Symptoms

Common signs and symptoms of GERD include:

• A burning sensation in your chest (heartburn), usually after eating, which might be worse at night
• Chest pain
• Difficulty swallowing
• Regurgitation of food or sour liquid
• Sensation of a lump in your throat

If you have nighttime acid reflux, you might also experience:

• Chronic cough
• Laryngitis
• New or worsening asthma
• Disrupted sleep

Diagnosis

Endoscopy

Your doctor might be able to diagnose GERD based on a physical examination and history of your signs and symptoms.

To confirm a diagnosis of GERD, or to check for complications, your doctor might recommend:

• Upper endoscopy: Your doctor inserts a thin, flexible tube equipped with a light and camera (endoscope) down your throat, to examine the inside of your esophagus and stomach. Test results can often be normal when reflux is present, but an endoscopy may detect inflammation of the esophagus (esophagitis) or other complications. An endoscopy can also be used to collect a sample of tissue (biopsy) to be tested for complications such as Barrett’s esophagus.
• Ambulatory acid (pH) probe test: A monitor is placed in your esophagus to identify when, and for how long, stomach acid regurgitates there. The monitor connects to a small computer that you wear around your waist or with a strap over your shoulder. The monitor might be a thin, flexible tube (catheter) that’s threaded through your nose into your esophagus, or a clip that is placed in your esophagus during an endoscopy and that gets passed into your stool after about two days.
• Esophageal manometry: This test measures the rhythmic muscle contractions in your esophagus when you swallow. Esophageal manometry also measures the coordination and force exerted by the muscles of your esophagus.
• X-ray of your upper digestive system: X-rays are taken after you drink a chalky liquid that coats and fills the inside lining of your digestive tract. The coating allows your doctor to see a silhouette of your esophagus, stomach and upper intestine. You may also be asked to swallow a barium pill that can help diagnose a narrowing of the esophagus that may interfere with swallowing.

Causes

• Certain food and drink – such as coffee, alcohol, chocolate and fatty or spicy foods
• Being overweight
• Smoking
• Pregnancy
• Stress and anxiety
• Some medicines, such as anti-inflammatory painkillers (like ibuprofen)
• A hiatus hernia – when part of your stomach moves up into your chest

Prevention

Do

• eat smaller, more frequent meals
• raise 1 end of your bed 10 to 20cm by putting something under your bed or mattress – make it so your chest and head are above the level of your waist, so stomach acid does not travel up towards your throat
• try to lose weight if you are overweight
• try to find ways to relax

Do not

• • have food or drink that triggers your symptoms
  • eat within 3 or 4 hours before bed
  • wear clothes that are tight around your waist
  • smoke
  • drink too much alcohol
  • stop taking any prescribed medicine without speaking to a doctor first

• Antacids that neutralize stomach acid. Antacids, such as Mylanta, Rolaids and Tums, may provide quick relief. But antacids alone will not heal an inflamed oesophagus damaged by stomach acid. Overuse of some antacids can cause side effects, such as diarrhoea or sometimes kidney problems.
• Medications to reduce acid production. These medications — known as H-2-receptor blockers — include cimetidine (Tagamet HB), famotidine (Pepcid AC) and nizatidine (Axid AR). H-2-receptor blockers do not act as quickly as antacids, but they provide longer relief and may decrease acid production from the stomach for up to 12 hours. Stronger versions are available by prescription.
• Medications that block acid production and heal the esophagus. These medications — known as proton pump inhibitors — are stronger acid blockers than H-2-receptor blockers and allow time for damaged esophageal tissue to heal. Over-the-counter proton pump inhibitors include lansoprazole (Prevacid 24 HR) and omeprazole (Prilosec OTC, Zegerid OTC).

Surgery and other procedures

GERD can usually be controlled with medication. But if medications do not help or you wish to avoid long-term medication use, your doctor might recommend:

Fundoplication. The surgeon wraps the top of your stomach around the lower esophageal sphincter, to tighten the muscle and prevent reflux. Fundoplication is usually done with a minimally invasive (laparoscopic) procedure. The wrapping of the top part of the stomach can be partial or complete.

Heartburn is a common symptom of acid reflux. Most people experience it from time to time, and in general, occasional heartburn is not a cause for concern. But if you get heartburn more than twice a week, you might have GERD. GERD is a chronic type of acid reflux that can cause complications if left untreated.