Alcohol
Citrus foods
Spicy or fried foods
Onions
Tomatoes
Pop
Chocolate
Juices

Take medicine

If you have GERD less that 3 times a week, over-the-counter antacids work well. Antacids come in pill or liquid form. The medicine lowers acid in your stomach for a short time. Follow the directions on the bottle. Take antacids 1 hour before or 2 hours after your other medicines. Tell your provider if you are using these medicines and how often.

If you have GERD more that 3 times a week or have other problems caused by GERD, you may need a prescription medicine. There are 2 types of prescription medicine used.

H2 blockers: Tagamet® (cimetidine); Zantac® (ranitidine); Axid® (nizatidine); or Pepcid® (famotidine). H2 blockers cut down the amount of acid made in the stomach.
Proton pump inhibitors (PPI): AcipHex® (rabeprazole); Nexium® (esomepraole); Prevacid® (lansoprazole); Prilosec® (omeprazole); Protonix® (Pantoprazole). PPI medicine blocks acid from being made in the stomach. PPI is the strongest of all the acid medicines.

Your provider will put you on the medicine that is best for your symptoms. Take this medicine as directed. After a few months, your doctor may try to cut back on the amount of acid medicine you take to see if the problem is getting better. The goal is for you to take the least amount of medicine to treat your symptoms. Continue lifestyle changes while you are on the medicine. If you do not get better, your provider may send you to a stomach specialist (gastroenterologist).